The treatment of quinine poisoning with charcoal haemoperfusion

Quinine poisoning is rare but serious. Attempts at treatment by active removal have proved unsuccessful because of its high degree of protein binding. We describe two cases of non-accidental overdose of quinine (19.5 g and 15 g) with potentially fatal serum quinine levels. Both patients were treated by 2 periods of charcoal haemoperfusion during which quinine clearances of up to 125 ml/min were obtained. Both patients recovered, though one had some residual visual disturbance. We suggest that in cases of quinine poisoning, charcoal haemoperfusion may be a safe and effective method of drug removal, to be used with stellate ganglion block.