HERBAL MONOGRAPHS QUININE/627Unproven Uses: Quinine is used internally to correct loss of
appetite, dyspepsia and flatulence with a sense of fullness.
The bark is used for malaria, flu, enlarged spleen, muscle
cramps, muscle pain, cancer and gastric disorders. External-
ly, it is used for scrapes and skin ulcers.
Chinese Medicine: Quinine is used for malaria, fever and
alcohol intoxication.Indian Medicine: The drug is used to treat intermittent fever,
malaria, intercostal neuralgia, sciatica and neuritis (especial-
ly of the arm).Homeopathic Uses: Quinine is used to treat general poison-
ing, attacks of feverT inflammation of the respiratory tract,
acute diarrhea, anemia, general debility, skin rashes and
neuralgia.
CONTRAINDICATIONS
Quinine should not be used during pregnancy.
PRECAUTIONS AND ADVERSE REACTIONS
General: Sensitization to Quinine and Quinidine have been
observed (eczema, itching). Even at therapeutic dosages, an
enhanced pseudohemophiliac effect can occur through the
triggering of thrombocytopenia.Drug Interactions: Because of the possibility of thrombocy-
topenia, care must be taken when Quinine preparations are
administered along with other drugs that are known to
precipitate thrombocytopenia.
OVERDOSAGE
In cases of overdose (more than 3 gm Quinine) or of long-
term administration of the drug or its alkaloids, nausea,
summer cholera, headache, fall of body temperature, intra-
vascular hemolysis, cardiac arrhythmias, buzzing in the ears,
hearing and visual disorders (all the way to complete
deafness and blindness) may occur. Death comes with
dosages of 10 to 15 gm of Quinine through heart failure and
asphyxiation. Following gastric lavage, the symptomatic
therapy for acute poisonings includes atropine for bradycar-
dia and phenytoin in the presence of tachycardic heart
rhythm disorders. Forced diuresis and hemodialysis are not
suitable as therapeutic measures.DOSAGE
Mode of Administration: Whole, cut and powdered drug are
used in various galenic preparations, including tonics, drops,
tablets, compresses, ampules, coated tablets, suppositories
and compound preparations.Preparation: A tea is prepared by pouring 150 ml of boiling
water over 1/2 teaspoonful of the drug and allowing it to
draw for 10 minutes. A decoction is prepared by adding 0.5 g
to 1 teacup of water. A tincture in the proportion of 1:5 in
75% ethanol is also used.
Daily Dosage: Total daily dose is 1 to 3 gm of drug. The
liquid extract daily dose is 0.6 to 3 gm of cinchona liquid
extract, which contains 4 to 5% total alkaloids. A daily dose
of 0.15 to 0.6 g cinchona extract with 15 to 20% total
alkaloids may also be used.The standard single dose of the extract is 0.2 gm. The liquid
extract single dose is 0.5 to 1 gm.Homeopathic Dosage: 5 drops, 1 tablet or 10 globules, every
30 to 60 minutes (acute) or 1 to 3 times a day (chronic);
parenterally: 1 to 2 ml sc, acute: 3 times daily; chronic: once
a day (HAB1).Storage: Keep protected from light and moisture.LITERATURE
Chinidin: Photoallergische Reaktion. In: DAZ 133(30):2765.
1993.
Hamorrhoidenbehandlung: Ambulant oder stationar. In: DAZ
133(40):3616. 1993.
Risdale CE, Hasskarls cinchona barks. 1. Historical review. In:
Reinwardtia 10, Teil 2: 245-264. 1985.
•Schonfeld, Fleischer K, Eichenlaub D, Die Malariavorbeugung.
Miickenschutz und Arzneimittel zur Kurzzeitprophylaxe und
Notfallbehandlung. In: DAZ 133(21):1981. 1993.
Further information in:
Chan, EH et al. (Eds.), Advances in Chinese Medicinal
Materials Research, World Scientific Pub. Co. Singapore 1985.
Hansel R, Keller K, Rimpler H, Schneider G (Hrsg.), Hagers
Handbuch der Pharmazeutischen Praxis, 5. Aufl., Bde 4-6
(Drogen): Springer Verlag Berlin, Heidelberg, New York, 1992-
1994.
Leung AY, Encyclopedia of Common Natural 'Ingredients Used
in Food Drugs and Cosmetics, John Wiley & Sons Inc., New
York 1980.
Lewin L, Gifte und Vergiftungen, 6. Aufl., Nachdruck, Haug
Verlag, Heidelberg 1992.
Madaus G, Lehrbuch der Biologischen Arzneimittel, Bde 1-3,
Nachdruck, Georg Olms Verlag Hildesheim 1979.
Manske RHF, Holmes HL, fortgefiihrt von Rodrigo RGA,*
Brossi A): The Alkaloids - Chemistry and Physiology, 111:1,
XIV: 181, XXXIV:331, Academic Press New York 1950-1997.
Roth L, Daunderer M, Kormann K, Giftpflanzen, Pflanzengifte,- Aufl., Ecomed Fachverlag Landsberg Lech 1993.
Steinegger E, Hansel R, Pharmakognosie, 5. Aufl., Springer
Verlag Heidelberg 1992.
Teuscher E, Lindequist U, Biogene Gifte - Biologie, Chemie,
Pharmakologie, 2. Aufl., Fischer Verlag Stuttgart 1994.
Teuscher E, Biogene Arzneimittel, 5. Aufl., Wiss. Verlagsges.
mbH Stuttgart 1997.