Interactions

Drug-Drug

• Concurrent use of Class IA antiarrhythmics (quinidine procainamide disopyramide or Class III antiarrhythmics, mefloquine, pimozide, or macrolide anti-infectives risk of arrhythmias and should be avoided

• Antacids absorption

• Cimetidine metabolism and may effects

• Rifampin and rifabutin metabolism and may effects; concurrent use with rifampin should be avoided

• May effects of neuromuscular blocking agents

• May serum digoxin levels; dose adjustments may be necessary

• May risk of hemolytic, ototoxic, or neurotoxic reactions when used concurrently with agents sharing these toxicities

• Concurrent use with quinidine may risk of adverse cardiovascular reactions

• May risk of bleeding with warfarin

• Concurrent use with mefloquine risk of seizures and adverse cardiovascular reactions

• Urinary alkalinizers including acetazolamide and sodium bicarbonate may blood levels

• Quinine inhibits the CYP3A4 and CYP2D6 enzyme systems and can levels of carbamazepine phenobarbital and phenytoin. A similar effect may occur with dextromethorphan metoprolol flecainide and paroxetine

• Carbamazepine phenobarbital and phenytoin induce metabolism and levels of quinine; frequent monitoring recommended

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