TRA-QUININE SYRUP

Each 5 ml contains:
Quinine sulphate 50mg
Read all of this leaflet carefully before you take this medicine.
• Keep this leaflet. You many need to read it again.
• If you have further question, please ask your Pharmacist or your Doctor.
• This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

In this leaflet:

1. What Tra-quinine syrup is and what it is used for:
2. Precautions and warning before you take Tra-quinine syrup
3. How to take Tra-quinine syrup
4. Possible side effects.
5. Symptoms and treatment of over dosage
6. How to store Tra-quinine syrup
7. Further information

1. WHAT TRA-QUININE SYRUP IS AND WHAT IT IS USED FOR 
Tra-quinine syrup is a proprietary anti-malaria medicine containing Quinine sulphate as the active drug. Quinine sulphate is a cinchona alkaloid which works by intercalating into the malaria parasite’s DNA, disrupting its replication and transcription. It also depresses the parasite’s oxygen uptake and carbohydrate metabolism. It is active against Plasmodium falciparum, malariae, ovale, and vivax. 

2. PRECAUTIONS AND WARNING BEFORE YOU TAKE TRA-QUININE SYRUP  

Contraindication:
• Do not take Tra-quinine syrup if you are allergic (hypersensitive) to the active drug or any of the ingredients of Tra-quinine syrup
• You have G6PD deficiency, optic neuritis, tinnitus or history of blackwater fever or thrombocytopenic purpura from previous quinine ingestion. 

Pregnancy and lactation:
• Tra-quinine syrup can be used in the treatment of uncomplicated and severe malaria in pregnancy under supervision.

Take special care with Tra-quinine syrup:
• If you have arrhythmias or are taking it together with sodium bicarbonate.

Stop taking Tra-quinine syrup:
At the first sign of a rash, dizziness, or tinnitus (buzzing, ringing, or whistling, occurring without an external stimulus) and seek immediate medical attention.

Taking other Medicines:
• Please inform your Pharmacist or Doctor if you are taking or about to take any other medicine, including those obtained without a prescription.

3. HOW TO TAKE TRA-QUININE SYRUP  
• You should take your medicine exactly as your Doctor or Pharmacist directs you.
• The medicine should preferably be taken after meals. 
• Unless otherwise directed by your physician, recommended use of oral quinine is 10 mg/kg body weight 8 hourly for 3 days.

4. POSSIBLE SIDE EFFECT
Like all medicines, Tra-quinine syrup can cause side effects, although not everybody gets them. Seizures, confusion, syncope, vertigo, photophobia, tinnitus and hearing impairment (especially with overdose) have been reported. GI adverse effects like anorexia, vomiting and epigastric distress have been reported, so are haematologic effects like hemolytic anaemia, thrombocytopenia and agranulocytosis. Hypersensitivity reactions such as rash, fever, pruritus, flushing, facial edema, dyspnea and asthma have also been reported. 

Possible interactions with food and drugs
Aluminium containing antacids may delay or decrease absorption of quinine, while mefloquine may cause additive cardiac effects, hence should not be used together. There should be close monitoring for use with drugs such as acetazolamide, digitoxin, digoxin, neuromuscular blockers and warfarin. 

5. SYMPTOMS AND TREATMENT OF OVER DOSAGE 
Signs and symptoms of overdose include tinnitus, vertigo, blindness, apprehension, vomiting and seizures. Treatment includes gastric lavage followed by supportive measures like fluid and electrolyte replacement, artificial respiration and stabilization of blood pressure and renal function.

6. HOW TO STORE TRA-QUININE SYRUP
Keep your Medication out of reach and sight of children.  Keep it in the original package and store below 30oc. Check the expiry date on the package and do not use if product is expired. 

7. FURTHER INFORMATION
In addition to quinine sulphate, the other ingredients in Tra-quinine syrup are: sucrose, sorbitol, sodium carboxymethyl cellulose, saccharine, citric acid, ascorbic acid, methylparaben, propylparaben, sodium benzoate, ethanol, flavour and erythrosine red. 

Date of publication / review: Effective January, 2014, this publication is subject to review every two years and upon receipt of new product information.

Manufacturer:
Trade winds Chemist Limited 
PLT 9B BLK1, Ayigya industrial area
Kumasi