The following adverse reactions have been reported with quinine sulfate.1 Most of these reactions are thought to be uncommon, but the actual incidence is unknown:
General: fever, chills, sweating, flushing, asthenia, lupus-like syndrome, and hypersensitivity reactions.
Hematologic: agranulocytosis, hypoprothrombinemia, thrombocytopenia, disseminated intravascular coagulation, hemolytic anemia, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, idiopathic thrombocytopenic purpura, petechiae, ecchymosis, hemorrhage, coagulopathy, blackwater fever, leukopenia, neutropenia, pancytopenia, aplastic anemia, and lupus anticoagulant.
Neuropsychiatric: headache, diplopia, confusion, altered mental status, seizures, coma, disorientation, tremors, restlessness, ataxia, acute dystonic reaction, aphasia, and suicide.
Dermatologic: cutaneous rashes (including urticarial, papular, or scarlatinal rashes), pruritus, bullous dermatitis, exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, fixed drug eruption, photosensitivity reactions, allergic contact dermatitis, acral necrosis, and cutaneous vasculitis.
Respiratory: asthma, dyspnea, and pulmonary edema.
Cardiovascular: chest pain, vasodilatation, hypotension, postural hypotension, tachycardia, bradycardia, palpitations, syncope, atrioventricular block, atrial fibrillation, irregular rhythm, unifocal premature ventricular contractions, nodal escape beats, U waves, QT prolongation, ventricular fibrillation, ventricular tachycardia, torsades de pointes, and cardiac arrest.
Gastrointestinal: nausea, vomiting, diarrhea, abdominal pain, gastric irritation, and esophagitis.
Hepatobiliary: granulomatous hepatitis, hepatitis, jaundice, and abnormal liver function test results.
Metabolic: hypoglycemia and anorexia.
Musculoskeletal: myalgias and muscle weakness.
Renal: hemoglobinuria, renal failure, renal impairment, and acute interstitial nephritis.
Special senses: visual disturbances, including blurred vision with scotomata, sudden loss of vision, photophobia, diplopia, night blindness, diminished visual fields, fixed pupillary dilatation, disturbed color vision, optic neuritis, blindness, vertigo, tinnitus, hearing impairment, and deafness.
1 Quinine sulfate [package insert]. Philadelphia, PA: Mutual Pharmaceutical Co.; 2006. Available at: http://thomsonweb.esourcegroup.com/files/PI_0.pdf.