Gomal Injection 300mg

About Gomal Injection 300mg

Gomal Injection Uses

• Severe and complicated Plasmodium falciparum malaria
• Cerebral malaria requiring urgent parenteral treatment
• Malaria in patients unable to take oral medicine due to vomiting
• Alternative antimalarial when artesunate injection is unavailable

Gomal Injection Benefits

• Rapidly lowers parasite levels in severe malaria
• Works quickly through intravenous or intramuscular routes
• Effective option in hospital settings when other antimalarials are not accessible
• Long established safety record in treating drug resistant malaria strains

What Experts Say

Quinine dihydrochloride is a cinchona alkaloid antimalarial that interferes with the malaria parasite's ability to detoxify heme released during hemoglobin breakdown inside infected red blood cells, causing a buildup of toxic byproducts that kill the parasite. It remains active against many Plasmodium falciparum strains resistant to older antimalarial drugs such as chloroquine.

World Health Organization guidance now prefers intravenous artesunate for severe malaria because large trials show it lowers mortality further than quinine, especially in children. Injectable quinine is still widely used across Pakistan when artesunate supply is limited, unavailable at a facility, or in situations such as early pregnancy where clinicians have long experience with quinine.

Because quinine strongly stimulates insulin release and can cause dangerous hypoglycemia, along with heart rhythm changes at high infusion rates, hospital protocols require slow controlled infusion, cardiac monitoring and regular blood glucose checks, particularly in children and pregnant women receiving this injection.

Drug Class

• Antimalarial, cinchona alkaloid class

Gomal Injection 300mg formula

• Quinine Dihydrochloride

Available forms

• Injection

How to use Gomal Injection 300mg?

• Administered only by a doctor or trained healthcare professional in a hospital setting
• Given as a slow intravenous infusion diluted in dextrose or saline, never as a rapid injection
• Can also be given by deep intramuscular injection when IV access is not possible
• Dose and infusion rate are calculated based on body weight
• Blood glucose, heart rhythm and blood pressure are monitored throughout treatment
• Treatment course is completed fully even after symptoms improve

Drug Interactions

• Mefloquine: Concurrent use increases the risk of seizures and heart rhythm disturbances, generally avoided
• Digoxin: Quinine raises digoxin blood levels, increasing toxicity risk
• QT prolonging drugs: Combining with certain antibiotics or antiarrhythmics raises the risk of dangerous heart rhythms
• Insulin and oral hypoglycemics: Combined use increases the risk of severe low blood sugar
• Warfarin: May enhance anticoagulant effect and increase bleeding risk
• Cimetidine: Slows quinine clearance and can raise blood levels

Risks and warnings

• Cinchonism: Can cause tinnitus, headache, nausea and blurred vision, usually reversible after stopping
• Hypoglycemia: Stimulates insulin release and can cause dangerously low blood sugar, especially in pregnant women and children
• Cardiac Risk: May prolong the QT interval and trigger irregular heartbeat if infused too quickly
• G6PD Deficiency: Can trigger severe hemolysis (blackwater fever) in patients with this enzyme deficiency
• Pregnancy: Used cautiously under close hospital supervision only when benefits outweigh risks
• Hypersensitivity: Avoid in patients with a known allergy to quinine or cinchona alkaloids

Gomal Injection Side Effects

• Ringing in the ears (tinnitus)
• Headache and dizziness
• Nausea and vomiting
• Blurred or disturbed vision
• Low blood sugar with sweating, shakiness or confusion
• Low blood pressure if infused too fast
• Irregular heartbeat or palpitations
• Pain, redness or swelling at the injection site
• Reduced platelet count with prolonged use
• Severe hemolysis and dark urine in G6PD deficient patients

Storage Conditions

• Store below 25°C, protected from light
• Keep ampoules in their original carton until use
• Do not freeze the injection solution
• Keep out of reach of children
• Discard any opened or unused ampoule after use, do not store partial doses