Drug interactions
Procainamide + Quinine
Severity: Major
Procainamide and Quinine: major interaction.
Last updated Sources: US FDA label
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
Both drugs prolong the QT interval, and procainamide can also compete with quinine for renal tubular secretion, raising quinine levels. This combination increases the risk of torsades de pointes.
What this interaction means in plain words
Procainamide and Quinine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive QT prolongation plus competition for renal cationic tubular secretion.
What to do
Avoid the combination where possible; if needed, monitor ECG continuously or frequently and check electrolytes. Consider procainamide levels and adjust doses.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Procainamide with Quinine?
MediHelp rates the interaction as major. Procainamide and Quinine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs prolong the QT interval, and procainamide can also compete with quinine for renal tubular secretion, raising quinine levels. This combination increases the risk of torsades de pointes.
How serious is the interaction between Procainamide and Quinine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible; if needed, monitor ECG continuously or frequently and check electrolytes. Consider procainamide levels and adjust doses.
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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