Injectable Quinine Treatment

Please refer to the full prescribing information and/or patient information supplied by the relevant marketing authorization holder for your country, as well as local policies and treatment guidelines as they may vary from country to country.

Manufacturers listed on this page meet internationally agreed quality standards. For more information on quality assured medicines, refer to the WHO Prequalification Programme and the Global Fund's strategy on quality assurance of medicines.

Manufacturer Registration status Formulation
Renaudin Laboratoire Approved by a stringent regulatory authority

300 mg/ml (600 mg/2 ml or 30 %) (pack of 10 or 100)

Intravenous injection of quinine is recommended by the WHO as an alternative to injectable artesunate and injectable artemether for the treatment of severe malaria.

  • Rapid IV administration of quinine is dangerous and should therefore be administered as a slow, rate controlled infusion that does not exceed 5mg salt/kg bodyweight per hour.

Never give injectable quinine as an IV bolus injection as lethal hypotension may occur. 

Alternative pre-referral:

Intramuscular quinine is recommended when IV infusion is not possible.

  • Give IM quinine in the anterior thigh to avoid sciatic nerve injury
  • IM quinine should be split, with 10 mg/kg bw given into each thigh
  • Undiluted quinine injection is painful when given by IM, so it is therefore best to administer in a buffered formulation or diluted to 60-100 mg/mL. 

Injectable quinine dosing table (IV)

Intravenous quinine dosing table
Category Dose
Initial dose 20 mg salt/kg bodyweight
Maintenance dose 10 mg salt/kg bodyweight every 8 hours starting 8 hours after loading dose. After 48 hours, 10 mg salt/kg bodyweight every 12 hours. 

Intramuscular quinine dosing table
Category Dose
Initial dose 20 mg/kg bodyweight split into 10 mg/kg bodyweight in each anterior thigh (either in buffered formulation or diluted to 60-100 mg/mL)
Maintenance dose 10 mg/kg bodyweight (either in buffered formulation or diluted to 60-100 mg/mL)


*If pre-referral injection of quinine has been given to patients, the initial loading dose should be reduced. 

 

2020 Injectable quine supply share by country

2020 Injectable quine supply share by country

Of note, the graph above does not include the largest user of inj quinine, which is DRC, as injectable quinine is produced domestically in the country and this is therefore not considered as part of the international supply of injectable quinine.