AREAS WHERE PARASITES ARE SENSITIVE TO QUININE : QUININE, 8 MG OF BASE PER KG THREE TIMES DAILY FOR 7 DAYS.
AREAS WHERE PARASITES ARE SENSITIVE TO BOTH SULFA DRUG-PYRIMETHAMINE AND QUININE, AND WHERE ADHERENCE MAY BE A PROBLEM : QUININE, 8 MG OF BASE PER KG THREE TIMES DAILY FOR 3 DAYS PLUS SULFADOXINE 1500 MG OR SULFALENE 1500 MG PLUS PYRIMETHAMINE 75 MG GIVEN ON THE FIRST DAY OF QUININE TREATMENT.
AREAS WITH MARKED DECREASE IN SUSCEPTIBILITY OF P. FALCIPARUM TO QUININE : QUININE 8 MG OF BASE PER KG THREE TIMES DAILY FOR 7 DAYS PLUS DOXYCYCLINE 100 MG OF SALT DAILY FOR 7 DAYS (NOT IN CHILDREN BELOW 8 YEARS OF AGE AND NOT DURING PREGNANCY); A PHARMACOLOGICALLY SUPERIOR REGIMEN WOULD INCLUDE A LOADING DOSE OF 200 MG OF DOXYCYCLINE FOLLOWED BY 100 MG DAILY FOR 6 DAYS. OR TETRACYCLINE 250 MG FOUR TIMES DAILY FOR 7 DAYS (NOT IN CHILDREN BELOW 8 YEARS OF AGE AND NOT IN PREGNANCY). OR CLINDAMYCIN 300 MG FOUR TIMES DAILY FOR 5 DAYS (NOT CONTRAINDICATED IN CHILDREN AND PREGNANCY).
INTRAVENOUS ADMINISTRATION : AN INITIAL DOSE OF 16.4 MG (EQUIVALENT TO 20 MG OF DIHYDROCHLORIDE)/KG IS INFUSED OVER 4 HOURS FOLLOWED BY 8.2 MG (EQUIVALENT TO 10 MG OF DIHYDROCHLORIDE) /KG EVERY 8 HOURS IN ADULTS AND EVERY 12 HOURS IN CHILDREN. THE INITIAL DOSE SHOULD BE HALVED IF THE PATIENT HAS RECEIVED QUININE, QUINIDINE OR MEFLOQUINE DURING THE PREVIOUS 12 - 24 HOURS. THE MAINTENANCE DOSE SHOULD BE REDUCED THREEFOLD IN PATIENTS WITH IMPAIRED RENAL FUNCTION.
WHERE FACILITIES FOR I.V. INFUSION DO NOT EXIST, QUININE I.M. CAN BE ADMINISTERED IN THE SAME DOSAGE. THE REQUIRED DOSE SHOULD BE DIVIDED EQUALLY BETWEEN TWO SITES, ONE IN EACH ANTERIOR THIGH. WHENEVER PARENTERAL QUININE IS USED, ORAL TREATMENT SHOULD BE RESUMED AS SOON AS THE PATIENT IS ABLE TO TAKE IT, AND CONTINUED FOR THE COMPLETION OF THE COURSE.