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Quinine Sulfate Capsules and Rifadin

Determining the interaction of Quinine Sulfate Capsules and Rifadin and the possibility of their joint administration.

Check result:

Quinine Sulfate Capsules <> Rifadin

Relevance: 02.11.2023 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 quiNINE together with rifAMPin is not recommended. Combining these medications may significantly reduce the blood levels and effects of quiNINE. Your doctor may be able to prescribe alternatives that do not interact. 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:

GENERALLY AVOID: Coadministration with rifampin may decrease the plasma concentrations of quinine. The mechanism is rifampin induction of CYP450 3A4, the isoenzyme primarily responsible for the metabolic clearance of quinine. 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. There have been reports of treatment failure associated with this interaction.

MANAGEMENT: Concomitant use of quinine and rifampin should generally be avoided. If clinically appropriate, isoniazid may be a safe and reasonable alternative to rifampin in patients requiring treatment with quinine, as administration of 300 mg/day for 1 week demonstrated no significant effects on the pharmacokinetics of quinine.

References

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
"Product Information. Qualaquin (quinine)." AR Scientific Inc, Philadelphia, PA.
Zhang H, Coville PF, Walker RJ, Miners JO, Birkett DJ, Wanwimolruk S "Evidence for involvement of human CYP3A in the 3-hydroxylation of quinine." Br J Clin Pharmacol 43 (1997): 245-52
"Product Information. Rifadin (rifampin)." Hoechst Marion-Roussel Inc, Kansas City, MO.
Mirghani RA, Yasar U, Zheng T, et al "Enzyme kinetics for the formation of 3-hydroxyquinine and three new metabolites of quinine in vitro; 3-hydroxylation by CYP3A4 is indeed the major metabolic pathway." Drug Metab Dispos 30 (2002): 1368-71
Twum-Barima Y, Carruthers SG "Quinidine-rifampin interaction." N Engl J Med 304 (1981): 1466-9
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

Quinine Sulfate Capsules

Generic Name: quinine

Brand name: Qualaquin, QM-260, Quinamm

Synonyms: Quinine, QuiNINE

What is Quinine Sulfate Capsules?

Rifadin

Generic Name: rifampin

Brand name: Rifadin, Rifadin IV, Rimactane

Synonyms: n.a.

What is Rifadin?

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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.

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