Prescription medicine
Quinidine
Quinidine is a prescription medicine with an FDA approval on record since 1950. FDA's NDC Directory lists it from 4 generic labelers, and pharmacies paid $4.92 per quinidine gluc ER 324 mg tablet in the October 7, 2026 NADAC survey.
- Generic listed
- Boxed warning
Check it at the source: the quinidine FDA label on DailyMed (effective February 1, 2018, Sun Pharmaceutical Industries, Inc.); the NDA 7529 record on Drugs@FDA; every quinidine label on DailyMed.
Highlights of the record
FDA label of February 1, 2018; NDC Directory, Drugs@FDA and Orange Book, October 8, 2026; NADAC October 7, 2026
In many trials of antiarrhythmic therapy for non-life-threatening arrhythmias, active antiarrhythmic therapy has resulted in increased mortality; the risk of active therapy is probably greatest in patients with structural heart disease. In the case of quinidine used to prevent or defer recurrence of atrial flutter/fibrillation, the best available data come from a meta-analysis described under CLINICAL PHARMACOLOGY/Clinical Effects above. In the patients studied in the trials there analyzed, the mortality associated with the use of quinidine was more than three times as great as the mortality associated with the use of placebo. Another meta-analysis, also described under CLINICAL PHARMACOLOGY/Clinical Effects, showed that in patients with various non-life-threatening ventricular arrhythmias, the mortality associated with the use of quinidine was consistently greater than that associated with the use of any of a variety of alternative antiarrhythmics.
Used for
From the label: indications and usageConversion of atrial fibrillation/flutter In patients with symptomatic atrial fibrillation/flutter whose symptoms are not adequately controlled by measures that reduce the rate of ventricular response, quinidine gluconate is indicated as a means of restoring normal sinus rhythm.
Forms and strengths
- 200 mg
- 300 mg
- 324 mg
Extended-release tablet; tablet.
On the market
- Earliest approval on file
- July 12, 1950 Quinidine Gluconate, Lilly; Drugs@FDA’s file, where older or withdrawn approvals can be missing
- Generic approvals
- 38 first July 15, 1975; 3 with a marketed status in Drugs@FDA
- Labelers listed (NDC)
- 4 of which 4 under generic applications, 0 under brand applications, repackagers included
Supply and safety
- Pharmacy cost (NADAC)
- $4.92 per tablet Quinidine gluc ER 324 mg tablet
- Shortage (FDA)
- No current entry
- Recalls by its makers (FDA)
- 1 since 2013 0 Class I among all firms' recalls; latest July 2, 2013
- FAERS reports
- 208 through July 30, 2026
What is quinidine used for?
From the label: indications and usageConversion of atrial fibrillation/flutter In patients with symptomatic atrial fibrillation/flutter whose symptoms are not adequately controlled by measures that reduce the rate of ventricular response, quinidine gluconate is indicated as a means of restoring normal sinus rhythm. If this use of quinidine gluconate does not restore sinus rhythm within a reasonable time (see DOSAGE AND ADMINISTRATION ), then quinidine gluconate should be discontinued. […]
Conditions named in the indications of quinidine's FDA labels, with every medicine labeled for each:
From other quinidine labelsAtrial fibrillation: Reduction of frequency of relapse into atrial fibrillation/flutter Chronic therapy with quinidine gluconate is indicated for some patients at high risk of symptomatic atrial fibrillation/flutter, generally patients who have had previous …
FDA pharmacologic class: Antiarrhythmic and Cytochrome P450 2D6 Inhibitor.
Source: FDA drug label (Quinidine Gluconate), Sun Pharmaceutical Industries, Inc., effective February 1, 2018 (SPL set 5023f053-fcc4-4c2c-aa59-9ec198ad185e), via openFDA; the full label on DailyMed
Is there a generic for quinidine?
The FDA approved the first generic quinidine on July 15, 1975. 38 generic applications are approved; 3 of them carry a current (not discontinued) marketing status in Drugs@FDA; that status is not evidence that the generic is on sale.
FDA's NDC Directory lists quinidine from 4 labelers under a generic (ANDA) application. A listing means the company has registered the product for sale; it does not show that every pharmacy stocks it.
