Drug interactions
Dabigatran + Quinine
Severity: Moderate
Dabigatran 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 intestinal P-glycoprotein, which can raise absorption of dabigatran etexilate and increase plasma dabigatran levels. Higher exposure raises the risk of bleeding, particularly with impaired renal function because dabigatran is mainly renally cleared.
What this interaction means in plain words
Dabigatran 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.
Why it happens
Quinine inhibits P-glycoprotein-mediated efflux of dabigatran etexilate in the gut, increasing its bioavailability.
What to do
Monitor for bleeding and check renal function. Avoid the combination when CrCl is below the labeled thresholds for P-gp inhibitors (below 30 mL/min for atrial fibrillation, below 50 mL/min for DVT/PE treatment).
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
Frequently asked questions
Can I take Dabigatran with Quinine?
MediHelp rates the interaction as moderate. Dabigatran 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 intestinal P-glycoprotein, which can raise absorption of dabigatran etexilate and increase plasma dabigatran levels. Higher exposure raises the risk of bleeding, particularly with impaired renal function because dabigatran is mainly renally cleared.
How serious is the interaction between Dabigatran 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 bleeding and check renal function. Avoid the combination when CrCl is below the labeled thresholds for P-gp inhibitors (below 30 mL/min for atrial fibrillation, below 50 mL/min for DVT/PE treatment).
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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