Is Quinine compatible with breastfeeding? Do we have alternatives for Quinine?

Quinine

December 8, 2017 (Very Low Risk)

Cinchona alkaloid used in the prophylaxis and treatment of malaria (Pérez 2009).
Administered orally or intravenously.

It is excreted in breast milk in clinically insignificant amounts (Mathew 2004, Phillips 1986, Terwilliger 1934), much lower than the dose used in newborns and infants (Fulton 1992).
No problems have been observed in infants whose mothers were taking it (FDA 2008, Terwilliger 1934).

Its use is authorized in infants and children.
Avoid in cases of glucose-6-phosphate dehydrogenase deficiency (Mathew 2004, WHO/UNICEF 2002, Fulton 1992).

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).

WHO list of essential medicines: compatible with breastfeeding (WHO / UNICEF, 2002).

Alternatives

We do not have alternatives for Quinine since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Chininum
  • Quinine Bisulfate
  • Quinine Dihydrochloride
  • Quinine Etabonate
  • Quinine Hydrobromide
  • Quinine Hydrochloride
  • Quinine Sulfate

Writings

  • κινίνη (Greek)
  • كينين (Arabic)
  • Хинин (Cyrillic)
  • 奎宁 (Chinese)
  • 奎寧 (Chinese)
  • キニン (Japanese)
  • キニーネ (Japanese)
  • C20H24N2O2 (Molecular formula)
  • (8S,9R)-6′-Methoxycinchonan-9-ol; (αR)-α-(6-Methoxy-4-quinolyl)-α-[(2S,4S,5R)-(5-vinylquinuclidin-2-yl)]methanol (Chemical name)
  • P01BC01 (ATC Code/s)

Drug trade names

References

  1. Pérez JL, Carranza C, Mateos F. Antiparasitarios. Revisión de los fármacos útiles en el tratamiento de parasitosis clásicas y emergentes. \ [Antiparasitic drugs. Review of the useful drugs in the treatment of classic and emergent parasitic diseases]. Rev Esp Quimioter. 2009Abstract Full text (link to original source) Full text (in our servers)
  2. Acofarma. Quinina. Ficha técnica. 2008 Full text (in our servers)
  3. FDA Quinine. Drug Summary. 2008 Full text (in our servers)
  4. Mathew JL. Effect of maternal antibiotics on breast feeding infants. Postgrad Med J. 2004Abstract
  5. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  6. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  7. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992Abstract
  8. Phillips RE, Looareesuwan S, White NJ, Silamut K, Kietinun S, Warrell DA. Quinine pharmacokinetics and toxicity in pregnant and lactating women with falciparum malaria. Br J Clin Pharmacol. 1986Abstract
  9. Terwilliger WG, Hatcher RA. The elimination of morphine and quinine in human milk. Surg Gynecol Obstet. 1934;58:823–826. 1934