- 1950 earliest approval on file
- 1975 first generic approved
- red ticks recalls
Source: Drugs@FDA, FDA NDC Directory and the Orange Book (openFDA bulk files, October 8, 2026)
What do pharmacies pay for quinidine?
In CMS's NADAC survey of October 7, 2026, pharmacies paid $4.92 per Quinidine gluc ER 324 mg tablet, about the same as a year earlier. The chart's scale runs from the lowest to the highest price shown, not from zero. NADAC is what retail pharmacies paid their wholesalers, per unit, in CMS's monthly survey; what a patient pays depends on insurance and the pharmacy.
- Quinidine gluc ER 324 mg tablet (generic)
| Strength and form | Brand or generic | Pharmacy cost | 30 tablets, or one pen or vial | 12-month change |
|---|---|---|---|---|
| Quinidine gluc ER 324 mg tablet | Generic | $4.92 per tablet | $147.66 | +0.8% |
Source: CMS National Average Drug Acquisition Cost (NADAC) survey, October 7, 2026: what retail pharmacies paid per unit; not a counter price
Has quinidine been recalled?
The FDA's Enforcement Report lists 1 recall naming quinidine since 2013: 0 Class I (the most serious), 1 Class II, 0 Class III; 0 still ongoing. A recall names products and lots, not every product of the medicine.
| Started | Class | Company | Reason |
|---|---|---|---|
| July 2, 2013 | Class II | Aidapak Services, LLC | Labeling: Label Mixup:quiNIDine SULFATE, Tablet, 200 mg may have potentially been mislabeled as the following drug: QUINAPRIL, Tablet, 40 mg, NDC 31722027090 … |
Source: FDA Enforcement Report (drug recalls) via openFDA, through October 8, 2026
What does the quinidine label say about other medicines?
The quinidine label names 32 other medicines in its interaction, contraindication or warning sections. The labels of 40 other medicines name quinidine. The sentences are the labels' own; a label lists what its studies and reports found, not every interaction.
| Medicine named | Section | What the label says |
|---|---|---|
| Amiodarone | drug interactions | By pharmacokinetic mechanisms that are not well understood, quinidine levels are increased by coadministration of amiodarone or cimetidine. |
| Caffeine | drug interactions | Conversely, the pharmacokinetics of quinidine are not significantly affected by caffeine, ciprofloxacin, digoxin, felodipine, omeprazole, or quinine. |
| Cimetidine | drug interactions | By pharmacokinetic mechanisms that are not well understood, quinidine levels are increased by coadministration of amiodarone or cimetidine. |
| Ciprofloxacin | drug interactions | Conversely, the pharmacokinetics of quinidine are not significantly affected by caffeine, ciprofloxacin, digoxin, felodipine, omeprazole, or quinine. |
| Codeine | drug interactions | In the case of prodrugs whose actions are actually mediated by P450 IID6 -produced metabolites (for example, codeine and hydrocodone, whose analgesic and antitussive effects appear to be mediated by morphine and hydromorphone, respectively), it may not be possible to achieve the desired clinical benefits in poor … |
| Digoxin | drug interactions | Altered pharmacokinetics of other drugs: Quinidine slows the elimination of digoxin and simultaneously reduces digoxin's apparent volume of distribution. |
| Diltiazem | drug interactions | Drug and Diet Interactions Altered pharmacokinetics of quinidine: Diltiazem significantly decreases the clearance and increases the t 1/2 of quinidine, but quinidine does not alter the kinetics of diltiazem. |
| Felodipine | drug interactions | Interactions with other dihydropyridine calcium channel blockers have not been reported, but these agents (including felodipine, nicardipine, and nimodipine ) are all dependent upon P450 IIIA4 for metabolism, so similar interactions with quinidine should be anticipated. |
| Flecainide | drug interactions | Non-interactions of quinidine with other drugs: Quinidine has no clinically significant effect on the pharmacokinetics of diltiazem, flecainide, mephenytoin, metoprolol, propafenone, propranolol, quinine, timolol, or tocainide. |
