Quinidine Sulfate (quinidine sulfate)

Dosage of quinidine gluconate or quinidine sulfate for the treatment of arrhythmias usually is expressed in terms of the salt. Dosage of quinidine gluconate for the treatment of malaria is expressed in terms of the base or salt.

On a molar basis, approximately 267 mg of quinidine gluconate is equivalent to 200 mg of quinidine sulfate.

Dosage of quinidine must be carefully adjusted according to individual requirements and response, and the general condition and cardiovascular status of the patient.

Quinidine therapy should be initiated or quinidine dosage adjusted in a setting where facilities and personnel for patient monitoring and resuscitation are continuously available, especially if the drug is used in patients with known structural heart disease or other risk factors for toxicity.

ECG monitoring of cardiac function and determination of plasma quinidine concentrations are recommended during quinidine therapy, especially when the drug is given IV or when more than 2 g of oral quinidine sulfate is administered daily, and in patients with an increased risk of adverse reactions to quinidine, such as patients with severe heart disease, hypotension, or hepatic or renal disease.

Quinidine should be used for conversion of atrial fibrillation/flutter only after alternative measures (e.g., use of other drugs to control ventricular rate) have been inadequate. Quinidine should be discontinued if sinus rhythm is not restored within a reasonable amount of time.

Quinidine should be discontinued if QRS complex widens to 130% of its pretreatment duration, QTc interval widens to 130% of its pretreatment duration and is greater than 500 milliseconds, P waves disappear, or the patient develops clinically important tachycardia, symptomatic bradycardia, or hypotension.

For the treatment of severe malaria, the initial loading dose and continuous IV infusion rate of quinidine gluconate do not need to be reduced in patients with renal failure. If renal failure persists or clinical improvement does not occur in such patients, the maintenance infusion rate should be reduced by one-third to one-half on the third day of the quinidine gluconate infusion.

Quinidine gluconate and quinidine sulfate are administered orally. Quinidine gluconate also is administered by IV infusion; IM administration is not recommended because absorption kinetics of the drug may vary depending on the patient's peripheral perfusion.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

Animal reproduction studies have not been performed to date with quinidine. It is not known whether quinidine can cause fetal harm when administered to pregnant women. Another cinchona alkaloid, quinine, has caused fetal blindness and has been implicated in congenital deafness. Quinidine should be used during pregnancy only when clearly needed. The safety of quinidine during labor and delivery is not known, but the drug exhibits oxytocic properties; the clinical importance remains to be established.

Since quinidine is distributed into milk, the drug should be avoided, if possible, in nursing women.

No enhanced messaging available.