Kininesulfaat 3x 250 mg per dag (gedurende 3 weken). Is dit geen te hoge dosis?

Aangezien er geen indicatie gekend is en er in de literatuur nog hogere dossissen beschreven staan, lijkt dit geen ongewone dosering.

Martindale beschrijft:

“Quinine is given as a number of salts and 100 mg of anhydrous quinine is equivalent to about: […] 121 mg of quinine sulfate.
[…]
A course of treatment with quinine for falciparum malaria usually lasts 7 days and in uncomplicated infections treatment should preferably be given by the oral route. The usual oral dose is 600 mg of quinine salt given every 8 hours for 7 days. For children, a dose of 10 mg of quinine salt per kg body-weight given every 8 hours for 7 days is recommended.
[…]
When used for the relief of nocturnal leg cramps, quinine is given at night in an oral dose of 200 to 300 mg of the sulfate or bisulfate”

Kan kininesulfaat vervangen worden door kininehydrochloride?

De mogelijkheid om de één door de ander te vervangen hangt af van de indicatie.

De Martindale beschrijft:

“Quinine has mild analgesic and antipyretic properties and is sometimes included in preparations used for the symptomatic relief of the common cold and influenza; additional salts that have been used for this purpose include the camsilate and the gluconate.

Quinine is used as several salts and 100 mg of anhydrous quinine is equivalent to about:
– 169 mg of quinine bisulfate
– 122 mg of quinine dihydrochloride
– 122 mg of quinine etabonate
– 130 mg of quinine hydrobromide
– 122 mg of quinine hydrochloride
– 121 mg of quinine sulfate

For the treatment of malaria quinine is given orally, usually as the sulfate, hydrochloride, or dihydrochloride, or parenterally as the dihydrochloride; quinine etabonate is sometimes used orally because unlike other quinine salts, which are intensely bitter, it is tasteless. They all contain about the same amount of quinine and any of them can be used when the dose is cited in terms of “quinine salt”; this is not the case for the bisulfate, which contains a correspondingly smaller amount of quinine. Quinine formate is sometimes given parenterally.
A course of treatment with quinine for falciparum malaria usually lasts 7 days and is accompanied by follow-on treatment with clindamycin, tetracycline, or doxycycline; in uncomplicated infections treatment should preferably be given by the oral route. The usual oral dose is 600 mg of quinine salt given every 8 hours for 7 days.

When used for the relief of nocturnal leg cramps, quinine is given at night in an oral dose of 200 to 300 mg of the sulfate or bisulfate. Quinine benzoate has also been used.”