Quinine

Increased risk of methemoglobinemia when concurrently exposed to articaine.

Increased risk of developing methemoglobinemia when concurrently exposed to this agent.

Increased risk of methemoglobinemia when concurrently exposed to this oxidizing agent with local anesthetics.

Increased risk of methemoglobinemia when local anesthetics are used concomitantly with quinine.

Increased risk of methemoglobinemia when concurrently exposed with bupivacaine.

Induces methemoglobinemia; concomitant use may increase risk for developing methemoglobinemia.

Concomitant use may increase risk of developing methemoglobinemia. Monitor closely.

Associated with increased methemoglobinemia risk when used with ropivacaine.

CYP3A4 inhibitor that increases quinine plasma levels. Concomitant administration should be avoided.

Increased risk of methemoglobinemia when used concurrently with lidocaine.

May cause methemoglobinemia when used concomitantly with lidocaine patch 5%.

Drug that increases risk of methemoglobinemia when used concurrently with lidocaine and capsaicin patch.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when used concurrently with lidocaine hydrochloride.

Associated with increased methemoglobinemia risk when used concurrently with local anesthetics.

Increased risk of methemoglobinemia when local anesthetic is concurrently exposed to quinine.

Concurrent exposure increases risk of methemoglobinemia in patients administered local anesthetics.

Increased risk of methemoglobinemia; drugs associated with methemoglobinemia when used with local anesthetics.

Increased risk of methemoglobinemia when used with lidocaine.

Increased risk of methemoglobinemia when lidocaine is concurrently exposed to quinine.

Increased risk of methemoglobinemia when local anesthetics are concurrently exposed to oxidizing agents.

Increased risk of methemoglobinemia when concurrently exposed.

Concomitant administration may produce electrocardiographic abnormalities and increase risk of convulsions. Delay mefloquine at least 12 hours after last dose if used for severe malaria treatment.

Concurrent exposure increases risk of methemoglobinemia in patients administered mepivacaine.

Increased risk of methemoglobinemia when penicillin is concurrently administered with quinine.

Increased risk of methemoglobinemia when prilocaine is concurrently exposed to quinine.

Increased risk of methemoglobinemia when used concurrently with prilocaine.

CYP3A4 inducer that decreases quinine plasma levels. Concomitant administration should be avoided.

Increases quinine plasma levels. Concomitant administration should be avoided.

Increased risk of developing methemoglobinemia when concurrently exposed to quinine.

May enhance the neuromuscular blocking action of succinylcholine.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of methemoglobinemia when used concurrently with triethanolamine salicylate.

CYP3A4 inhibitor that increases quinine plasma levels. Concomitant administration should be avoided.

Increased risk of methemoglobinemia when used with Trubrexa Transdermal Patch.

Antacids containing aluminum and/or magnesium may delay or decrease absorption of quinine. Concomitant administration should be avoided.

Reduces renal clearance of amantadine by approximately 30%.

Reduces renal clearance of amantadine hydrochloride by approximately 30%.

No change in quinine dosage necessary with concomitant use. Patients should be monitored closely for adverse reactions associated with quinine.

May increase risk of methemoglobinemia when concurrently exposed with bupivacaine.

Increased risk of methemoglobinemia when concurrently exposed.

Increased risk of developing methemoglobinemia when concurrently exposed.

CYP3A4 inhibitor that increases plasma levels of carbamazepine; dose adjustment and/or plasma level monitoring may be necessary.

Nonspecific CYP450 inhibitor that may increase quinine levels. Ranitidine is preferred. Patients should be monitored closely for adverse events associated with quinine.

Digoxin AUC increased 34-38%. Reduce digoxin dose by 15-30% and monitor serum concentrations.

CYP3A4 inhibitor. No change in quinine dosage necessary but patients should be monitored closely for adverse reactions associated with quinine.

Drug that increases risk of methemoglobinemia when used concomitantly with lidocaine and tetracaine.

Increased risk of methemoglobinemia when concurrently exposed with bupivacaine.

Cationic drug eliminated by renal tubular secretion with potential for interaction with metformin by competing for common renal tubular transport systems.

CYP3A4 inducer that may decrease quinine plasma concentrations. Frequent monitoring of anticonvulsant drug concentrations and adverse reactions is recommended.

CYP3A4 inducer that may decrease quinine plasma concentrations. Patients should be monitored closely for adverse reactions associated with phenytoin.

Nonspecific CYP450 inhibitor. Preferred over cimetidine when concomitant use necessary. Patients should be monitored for adverse events associated with quinine.

Rifapentine may increase metabolism and decrease activity. Dosage adjustment may be necessary.

May enhance the neuromuscular blocking action of succinylcholine.

May be concomitantly administered with quinine. Patients should be monitored closely for adverse reactions associated with quinine.

No change in quinine dosage necessary with concomitant use. Patients should be monitored closely for adverse reactions associated with quinine.

Urinary alkalizers (acetazolamide, sodium bicarbonate) Urinary alkalinizing agents may increase plasma quinine concentrations.

Atorvastatin (CYP3A4 substrate) Rhabdomyolysis with acute renal failure secondary to myoglobinuria was reported in a patient taking atorvastatin administered with a single dose of quinine. Quinine may increase plasma concentrations of atorvastatin, thereby increasing the risk of myopathy or rhabdomyolysis. Thus, clinicians considering combined therapy of quinine sulfate with atorvastatin or other HMG-CoA reductase inhibitors (“statins”) that are CYP3A4 substrates (e.g., simvastatin, lovastatin) should carefully weigh the potential benefits and risks of each medication.

Thus, clinicians considering combined therapy of quinine sulfate with atorvastatin or other HMG-CoA reductase inhibitors (“statins”) that are CYP3A4 substrates (e.g., simvastatin, lovastatin) should carefully weigh the potential benefits and risks of each medication.

Thus, clinicians considering combined therapy of quinine sulfate with atorvastatin or other HMG-CoA reductase inhibitors (“statins”) that are CYP3A4 substrates (e.g., simvastatin, lovastatin) should carefully weigh the potential benefits and risks of each medication.