| Haloperidol | drug interactions | Serum levels of haloperidol are increased when quinidine is coadministered. |
| Hydrocodone | drug interactions | In the case of prodrugs whose actions are actually mediated by P450 IID6 -produced metabolites (for example, codeine and hydrocodone, whose analgesic and antitussive effects appear to be mediated by morphine and hydromorphone, respectively), it may not be possible to achieve the desired clinical benefits in poor … |
| Hydromorphone | drug interactions | In the case of prodrugs whose actions are actually mediated by P450 IID6 -produced metabolites (for example, codeine and hydrocodone, whose analgesic and antitussive effects appear to be mediated by morphine and hydromorphone, respectively), it may not be possible to achieve the desired clinical benefits in poor … |
| Ketoconazole | drug interactions | Perhaps because of competition for the P450 IIIA4 metabolic pathway, quinidine levels rise when ketoconazole is coadministered. |
| Metoprolol | drug interactions | Non-interactions of quinidine with other drugs: Quinidine has no clinically significant effect on the pharmacokinetics of diltiazem, flecainide, mephenytoin, metoprolol, propafenone, propranolol, quinine, timolol, or tocainide. |
Every other medicine the quinidine label names
| Medicine named | Section | What the label says |
|---|---|---|
| Mexiletine | drug interactions | Cytochrome P450 IID6 is an enzyme critical to the metabolism of many drugs, notably including mexiletine, some phenothiazines, and most polycyclic antidepressants. |
| Morphine | drug interactions | … hydrocodone, whose analgesic and antitussive effects appear to be mediated by morphine and hydromorphone, respectively), it may not be possible to achieve the desired clinical benefits in poor … |
| Nicardipine | drug interactions | Interactions with other dihydropyridine calcium channel blockers have not been reported, but these agents (including felodipine, nicardipine, and nimodipine ) are all dependent upon P450 IIIA4 for … |
| Nifedipine | drug interactions | Very rarely, and again by mechanisms not understood, quinidine levels are decreased by coadministration of nifedipine. |
| Nimodipine | drug interactions | Interactions with other dihydropyridine calcium channel blockers have not been reported, but these agents (including felodipine, nicardipine, and nimodipine ) are all dependent upon P450 IIIA4 for … |
| Omeprazole | drug interactions | Conversely, the pharmacokinetics of quinidine are not significantly affected by caffeine, ciprofloxacin, digoxin, felodipine, omeprazole, or quinine. |
| Phenobarbital | drug interactions | Hepatic elimination of quinidine may be accelerated by coadministration of drugs ( phenobarbital, phenytoin, rifampin ) that induce production of cytochrome P450 IIIA4 . |
| Phenytoin | drug interactions | Hepatic elimination of quinidine may be accelerated by coadministration of drugs ( phenobarbital, phenytoin, rifampin ) that induce production of cytochrome P450 IIIA4 . |
| Procainamide | drug interactions | Perhaps by competing for pathways of renal clearance, coadministration of quinidine causes an increase in serum levels of procainamide. |
| Propafenone | drug interactions | … pharmacokinetics of diltiazem, flecainide, mephenytoin, metoprolol, propafenone, propranolol, quinine, timolol, or tocainide. |
| Propranolol | drug interactions | Coadministration of propranolol usually does not affect quinidine pharmacokinetics, but in some studies the β-blocker appeared to cause increases in the peak serum levels of quinidine, decreases in … |
| Quinine | contraindications | … developed thrombocytopenic purpura during prior therapy with quinidine or quinine (see WARNINGS ). |
| Rifampin | drug interactions | Hepatic elimination of quinidine may be accelerated by coadministration of drugs ( phenobarbital, phenytoin, rifampin ) that induce production of cytochrome P450 IIIA4 . |
| Sodium bicarbonate | drug interactions | Drugs that alkalinize the urine ( carbonic-anhydrase inhibitors, sodium bicarbonate, thiazide diuretics ) reduce renal elimination of quinidine. |
