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Quinidine Sulfate Coupon - Quinidine Sulfate 300mg tablet

Quinidine Sulfate

Generic Cin-Quin
Used for Atrial Fibrillation, Malaria, Ventricular Arrhythmia
Used for Atrial Fibrillation, Malaria, Ventricular Arrhythmia

Quinidine is one of the oldest antiarrhythmic medications, but isn't used as often these days since there are better alternatives.

Reviewed by:
reviewer
Aileen Chu, PharmD, BCPS
reviewer
Allison Gourley, PharmD
Last reviewed on August 2, 2021
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostAlternativesImagesPricesMedicare
basics-icon

What is Quinidine?

What is Quinidine used for?

  • Treatment of atrial fibrillation or flutter

  • Prevention of atrial fibrillation or flutter

  • Prevention of ventricular arrhythmias

How Quinidine works

Quinidine is an antiarrhythmic. It works by blocking sodium channels, which play a major part in your heart's electrical activity. It slows down abnormal electricity in your heart in order to treat or prevent abnormal rhythms.

Are you looking for information on quinine (Qualaquin) for treatment of malaria instead?

Drug Facts

Common BrandsQuinora (brand no longer available)
Drug ClassAntiarrhythmic
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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$1293.18(save 97.88%)
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What are the side effects of Quinidine?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Diarrhea (35%)
  • Upset stomach (22%)
  • Lightheadedness (15%)
  • Headache (7%)
  • Fatigue (7%)
  • Palpitations (7%)
  • Chest pain (6%)
  • Weakness (5%)
  • Rash (5%)

Other Side Effects

  • Problems with vision
  • Change in sleep habits
  • Shaking or tremor
  • Nervousness
  • Difficulty with coordination or movement
  • Liver injury
  • Autoimmune reactions

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Abnormal heart rhythm: chest pain or discomfort, weakness, dizziness, or fainting

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Abdominal pain and/or yellow eyes or skin

blurred and/or double vision, confusion, delirium, disturbed color perception, headache, noises or ringing in the ear, and/or visual intolerance of light

dizziness or lightheadedness

fainting

fever

Rare

Chest pain, fever, general discomfort, joint pain, joint swelling, muscle pain, and/or skin rash

nosebleeds or bleeding gums

unusual tiredness or weakness and/or pale skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea

loss of appetite

muscle weakness

nausea or vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Quinidine

thumbs-up

Pros

A preferred choice for some people with Brugada syndrome

Available in a lower-cost, generic form

thumbs-down

Cons

Higher chance of death compared to alternatives; only used in very specific scenarios

Many drug interactions

pharmacist-tips

Pharmacist tips for Quinidine

pharmacist

  • When starting on quinidine, you may need to stay in the hospital for a few days so that providers can monitor your heart rhythm and watch for side effects more closely.

    • For treatment of atrial fibrillation or flutter, quinidine should only be used after you have tried medications that slow down the heart rate, such as digoxin (Lanoxin) or beta-blockers (like metoprolol). In general, you should continue to take those medications when you start on quinidine, unless your provider has specifically told you to stop taking them or to take a different dose.

      • For prevention of atrial fibrillation or flutter, the goal is to make these rhythms happen less frequently. It's normal to still have bouts of arrhythmia while on quinidine, but let your provider know if it's still happening too frequently.

        • You can break the extended-release tablets in half so that it's easier to adjust your dose, but don't or crush or chew them.

          • Diarrhea is a common side effect from both types of quinidine tablets. Let your provider know if it's bothersome, or if it is causing you to become dehydrated.

            • Make sure your provider and pharmacist know all of the medications that you're taking, so they can help you look out for any dangerous interactions with quinidine.

              • Quinidine also kills certain strains of malaria, though the oral form of quinidine isn't typically used to treat or prevent malaria.

                faqs

                Frequently asked questions about Quinidine

                Is quinidine a beta-blocker?
                Quinidine doesn't belong to the class of medications called beta-blockers (medications that end in -lol such as metoprolol (Lopressor) or carvedilol (Coreg)). It doesn't have any beta-blocking effects. Some people may need to take this medication in combination with a beta-blocker.
                Is quinidine still used?
                Quinidine isn't used very much these days for arrhythmias (abnormal heart rhythms). It's a very old drug with many potential side effects, and there are usually better alternatives available. Quinidine can still be helpful in certain situations, though; for example, it's a preferred medication for treating Brugada Synrdome, a rare type of arrhythmia. Your heart specialist will determine if this medication is right for you based on your specific condition and other medical problems. Quinidine is also one of the main ingredients in Nuedexta (dextromethorphan/quinidine), which is used to treat a condition called pseudobulbar affect.
                What is the generic name for quinidine?
                Quinidine is the generic name of this medication. It's available as quinidine sulfate tablets and quinidine gluconate extended-release tablets. Quinidine used to come in various brand-names such as Cardioquin, Cin-Quin, and Quinidex, but those are no longer available. Currently, quinidine is only available as a generic form.
                What is the difference between quinine and quinidine?
                The chemical structures of quinine and quinidine are very similar. Quinine (Qualaquin) is primarily used to treat malaria infections, while quinidine is used for abnormal heart rhythms (arrhythmias).
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                What are the risks and warnings for Quinidine?

