The dosage is expressed in terms of salt:
Child and adult: loading dose: 20 mg/kg administered over 4 hours, then keep the vein open with an infusion of 5% glucose over 4 hours maintenance dose: 8 hours after the start of the loading dose, 10 mg/kg every 8 hours (alternate quinine over 4 hours and 5% glucose over 4 hours)
For adults, administer each dose of quinine in 250 ml. For children under 20 kg, administer each dose of quinine in a volume of 10 ml/kg.
Do not administer a loading dose to patients who he received oral quinine or mefloquine within the previous 24 hours: start with maintenance dose.
Duration Treat parenterally for at least 24 hours, then, if the patient can tolerate the oral route, change to a complete 3-day course of an artemisinin-based combination (or if not ailable oral quinine to complete 7 days of quinine treatment). If not, continue parenteral treatment until the patient can change to oral route (without exceeding 7 days of parenteral treatment). Contra-indications, adverse effects, precautions May cause: hypoglycaemia; auditory and visual disturbances, cardiac disorders (especially in the event of overdose), hypersensitivity reactions, cardiac depression if injected undiluted by IV route. In patients with acute renal failure, reduce the dose by one-third if the parenteral treatment lasts more than 48 hours. Monitor blood glucose (reagent strip test). Do not administer simultaneously with mefloquine (risk of seizures, cardiac toxicity). Administer mefloquine 12 hours after the last dose of quinine. Pregnancy: no contra-indication. The risk of quinine-related hypoglycaemia is very high in pregnant women. Breast-feeding: no contra-indication Remarks 10 mg quinine dihydrochloride = 8 mg quinine base. Administration by IM deep injection (into the anterior thigh only) is possible when infusion cannot be performed (e.g. before transferring a patient). However this may cause numerous complications. Doses are the same as for the IV route. Quinine should be diluted (1/2 or 1/5). For the loading dose, administer half the dose into each thigh. Storage – Below 25 °C