| Succinylcholine | drug interactions | Quinidine potentiates the actions of depolarizing (succinylcholine, decamethonium) and non-depolarizing ( d -tubocurarine, pancuronium) neuromuscular blocking agents. |
| Timolol | drug interactions | … flecainide, mephenytoin, metoprolol, propafenone, propranolol, quinine, timolol, or tocainide. |
| Verapamil | drug interactions | Hepatic clearance of quinidine is significantly reduced during coadministration of verapamil, with corresponding increases in serum levels and half-life. |
| Warfarin | drug interactions | By a mechanism that is not understood, quinidine potentiates the anticoagulatory action of warfarin, and the anticoagulant dosage may need to be reduced. |
Other labels that name quinidine
- Afatinib
- Amantadine
- Amitriptyline
- Aripiprazole
- Aripiprazole lauroxil
- Artemether and lumefantrine
- Asenapine
- Atazanavir
- Atomoxetine
- Azithromycin
- Carvedilol
- Cisatracurium
- Citalopram
- Clarithromycin
- Clomipramine
- Clozapine
- Cobicistat
- Dabigatran
- Darifenacin
- Darunavir
- Deferasirox
- Desipramine
- Deutetrabenazine
- Diazepam
- Dicyclomine
- Disopyramide
- Donepezil and memantine
- Doxepin
- Eliglustat
- Ensitrelvir
- Enzalutamide
- Ephedrine
- Epinephrine
- Erythromycin
- Etrasimod arginine
- Etravirine
- Ferric oxyhydroxide
- Fluconazole
- Fluoxetine
- Fluvoxamine
- Fosamprenavir
- Foscarnet
- Iloperidone
- Imipramine
- Itraconazole
- Lanreotide
- Letermovir
- Levofloxacin
- Lidocaine
- Loperamide
- Macimorelin
- Mefloquine
- Metoclopramide
- Metronidazole
- Mifepristone
- Milsaperidone
- Moxifloxacin
- Naldemedine
- Naloxegol
- Nebivolol
- Nelfinavir
- Nisoldipine
- Nortriptyline
- Octreotide
- Oliceridine
- Ozanimod
- Palbociclib
- Paliperidone
- Paroxetine
- Pimavanserin
- Pimozide
- Ponesimod
- Posaconazole
- Prazosin
- Rimegepant
- Ritonavir
- Rocuronium
- Sertraline
- Siponimod
- Sotalol
- Stiripentol
- Sucralfate
- Tetrabenazine
- Tolterodine
- Toremifene
- Tramadol
- Trazodone
- Trimipramine
- Ubrogepant
- Vardenafil
- Voriconazole
- Ziprasidone
Source: FDA drug label (Quinidine Gluconate), Sun Pharmaceutical Industries, Inc., effective February 1, 2018 (SPL set 5023f053-fcc4-4c2c-aa59-9ec198ad185e), via openFDA; the full label on DailyMed
What do FAERS reports show for quinidine?
The FDA Adverse Event Reporting System holds 208 reports that list quinidine among the medicines taken, through July 30, 2026, each a report of something that happened, not proof the medicine caused it; 18 are coded as a death and 75 as a hospital stay. Counts follow how widely a medicine is used and watched, and they are not a measure of how risky it is.
The most reported reactions
Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026
What else is labeled for the same conditions as quinidine?
3 other medicines are given the same way (oral) and in the same FDA class as quinidine or labeled mainly for the same use (atrial fibrillation), the same class first. Atrial fibrillation lists all 17 medicines labeled for it, by any route. They are listed as records, not as substitutes: whether one can replace another is a prescriber's decision.
| Medicine | Shared indication | Generic labelers (oral) | Pharmacy cost | Shortage |
|---|---|---|---|---|
| Sotalol | Atrial fibrillation | 18 labelers | $0.0707 per tablet 80 mg tablet | No current entry |
| Propafenone | Atrial fibrillation | 14 labelers | $0.115 per tablet 150 mg tablet | No current entry |
| Dofetilide | Atrial fibrillation | 12 labelers | $0.203 per capsule 125 mcg capsule | No current entry |
Source: FDA drug labels (indications), NDC Directory, NADAC of October 7, 2026, FDA shortages (October 8, 2026)
What next?
- Alternatives to quinidine
- 3 medicines for the same use
- Other antiarrhythmics
- the pharmacologic class, with prices and generics
- Quinidine side effects
- the label's list beside FAERS reports
- Check an interaction
- what two or more labels say about each other