Drug Interactions With Quinine
Class I and Class III Arrhythmia Medications
Taking quinine with medications used to treat an abnormal heart rhythm increases your risk for serious heart arrhythmia, including QT prolongation. These medications should not be used together. If you currently take a medication for an abnormal heart rhythm, talk to your doctor about this before starting quinine treatment.
CYP 3A4 Inducer Medications
The body breaks down quinine using enzymes in the liver known as CYP 3A4 enzymes. Some other medications (known as CYP 3A4 inducers) can increase the activity of these enzymes. Combining quinine with one of these CYP 3A4 inducers may decrease the level of quinine in your body, making it less effective. Your healthcare provider may need to monitor you more closely to make sure quinine is working if you take it with a CYP 3A4 inducer.
CYP 3A4 Inhibitor Medications
The body breaks down quinine using enzymes in the liver known as CYP 3A4 enzymes. Some of other medications (known as CYP 3A4 inhibitors) can decrease the activity of these enzymes. Combining quinine with one of these CYP 3A4 inhibitors may increase the level of quinine in your body, increasing your risk for side effects. Your healthcare provider may monitor you more closely for side effects, and may need to decrease your quinine dose if you take it with a CYP 3A4 inhibitor.
Taking quinine with dapsone increases the risk of serious blood reactions. This risk is probably highest in people who have certain blood conditions, such as glucose-6-phosphate dehydrogenase (G6PD) deficiency, methemoglobin reductase deficiency, or hemoglobin M.
If you have one of these conditions, you should avoid using dapsone while taking quinine. Discuss the situation with your healthcare provider before starting quinine. If you do take these medications together, your healthcare provider will need to closely monitor you for blood reactions.