Quinine Sulphate 250mg Mekophar Treatment of malaria (180 tablets)

Dosage form Box of 180 capsules
Specifications Quinin sulfate

Ingredient

Composition informationContent
Quinin sulfate250mg

Uses

Indications

Quinininin Sulfate 250 mg is indicated in the following cases:

  • The uncomplicated malaria treatment due to P. Falciparum. Plasmodium Falciparum, P. Vivax, P. Ovale, P. Malariae, has little effect on the body and red blood cells. The drug has the effect of killing gametes of P. Vivax, P. Malariae, without the effect of killing gametes of P. Falciparum. Hence do not use quinin to prevent disease.

    poisoned quinine, less effects than chloroquin in the room and treat malaria but have a special value to treat severe malaria and malignant malaria caused by P. Falciparum resistant chloroquin or caused by multi -resistant strains.

    Quinin can also be specially resistant to P. Falciparum, in treatment must be used in combination with a schizophrenic killer in blood that works as slower as sulfadoxin or tetracyclin.

    The mechanism of action of quinin on malaria parasites is to prevent nucleic acid synthesis or reduce the function of the target. Quinine reduces oxygen absorption and metabolism of carbohydrates, interfering into the DNA string, interrupting the replication process and transcription of the parasite.

    pharmacokinetics

    When drinking Quinin salt, in healthy adults, 76 - 88% of the drug is absorbed and reaches the maximum concentration in the blood after 1-3 hours. The absorption of drugs is less affected by food but is slow by aluminum anti -acid drugs and/or magnesi.

    In malaria, higher absorption of drugs than healthy people, may be due to malaria impaired liver function, leading to reduced body clearance of the body and reduce the distribution of the drug. The clearance coefficient decreases more than the distribution volume, so the sale time increases about 11 - 18 hours.

    Quinin is easy to diffuse into fetal tissues, metabolism in the liver.

    quinin sulfate is converted into 4 main substances, in which, 3-hygroxyquinin is the main metabolic substance with inferior activity than Quinin Sulfate.

    Quinin is excreted mainly through the kidney with a ratio of

    • Before taking Quinine Sulphate 250mg Mekophar Treatment of malaria (180 tablets)

    How to use

    Quinin Sulfate 250 mg oral.

    Should take Quinin Sulfate 250 mg during meals to reduce the digestive tract irritation. In case of vomiting, should use injection.

    Dosage

    Dosage:

    Quinin sulfate 250 mg by weight: 30 mg quinin sulfate/kg/24 hours, divided 3 times/day, for 7 days.

    Dosage Quinin sulfate 250mg in age group without weight:

    age group

    Number of tablets/day x Date number

    Notes

    1 tablet/day x 7 days

    Divide 3 times a day

    1 - Under 5 years old

    1 quarter/day x 7 days

    5 - Under 12 years old

    3 tablets/day x 7 days

    5 tablets/day x 7 days

    6 tablets/day x 7 days

    Falciparum, must not use a simple malaria drug, must be coordinated to limit drug resistance and increase the effectiveness of healing, quinine is often coordinated with clindamycin, tetracycline or Doxycycline.

    Combining Quinin Sulfate with DoxycyCline (each tablet contains 100 mg of DoxycyClin): only used to combine Quinin Sulfate with DoxycyCline in adults and children over 8 years old. Take Quinin with the above dose, combined with Doxycyclin:

  • Doxycycline dose of 100 mg tablets calculated by weight: 3 mg doxycyclin/kg/day, oral 1 time/day, used for 7 days.
  • Doxycycline dose of 100 mg tablets calculated by age group if no weight:

    • Age group

    Number of tablets/day x Date number

    8 - Under 12 years old

    1 quarter/day x 7 days

    4 tablets/day x 7 days

    1 tablet/day x 7 days

    Take Quinin with the above dose, combined with clindamycin:

  • Clindamycin dose of 150 mg tablets and 300 mg tablets calculated by weight: 15 mg Clindamycin/kg/day, divided 2 times/day, used for 7 days.
  • Clindamycin dose of 150 mg tablets and 300 mg tablets in age group if no weight:

    • Number of tablets/day x Date number

    age group

    tablets 300 mg Clindamycin

    under 3 years old

    1 tablet/day x 7 days

    ½ capsules/day x 7 days

    1 quarter/day x 7 days

    ¾/day x 7 days

    2 tablets/day x 7 days

    1 tablet/day x 7 days

    3 tablets/day x 7 days

    1 quarter/day x 7 days

    4 tablets/day x 7 days

    2 tablets/day x 7 days

    along the tablet for the dose ¾. hydrochloride).

    Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

    What to do when overdose? Overdose symptoms may appear after 1 hour or longer medication. The lesions left in the eye are the most severe manifestations, the common symptoms in the eye are reduced the concentric market or the dark spot. The QRS complex may be expanded, arrhythmia, sometimes T waves are sound, curly ventricular arrhythmia. Hematuria has been encountered in acute heart failure. In some cases, after 24 hours of severe arrhythmia. Black urine fever is often due to chronic poisoning caused by Quinine, severe hemolysis, hemoglobin, hemoglobin, otherwise cure can cause kidney failure and death.

    Handling

    Mainly treat symptoms and support, pay attention to maintaining blood pressure, respiration, kidney function and cure arrhythmia. Measures include:

  • Limit absorption: Take activated carbon, dose 25 - 50 g (within 2 hours after taking the medication), gastrointestinal - intestines.
  • Increased excretion: Take activated carbon in the form of granular, start drinking 50 g and then drink 25 g every 4 hours, repeat many times. Acid urinary tract, hemorrhage, blood transfusions, plasma changes are not effective in increasing quinine elimination.
  • Preventing or restoring retinal damage by taking vasodilators and closing lymph nodes.
  • Cases of severe heart poisoning: Using muscle contraction drugs such as isoprenalin, dopamine or prenalterol.
  • Treatment of convulsions: Use Diazepam 5 - 10 mg, children use 0.1 - 0.2 mg/kg body weight.
  • Treatment of arrhythmia, level and heart condition.

