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Quinidine (Quinidine Sulfate) - Summary

 

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BOX WARNING

Mortality

In many trials of antiarrhythmic therapy for non-life-threatening arrhythmias, active antiarrhythmic therapy has resulted in increased mortality; the risk of active therapy is probably greatest in patients with structural heart disease.

In the case of quinidine used to prevent or defer recurrence of atrial flutter/fibrillation, the best available data come from a meta-analysis described under CLINICAL PHARMACOLOGY, Clinical Effects above. In the patients studied in the trials there analyzed, the mortality associated with the use of quinidine was more than three times as great as the mortality associated with the use of placebo.

Another meta-analysis, also described under CLINICAL PHARMACOLOGY, Clinical Effects, showed that in patients with various non-life-threatening ventricular arrhythmias, the mortality associated with the use of quinidine was consistently greater than that associated with the use of any of a variety of alternative antiarrhythmics.

 

QUINIDINE SUMMARY

QUINIDINE SULFATE Extended-release TABLETS, USP

Quinidine is an antimalarial schizonticide and an antiarrhythmic agent with class 1a activity; it is the d–isomer of quinine and its molecular weight is 324.

Treatment of malaria

Quinidine gluconate injection is indicated for the treatment of life–threatening Plasmodium falciparum malaria.

Conversion of atrial fibrillation/flutter

Quinidine gluconate injection is also indicated (when rapid therapeutic effect is required, or when oral therapy is not feasible) as a means of restoring normal sinus rhythm in patients with symptomatic atrial fibrillation/flutter whose symptoms are not adequately controlled by measures that reduce the rate of ventricular response. If this use of quinidine gluconate does not restore sinus rhythm within a reasonable time, then its use should be discontinued.

Treatment of ventricular arrhythmias

Quinidine gluconate injection is also indicated for the treatment of documented ventricular arrhythmias, such as sustained ventricular tachycardia, that in the judgement of the physician are life–threatening. Because of the proarrhythmic effects of quinidine, its use with ventricular arrhythmias of lesser severity is generally not recommended, and treatment of patients with asymptomatic ventricular premature contractions should be avoided. Where possible, therapy should be guided by the results of programmed electrical stimulation and/or Holter monitoring with exercise.

Antiarrhythmic drugs (including quinidine) have not been shown to enhance survival in patients with ventricular arrhythmias.

QUINIDINE NEWS HIGHLIGHTS

Published Studies Related to Quinidine

Dextromethorphan and quinidine in adult patients with uncontrolled painful diabetic peripheral neuropathy: a 29-day, multicenter, open-label, dose-escalation study. [2006.10]

Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis. [2006.05]

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Clinical Trials Related to Quinidine

Safety and Efficacy of Dextromethorphan and Quinidine in the Treatment of the Pain of Diabetic Neuropathy [Completed]

Safety and Efficacy of AVP-923 in PBA Patients With ALS or MS [Recruiting]

Safety/Efficacy of AVP-923 in the Treatment of Emotional Lability (Uncontrolled Crying & Laughing) in Patients With ALS [Completed]

Induction of Drug Metabolism: In Vivo Comparison of Carbamazepine and Oxcarbazepine. [Active, not recruiting]

High Intensity Focused Ultrasound (HIFU) Ablation System Study [Suspended]

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Page last updated: 2007-02-12

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