About us Contacts Drug interactions: 390 212
Drug search by name

Quinine and RE-PB Hyos Elixir

Determining the interaction of Quinine and RE-PB Hyos Elixir and the possibility of their joint administration.

Check result:
Quinine <> RE-PB Hyos Elixir
Relevance: 21.05.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using PHENobarbital together with quiNINE may affect the blood levels and effects of both medications. Specifically, PHENobarbital levels may increase and quiNINE levels may decrease. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Let your doctor know if your conditions worsen or you experience increased side effects of PHENobarbital such as drowsiness, dizziness, vision problems, incoordination, and shallow or difficult breathing. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Coadministration with inducers of CYP450 3A4 including phenobarbital may decrease the plasma concentrations of quinine, which is primarily metabolized by the isoenzyme. The interaction has been studied with rifampin, a potent CYP450 3A4 inducer, and treatment failures have been reported. In patients with uncomplicated Plasmodium falciparum malaria who received quinine sulfate 10 mg/kg concomitantly with rifampin 15 mg/kg/day for 7 days, the median quinine systemic exposure (AUC) between days 3 and 7 of therapy was 75% lower than that observed in patients who received quinine monotherapy. Likewise, in nine healthy subjects who received a single 600 mg oral dose of quinine sulfate following pretreatment with rifampin 600 mg/day for 2 weeks, the mean quinine peak plasma concentration (Cmax) and AUC decreased by 55% and 85%, respectively. The extent to which other, less potent inducers of CYP450 3A4 may interact with quinine is unknown.

MONITOR: Coadministration with quinine may increase the serum concentrations of phenobarbital. The mechanism of interaction has not been described. In 8 healthy subjects, oral administration of a single 120 mg dose of phenobarbital in combination with a single 600 mg dose of quinine sulfate resulted in an average 53% increase in phenobarbital peak serum concentration (Cmax) and a 81% increase in systemic exposure (AUC) compared to administration alone. Mean urinary recovery of phenobarbital over 24 hours was also profoundly increased by quinine.

MANAGEMENT: The possibility of treatment failure should be considered if quinine must be used in combination with phenobarbital. Patients receiving quinine for malaria should be closely monitored. In addition, serum phenobarbital levels and pharmacologic response should be monitored during and after treatment with quinine, and the phenobarbital dosage adjusted as necessary. Patients should be advised to contact their physician if they experience potential signs and symptoms of phenobarbital toxicity such as sedation, hypotension, nystagmus, ataxia, and respiratory depression.

References
  • "Product Information. Qualaquin (quinine)." AR Scientific Inc, Philadelphia, PA.
  • Wanwimolruk S, Kang W, Coville PF, Viriyayudhakorn S, Thitiarchakul S "Marked enhancement by rifampicin and lack of effect of isoniazid on the elimination of quinine in man." Br J Clin Pharmacol 40 (1995): 87-91
  • Amabeoku GJ, Chikuni O, Akino C, Mutetwa S "Pharmacokinetic interaction of single doses of quinine and carbamazepine, phenobarbitone and phenytoin in healthy volunteers." East Afr Med J 70 (1993): 90-3
  • Twum-Barima Y, Carruthers SG "Quinidine-rifampin interaction." N Engl J Med 304 (1981): 1466-9
  • Pukrittayakamee S, Prakongpan S, Wanwimolruk S, Clemens R, Looareesuwan S, White NJ "Adverse effect of rifampin on quinine efficacy in uncomplicated falciparum malaria." Antimicrob Agents Chemother 47 (2003): 1509-1513
Quinine

Generic Name: quinine

Brand name: Qualaquin, QM-260, Quinamm

Synonyms: QuiNINE

RE-PB Hyos Elixir

Generic Name: atropine / hyoscyamine / phenobarbital / scopolamine

Brand name: Donnatal, D-Tal, Phenohytro, Chardonna-2, Hyosophen, Donnapine, Elixiral, Bellatal, Spasmolin, Haponal, Antispas, Barbidonna, Donnatal Extentabs, Antispasmodic, Bellalphen, Donnaphen, Spasquid, Alkabel-SR, Bellatal ER, Servira, PB-Hyos, Quadrapax, Phenobarbital with Belladonna Alkaloids

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction