Quinine and Pregnancy
The U.S. Food and Drug Administration classifies quinine (Qualaquin) as a pregnancy Category C medication, which means it may not be safe for pregnant women to use this medication. Some animal studies indicated that the drug might increase the risk of birth defects or other problems. However, this may not necessarily apply to humans, and quinine may be prescribed if the benefits outweigh the risks.
Can Pregnant Women Take Quinine?Quinine sulfate (Qualaquin®) is a prescription medication used in the treatment of uncomplicated (mild) malaria. Based on the results of animal studies, it may not be safe for pregnant women to take quinine.
What Is Pregnancy Category C?The U.S. Food and Drug Administration (FDA) uses a pregnancy category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. Pregnancy Category C is given to medicines that have not been studied in pregnant humans, but appear to cause harm to the fetus in animal studies.
Also, medicines that have not been studied in any pregnant women or animals are automatically given a pregnancy Category C rating.
In animal studies, giving up to four times the normal quinine dose to pregnant rabbits, chinchillas, and dogs caused problems in the offspring. These problems included miscarriages and abnormal brain and ear development. However, when this medication was given to pregnant rats and monkeys, no problems were observed in the offspring. It is important to note that animals do not always respond to medicines in the same way that humans do.
Many pregnant women have been treated for malaria with normal doses of quinine. Studies have looked at whether or not infants born to these women had an increased risk of problems compared to what would be expected from a normal pregnancy. These studies did not show an increased risk with quinine use.
However, there are cases of pregnant women taking very high quinine doses during the first trimester. In these cases, many of the infants were born with problems, including brain problems and abnormal limb development.
In addition, pregnant women may have a higher risk for low blood sugar (hypoglycemia) when given quinine (see Precautions and Warnings With Quinine for more information).
It should be noted that a malaria infection is particularly dangerous and life-threatening in pregnant women. Malaria can also increase the risk for miscarriage and premature labor. Therefore, it is very important that a pregnant woman with malaria be treated. Quinine is not the only treatment option for malaria; however, in some cases, it may be the best option available.
A healthcare provider will choose the best malaria treatment based on the risks and benefits of each option. A pregnancy Category C medicine, such as quinine, may be given to a pregnant woman if the healthcare provider believes that the benefits to the woman outweigh any possible risks to the unborn child.