                Quinidine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                risk-warning

                Higher risk of death

                • Risk factors: Abnormal heart structure (including heart failure and history of heart attack)

                  Some studies have shown that people who took quinidine for abnormal heart rhythms (arrhythmias) that were not life-threatening had a greater risk of dying, compared to those who took a placebo or other antiarrhythmic. Your prescriber should give you quinidine only for life-threatening arrhythmias and only when absolutely necessary.

                  risk-warning

                  Arrhythmia (abnormal heart rhythm)

                  • Risk factors: Slow heart rate | Low levels of potassium, magnesium, or calcium | High levels of quinidine in the blood | Long-QT syndrome | History of torsades de pointes (a type of arrhythmia) | 'Heart block' without a pacemaker

                    Antiarrhythmic medications like quinidine can cause new or worsened arrhythmia, including rhythms that are too fast or too slow. Many of these conditions are life-threatening, so you should only take this medication if you have a serious heart condition and if you are able to follow-up with your provider regularly to monitor your heart health. You will get an EKG (test of your heart's electrical activity) on a regular basis to make sure the quinidine is working as it should. If your electrolyte levels are low, you may need to take supplements. If you ever experience chest discomfort, dizziness, fainting, or fast heartbeat while you are on quinidine, get medical help right away.

                    risk-warning

                    Quinidine levels too high/low

                    • Risk factors: Liver disease | Kidney disease | Heart failure | Taking medications that interact with quinidine

                      Poor liver or kidney function, heart failure, and certain medications can cause quinidine levels in the body to be higher, leading to more side effects. On the other hand, some medications can cause quinidine levels to be too low, making it not work as well. If you have any of these risk factors, your provider may check lab and heart tests more frequently to be safe. Be sure to talk to your providers, including your pharmacist, about all the medications you are taking.

                      risk-warning

                      Drug interactions

                      Many medications can affect the levels of quinidine in the body. At the same time, quinidine can also also cause problems with other medications by affecting their levels or making them work more strongly. Be sure to talk to your providers, including your pharmacist, about all the medications you are taking. While you are on quinidine, don't start or change your medications without first talking with your provider or pharmacist.

                      dosage

                      Quinidine dosage forms

                      The average cost for 60 tablets of 300mg of Quinidine is $215.70 with a free GoodRx coupon. This is 83.32% off the average retail price of $1293.18.
                      tablet
                      Tablet
                      DosageQuantityPrice as low asPrice per unit
                      200mg90 tablets$27.45$0.30
                      300mg60 tablets$215.70$3.59

                      Typical dosing for Quinidine

                      For all of the following uses, your provider will need to closely monitor your heart rhythm, heart rate, and blood pressure, and will adjust the dose based on rhythm changes and/or side effects.

                      Treatment of atrial fibrillation or flutter:

                      • Quinidine sulfate tablets: A typical dose is 400 mg by mouth every 6 hours.

                      • Quinidine gluconate extended-release tablets: A typical dose is 648 mg by mouth every 8 hours. Your provider may have you try a lower dose of 324 mg every 8 hours for 2 days, then 648 mg every 12 hours for 2 days, then 648 mg every 8 hours for up to 4 days.

                      Prevention of atrial fibrillation, atrial flutter, or ventricular arrhythmias:

                      • Quinidine sulfate tablets: A typical starting dose is 200 mg by mouth every 6 hours.

                      • Quinidine gluconate extended-release tablets: A typical dose is 324 mg by mouth every 8 to 12 hours.

                      interactions

                      Interactions between Quinidine and other drugs

                      Quinidine may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Quinidine. Please note that only the generic name of each medication is listed below.

                      Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                      Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                      Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                      drug-cost

                      How much does Quinidine cost?

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                      Quinidine (generic)
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                      alternatives

                      What are alternatives to Quinidine?

                      There are a number of medications that your doctor can prescribe in place of Quinidine. Compare a few possible alternatives below.
                      Quinidine
                      Used for:

                      • Treatment of atrial fibrillation or flutter

                      • Prevention of atrial fibrillation or flutter

                      • Prevention of ventricular arrhythmias

                      $27.45 Lowest GoodRx priceView Prices
                      Flecainide
                      Used for:

                      • Prevention of paroxysmal supraventricular tachycardias (PSVT)

                      • Prevention of paroxysmal atrial fibrillation/flutter (PAF)

                      • Prevention of ventricular arrhythmias

                      $15.00 Lowest GoodRx priceView Prices
                      Amiodarone (Pacerone)
                      Used for:

                      • Life-threatening ventricular fibrillation that keeps coming back (when other antiarrhythmics haven't worked well)

                      • Life-threatening tachycardia that keeps coming back (when other antiarrhythmics haven't worked)

                      $9.00 Lowest GoodRx priceView Prices
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                      Quinidine Sulfate Coupon - Quinidine Sulfate 300mg tablet
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