Pharmacokinetics in children

There is only a single pharmacokinetic study known in children. That study shows that the elimination half-life in children is 2.5-6.7 hours (N = 13, ages 4 to 22 years). The therapeutic plasma concentration is 2-5 mg/l.

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Conduction disorders, extension of the QTc interval, bradycardia, hypotension, gastrointestinal problems, hypersensitivity reaction (fever, vision disorders haematological abnormalities), tinnitus.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Adjust the dosage under ECG monitoring; have the serum levels measured if necessary. Hypokalaemia should be corrected beforehand. Because of the risk of hypersensitivity reactions, a test dose is often given first.

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

• CARDIOVASCULAR SYSTEM
• CARDIAC THERAPY

ANTIARRHYTHMICS, CLASS I AND III

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

References

1. Rademaker C.M.A. et al, Geneesmiddelen-Formularium voor Kinderen, 2007
2. Szefler SJ, et al., Rapid elimination of quinidine in pediatric patients., Pediatrics, 1982, 70, 370-5
3. Baruteau AE et al, Quinidine therapy in children affected by Brugada syndrome: are we far from a safe alternative? , Cardiol Young, 2009, Dec;19(6), 652-4
4. Mehrotra S et al., Successful use of quinine in the treatment of electrical storm in a child with Brugada syndrome, J Cardiovasc Electrophysiol, 2011, May;22(5), 594-7
5. NVK, Werkboek kinderhematologie, www.hematologienederland.nl/werkboek-kinderhematologie, Geraadpleegd 07 Aug 2015
6. Baruteau AE et al, Quinidine therapy in children affected by Brugada syndrome: are we far from a safe alternative?, Cardiol Young, 2009, Dec;19(6), 652-4

Changes

Therapeutic Drug Monitoring

Overdose