Warfarin Institute of America
Dedicated To Your Health
INTERACTION WITH QUININE
I have been unable to find any report of anyone experiencing any harm from this interaction. These are both very old medications. I suspect that if there was any serious interaction it would have been reported many times by now.
Here is a report from one patient that I saw. This is probably a fairly typical case. The patient had been on a steady dose of warfarin for several months. She complained of leg cramps, and her physician prescribed quinine. At the next visit, her INR was 3.6. I have been monitoring this lady for about three years. I knew that she seldom takes anything for more than a few doses before she becomes upset and stops the new drug. At the next visit, she reported that she had worried about the INR being 3.6 and decided that she could tolerate the leg cramps. She stopped the quinine and her INR returned to 2.7. Her warfarin dose remained unchanged.
If you are taking warfarin and start quinine and the INR increases, you might consider this as a possible cause. Most people will not take the quinine every night, so the INR may fluctuate.
On the basis of published reports and my experience, I see no reason to avoid this combination.
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Last updated November 20, 2004