Quinine Sulfate adverse reactions
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chetan Lokhande, M.B.B.S [2]
Adverse Reactions
Overall
Quinine can adversely affect almost every body system. The most common adverse events associated with quinine use are a cluster of symptoms called "cinchonism", which occurs to some degree in almost all patients taking quinine. Symptoms of mild cinchonism include headache, vasodilation and sweating, nausea, tinnitus, hearing impairment, vertigo or dizziness, blurred vision, and disturbance in color perception. More severe symptoms of cinchonism are vomiting, diarrhea, abdominal pain, deafness, blindness, and disturbances in cardiac rhythm or conduction. Most symptoms of cinchonism are reversible and resolve with discontinuation of quinine.
The following adverse reactions have been reported with quinine sulfate. Most of these reactions are thought to be uncommon, but the actual incidence is unknown:
General
Fever, Chills, Sweating, Flushing, Asthenia, Lupus-Like Syndrome, And Hypersensitivity Reactions.
Hematologic
Agranulocytosis, Hypoprothrombinemia, Thrombocytopenia, Disseminated Intravascular Coagulation, Hemolytic Anemia; Hemolytic Uremic Syndrome , Thrombotic Thrombocytopenic Purpura, Idiopathic Thrombocytopenic Purpura, Petechiae, Ecchymosis, Hemorrhage, Coagulopathy, Blackwater Fever, Leukopenia, Neutropenia, Pancytopenia, Aplastic Anemia, And Lupus Anticoagulant.
Neuropsychiatric
Headache, Diplopia, Confusion, Altered Mental Status, Seizures, Coma, Disorientation, Tremors, Restlessness, Ataxia, Acute Dystonic Reaction, Aphasia, And Suicide.
Dermatologic
Cutaneous Rashes, Including Urticarial, Papular, Or Scarlatinal Rashes, Pruritus, Bullous Dermatitis, Exfoliative Dermatitis, Erythema Multiforme, Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, Fixed Drug Eruption, Photosensitivity Reactions, Allergic Contact Dermatitis,Acral Necrosis, And Cutaneous Vasculitis.
Respiratory
Asthma, Dyspnea, Pulmonary Edema.
Cardiovascular
Chest Pain, Vasodilatation, Hypotension, Postural Hypotension, Tachycardia, Bradycardia, Palpitations, Syncope, Atrioventricular Block, Atrial Fibrillation, Irregular Rhythm, Unifocal Premature Ventricular Contractions, Nodal Escape Beats, U Waves, Qt Prolongation, Ventricular Fibrillation, Ventricular Tachycardia, Torsades De Pointes, And Cardiac Arrest.
Gastrointestinal
Nausea, Vomiting, Diarrhea, Abdominal Pain, Gastric Irritation, And Esophagitis.
Hepatobiliary
Granulomatous Hepatitis, Hepatitis, Jaundice, And Abnormal Liver Function Tests.
Metabolic
Hypoglycemia And Anorexia.
Musculoskeletal
Myalgias And Muscle Weakness.
Renal
Hemoglobinuria, Renal Failure, Renal Impairment, And Acute Interstitial Nephritis.
Special Senses
Visual Disturbances, Including Blurred Vision With Scotomata, Sudden Loss Of Vision, Photophobia, Diplopia, Night Blindness, Diminished Visual Fields, Fixed Pupillary Dilatation, Disturbed Color Vision, Optic Neuritis, Blindness, Vertigo, Tinnitus, Hearing Impairment, And Deafness.[1]
References
Adapted from the FDA Package Insert.