Quinine for malaria

Date: November 2024, Version 4

Quick take

Quinine can be used in pregnancy if a doctor thinks it is the best option to treat malaria.

What is it?

Quinine is an antimalarial drug. It may be recommended to treat malaria in people who have caught the infection.

Benefits

What are the benefits of using quinine in pregnancy?

Quinine can treat malaria and tends to be used when other drugs are not suitable. This is important as malaria infection can be life-threatening and has been linked to stillbirth, preterm delivery, low infant birth weight, and death of the baby after birth.

Risks

What are the risks of using quinine in pregnancy?

Quinine use in later pregnancy has been linked to low blood sugar in the mother. It is also thought that it can stimulate contractions of the womb in some women.

Because malaria is life-threatening for both the woman and her baby, if quinine is needed because other drugs will not work, it should not be avoided just because a woman is pregnant.

Alternatives

Are there any alternatives to using quinine in pregnancy?

Possibly. Other antimalarial medicines are available. However, if quinine is recommended, this is because it is the best option to treat a malaria infection.

If you are pregnant or planning a pregnancy and need to travel, please speak to your GP or local travel clinic to find out which antimalarial medicine is best.

No treatment

What if I prefer not to take quinine during pregnancy?

If possible, you should avoid travelling to areas with malaria during pregnancy. If travel is essential, you will need to take an antimalarial drug to prevent you from catching malaria. Your GP or travel clinic will be able to advise you on which medicine is suitable for the area you are visiting.

As well as taking antimalarial medicines, you should avoid mosquito bites by taking appropriate measures, such as wearing a DEET-based insect repellent, covering up bare skin with clothing as much as possible, avoiding being outdoors at dawn and dusk when mosquitos are most active, and using bed nets which have been treated with insect repellent.

Will I or my baby need extra monitoring?

As part of routine antenatal care in the UK, women are invited for a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. No further scans to check for birth defects will be required due to use of quinine, although women who have had a malaria infection in pregnancy will be offered extra monitoring of the baby’s growth and wellbeing.

Are there any risks to my baby if the father has used quinine?

There is currently no evidence that quinine used by the father can harm your baby through effects on the sperm.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.