• Type: Antimalarial, Antiarrhythmic (Class I)
  • Routes of Administration: IV (discontinued in America), oral
  • Common Trade Names:
    • Quinaglute
    • Quinidex

Adult Dosing

Ventricular dysrhythmias[1]

  • Quinidine gluconate IV 0.25 mg/kg/min over 20-40 min, max 10 mg/kg per conversion attempt
  • PO alternative: 648 mg PO q8 x3-4 doses

Severe malaria

  • Load 10 mg/kg IV over 2hrs, then 0.02 mg/kg/min IV/PO x3 days, in conjunction with doxycycline OR
  • Load 24 mg/kg IV infused over 4 hours, then 12 mg/kg IV infused over 4h q8h starting 8h after initial loading dose

Pediatric Dosing

  • Malaria: same weight-based dosing as above

Special Populations



  • Allergy to class/drug
  • Cardiac rhythm dependent upon junctional or idioventricular pacemaker (in absence of artificial pacemaker)
  • Myasthenia gravis
  • History of ITP or TTP associated with quinine or quinidine

Adverse Reactions


  • Prolonged QT, torsades de points, ventricular arrythmia
  • Hepatotoxicity
  • Kidney disease


  • Diarrhea, nausea/vomiting
  • Headache, lightheadedness
  • Palpitations
  • Rash


  • Half-life: 3-8h
  • Metabolism: Hepatic
  • Excretion:

Mechanism of Action

  • Class IA antiarrhythmic: inhibits depolarizing sodium channels in cardiac muscle and purkinje fibers
  • Antimalarial action: intraerythrocytic schizonticide to p. vivax and p. malariae, acts against asexual erythrocytic phase of p. falciparum


  • Inexpensive with restricted indications, causing it to be inaccessible in many areas globally
  • Main manufacturer halted production in 2010[3]
  • Discontinue quinidine infusion if[4]:
    • Sinus rhythym restored
    • QRS complex widens > 130% of pre-treatment QRS duration
    • QTc widens > 130% of pre-treatment duration OR > 500 ms
    • Disappearance of T-waves
    • Development of significant tachycardia, symptomatic bradycardia, hypotension

See Also


  1. Athena Health. Epocrates. Quinidine Gluconate Monograph. https://online.epocrates.com/u/10a72/quinidine+gluconate.
  2. Viskin S et al. Quinidine, A Life-Saving Medication for Brugada Syndrome, Is Inaccessible in Many Countries. J Am Coll Cardiol. 2013;61(23):2383-2387.
  3. Olsson G.; To the editor—Market withdrawal of quinidine bisulfate (Kinidin Durules) in 2006. Heart Rhythm. 2010;7:864
  4. Quinidine gluconate dilution. GlobalRPH. http://www.globalrph.com/quinidine_gluconate_dilution.htm