Drug interactions
Quinine + Ranolazine
Severity: Major
Quinine and Ranolazine: major 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
Ranolazine prolongs the QT interval in a dose-related way, and quinine adds to this effect. Quinine may also inhibit CYP3A4 and P-gp, increasing ranolazine exposure.
What this interaction means in plain words
Quinine and Ranolazine 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.
Quinine belongs to Anti Parasitic; Ranolazine belongs to Cardiovascular.
Why it happens
Additive QT prolongation, with quinine inhibition of CYP3A4 and P-glycoprotein raising ranolazine levels.
What to do
Avoid if possible; if used together, monitor ECG and electrolytes and limit ranolazine to the lowest effective dose.
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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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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Frequently asked questions
Can I take Quinine with Ranolazine?
MediHelp rates the interaction as major. Quinine and Ranolazine 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. Ranolazine prolongs the QT interval in a dose-related way, and quinine adds to this effect. Quinine may also inhibit CYP3A4 and P-gp, increasing ranolazine exposure.
How serious is the interaction between Quinine and Ranolazine?
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 if possible; if used together, monitor ECG and electrolytes and limit ranolazine to the lowest effective dose.
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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