    • What to do when forgetting a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

    Side Effects

    When using Quinin Sulfate 250 mg, you may experience unwanted effects (ADR).

    Unwanted effect is due to high doses or may be due to hypersensitivity reactions and patients's allergies.

    Uncommon, 1/1000

  • The whole body: Hypersensitivity (Canhkina syndrome) manifests itself by tinnitus symptoms, temporary hearing loss, headache, nausea, blurred vision or color disorders.
  • Central nervous system: stimulating, delirium, anxiety.
  • Digestive: Vomiting, abdominal pain, diarrhea, anorexia.
  • Respiratory: Difficulty breathing, asthma, angina.
  • musculoskeletal: muscle weakness, muscle pain.
  • Cardiovascular: atrial block - ventricle, bradycardia, chest drumming, prolonged qt, lower blood pressure, fainting.
  • Body: Fever.
  • blood: Anemia, thrombocytopenia, granulocytosis, anemia, decreased prothrombin, hemolytic, hemorrhage, hyperemia syndrome and hemolysis, blood coagulation disorders, decreased peripheral blood.
  • Skin: Outside, urticaria, Stevens - Johnson syndrome, poisoned epidermal necrosis.
  • kidney: Nephrotic failure, interstitial nephritis, urinary hemoglobin.
  • Hepatitis: Hepatitis, granular hepatitis, jaundice.

    • Notify the doctor with unwanted effects when using the drug.

    Instructions on how to handle ADR

    When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

    Warnings

    Before using the drug you need to read the instructions carefully and refer to the information below.

    Contraindicated

    Quinininin Sulfate 250 mg contraindicated in the following cases:

  • There is a history of sensitivity to Quinin, Quinidin or Mefloquin or any ingredient of the drug.
  • allergies to drinks containing quinin as spices.
  • deficiency G6PD.

    • Precautions when using

    with the following patients need to monitor and reduce the dose:

  • There is a hypersensitivity to Quinin, Quinidin or Mefloquin, especially when there are symptoms in the skin, angioedema, visual or hearing symptoms.
  • Patients with atrial - ventricle, arrhythmia, severe heart disease, deficiency G6PD because it can cause blood soluble, black urine fever, hypoglycemia, kidney failure.

    • Stop the drug immediately if you see symptoms of hemolytic symptoms.

    Be cautious for patients with rare genetic disorders in galactose tolerance, lactase deficiency or glucose-galactose absorption disorders.

    The ability to drive and operate machinery

    Precautions when used for train drivers and operating machines because the drug can cause blurred vision or color change when looking or tinnitus.

    Pregnancy

    During pregnancy only use this medication when suffering from severe, malignant malaria that no other drug is suitable to save the patient's life.

    When using treatment dose: Quinin does not cause disability at birth, but increases insulin and can cause severe hypoglycemia in pregnant people. Quinin can cause thrombocytopenia in mothers and newborn babies, which can cause hemolysis due to G6PD in newborn children.

    Breastfeeding period

    Quinin excreted small amounts through milk. Take the dose of 300 mg and 640 mg, the maximum concentration in milk is 2.2 micrograms/ml, average 1 microgram/ml after 3 hours. There is no bad effect on breastfeeding, so Quinin can be used with nursing mothers. Only use drugs when really necessary and outstanding benefits.

    Medicine interaction

    antacids containing aluminum and/or magnesi can slow down the absorption of digestive quinins, so it is necessary to take two drugs apart.

    Due to the following interactions may need to adjust the dose in treatment:

  • cimetidine reduces the retention of the kidneys and increases the half -life of quinin, so it increases the concentration of quinine in plasma. Ranitidine has little effect.
  • rifampicin may increase the rate of quinine excretion by 6 times, reducing plasma quinine concentrations.
  • Urine acid -causing drugs can increase the excretion of quinine into the urine.
  • quinin slowly absorbs and increases the concentration of plasma digoxin and related cardiac glycosides. Quinin increases the concentration of warfarin in plasma and related anticoagulants.
  • quinine increases the effects of nerve - muscle maple medications and antagonists with acetylcholinininthinininthinines inhibitors, caused by quinine on nerve -muscle connection points.
  • Increased risk of ventricular arrhythmia if quinin is used with halofantrin or anti -arrhyths such as amiodaron, antihistamine drugs Astemizol, Terfenadin, Cisaprid and PimozID psychotic drugs.
  • may increase the risk of convulsions or severe ventricular arrhythmia when using quinin with mefloquin.
  • Avoid simultaneous use of macrolid antibiotics (erythromycin, troleandomycin), ritonavir (due to increased concentration, reduction of quinine clearance), Artemether, Lumefantrin, Conivaptan, Silodosin, Topotecan.
  • Simultaneously using quinine with Atorvastatin may increase the risk of muscle or muscle disease.
  • quinin can reduce the effect of codeine, tramadol.
  • Some herbs that interact with Quinin can reduce the concentration of Quinin in the blood (St. John's Wort) or may cause over -blood pressure lower (California opium, frequency oil, hemp, mistletoe, shallow coconut).
  • ketoconazole increases absorption, reducing the concentration of quinin when used simultaneously.

    • Storage

    In a dry place, avoid light, the temperature does not exceed 30 ° C.

    Expiry date: 60 months from the date of production. Do not use overdue drugs stated on the packaging.

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