Adult Dosing
Atrial fibrillation/flutter conversion
- 0.25 mg/kg/minute IV x 20-40 minutes
- Max: 10 mg/kg IV per conversion attempt
Ventricular arrhythmias
- 0.25 mg/kg/minute IV x 20-40 minutes
- Max: 10 mg/kg IV per conversion attempt
Severe malaria
- 0.02 mg/kg/minute IV x 3 days
- Start: 10 mg/kg IV over 1-2 hrs
- Alt: 24 mg/kg IV over 4 hrs, then 12 mg/kg IV/PO q8 hrs x 7 days
Pediatric Dosing
- Safety and effectiveness in pediatrics have not been established
[Outline]
See Supplemental Patient Information
- Rapid infusion of quinidine can cause peripheral vascular collapse and severe hypotension, hence administer slowly
- Prolong QTc interval leading to torsades de pointes, a life-threatening ventricular arrhythmia has been reported with quinidine. Bradycardia, hypokalemia, hypomagnesemia or high serum levels of quinidine increases the risk of torsades. Use cautiously in patients with preexisting long-QT syndromes or history of torsades de pointes
- Ventricular arrhythmias including frequent extrasystoles, ventricular tachycardia, ventricular flutter, and ventricular fibrillation have been reported with quinidine
- Use of quinidine in patients with atrial flutter/fibrillation can lead to slowing of the atrial rate with a consequent increase in the ventricles beats (>200 beats/min). Hence prior to initiation of quinidine therapy achieve partial atrioventricular block using conduction-reducing drugs such as digitalis, verapamil, diltiazem, or a ß-receptor blocking agent
- Renal and hepatic impairment slow down the elimination of quinidine and CHF causes a reduction in quinidine’s apparent volume of distribution leading to quinidine toxicity, hence consider dose reduction in these patients
- Physical or pharmacological vagal maneuvers undertaken to terminate paroxysmal supraventricular tachycardia will be ineffective in patients receiving quinidine, as quinidine opposes the atrial and A-V nodal effects of vagal stimulation
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Risk of complete AV block
- Preexisting long-QT syndromes
- History of torsades de pointes
- Sick sinus syndrome
- Bradycardia
- Hypokalemia
- Hypomagnesemia
- CHF
Supplemental Patient Information
- Advise patients not take this medication if they have history of allergic reaction to quinidine or quinine (Qualaquin), including easy bruising or unusual bleeding
- Advise patients not use this medication without consulting a physician, if they are breastfeeding a baby
- Advise patients to stop using the medicine for a short time prior to undergoing any surgery
- Caution: Look alike/sound alike confused with: quinacrine and quinine
Pregnancy Category:C
Breastfeeding: Probably safe. Exclusively breastfed infants should be carefully monitored if this drug is used during lactation, possibly including measurement of serum levels to rule out toxicity if there is a concern. This information is based upon LactMed database http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 18 April 2011). According to manufacturer data administration of quinidine should (if possible) be avoided in lactating women who continue to nurse.
US Trade Name(s)
US Availability
quinidine gluconate (generic)
- INJ: 80 mg/mL (10 mL vial)
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
[Outline]