Drug Notebook

FDA Alerts

    Mortality
  • In many antiarrhythmic drug trials for non-life-threatening arrhythmias, active drug treatment was associated with increased mortality.
  • Risk of antiarrhythmic drug therapy probably is greatest in patients with structural heart disease.
  • Pooled analysis of data from several randomized, controlled studies in patients with atrial flutter and fibrillation indicates that quinidine therapy may be associated with a mortality rate 3 times higher compared with that associated with placebo; consider the increased risk of death when initiating quinidine therapy.
  • Pooled analysis of clinical trials showed mortality with quinidine for non-life-threatening ventricular arrhythmias as consistently exceeding that associated with various alternative antiarrhythmic drugs (i.e., flecainide, mexiletine, propafenone, tocainide).
  • Excessive mortality or nonfatal cardiac arrest rate (7.7%) in encainide- or flecainide-treated patients with asymptomatic non-life-threatening ventricular arrhythmias (with MI history >6 days but <2 years) in NHLBI's long-term CAST study relative to placebo.
  • Applicability of CAST findings to other populations (e.g., those without recent MI) uncertain.

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quinidine
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(KWIH nih deen)

What is the most important information I should know about quinidine?

Contact your doctor immediately if you experience ringing in the ears, changes in vision, dizziness, fainting, a rapid heartbeat, headache, nausea, a rash, or difficulty breathing.

Do not skip doses or change your dosing schedule without talking to your doctor. Changing your schedule could make your condition worse. Quinidine may be taken with food to lessen stomach upset. Do not crush, chew, or break any extended- or sustained-release formulations of quinidine. Swallow them whole. If you are not sure whether you have a long-acting form of quinidine, ask your pharmacist, nurse, or doctor.

What is quinidine?

Quinidine affects the way that the heart beats.

Quinidine is used to treat irregular heartbeat patterns.

Quinidine may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking quinidine?

Before taking quinidine, tell your doctor if you have

You may not be able to take quinidine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Quinidine is in the FDA pregnancy category C. This means that it is not known whether quinidine will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment. Quinidine passes into breast milk. It is not known whether quinidine will affect a nursing infant. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take quinidine?

Take quinidine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Quinidine may be taken with food to lessen stomach upset. Do not crush, chew, or break any extended- or sustained-release formulations of quinidine. Swallow them whole. If you are not sure whether you have a long-acting form of quinidine, ask your pharmacist, nurse, or doctor. Do not skip doses or change your dosing schedule without talking to your doctor. Changing your schedule could make your condition worse.

It is important to take quinidine regularly to get the most benefit.

Your doctor may want you to have blood tests or other medical evaluations during treatment with quinidine to monitor progress and side effects.

Grapefruit and grapefruit juice may interact with quinidine. The interaction could lead to potentially adverse effects. You should discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Store quinidine at room temperature away from moisture and heat.
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