Quinine Rifampicin

Enzyme inhibitors, such as cimetidine and ketoconazole, increase the toxicity of quinine or quinidine (43), while enzyme inducers, such as rifampicin, reduce the toxic effects (44). 

Burgess K,Lopez A,GaudryLE, Chong BH Rifampicin-dependent antibodies bind a similar or identical epitope to glycoprotein IX-specific quinine-dependent antibodies. Blood 2000 95 1988-92. 

Wanwimolruk S, Kang W, Coville PF, Viriyayudhakon S, Thitiarchakul S. K ked enhancement by rifampicin and lack of effect of isoniazid on the elimination of quinine in man. BrJ CUnPharmacol( 995) 40,87-91. 

Rifampicin induces the metabolism of quinine, which may result in subtherapeutic quinine levels. 

A study in 9 healthy subjects found that the clearance of a single 600-mg dose of quinine sulfate was increased more than sixfold by pretreatment with rifampicin 600 mg daily for 2 weeks. The elimination half-life of quinine was decreased from about 11 hours to 5.5 hours. ... 

A report describes a patient with myotonia, controlled with quinine, whose symptoms worsened within 3 weeks of starting to take rifampicin for the treatment of tuberculosis. Peak quinine levels were found to be low, but rose again when the rifampicin was stopped. Control of the myotonia was regained 6 weeks later. ... 

Osborn JE, Pettit MJ, Graham P. Interaction between rifampicin and quinine case report. PharmJ 9Z9) 243, 704. 

Wanwimolruk S, Wong S-M, Zhang H, Coville PF, Walker RJ. Metabolism of quinine in man identification of a major metabolite, and effects of smoking and rifampicin pretreatment. J Pharm Pharmacol (1995) 47, 957-63. 

Besides ampicillin there are numerous other drugs which cause maculopapular eruptions. The drugs most frequently mentioned are other penicillins, streptomycin, rifampicin, sulfonamides, pyrazolidine derivatives (phenylbutazone), pyrazolones, barbiturates, tricyclic antidepressants, hydantoin derivatives, indomethacin, quinine, and meprobamate (Kauppinen 1972 Korting 1972 Louis and Schulz 1973 Schuppli 1972 Thiers et al. 1964). 

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