Drug interactions
Brexpiprazole + Quinine
Severity: Moderate
Brexpiprazole and Quinine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Quinine inhibits CYP2D6, one of the main pathways that clears brexpiprazole, so brexpiprazole exposure can rise. The effect becomes larger if a CYP3A4 inhibitor is also being taken, and can increase adverse effects such as akathisia, sedation and orthostasis.
What this interaction means in plain words
Brexpiprazole and Quinine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Brexpiprazole belongs to Central Nervous System; Quinine belongs to Anti Parasitic.
Why it happens
Inhibition of CYP2D6-mediated metabolism of brexpiprazole by quinine.
What to do
Monitor for brexpiprazole adverse effects and consider reducing its dose during quinine use. Reduce the brexpiprazole dose to a quarter of the usual dose if a CYP3A4 inhibitor is also given with the CYP2D6 inhibitor.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine Contraindicated
Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Quinine?
MediHelp rates the interaction as moderate. Brexpiprazole and Quinine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Quinine inhibits CYP2D6, one of the main pathways that clears brexpiprazole, so brexpiprazole exposure can rise. The effect becomes larger if a CYP3A4 inhibitor is also being taken, and can increase adverse effects such as akathisia, sedation and orthostasis.
How serious is the interaction between Brexpiprazole and Quinine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for brexpiprazole adverse effects and consider reducing its dose during quinine use. Reduce the brexpiprazole dose to a quarter of the usual dose if a CYP3A4 inhibitor is also given with the CYP2D6 inhibitor.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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