· The mechanism of action of quinine has not been fully resolved.The most widely accepted hypothesis of its action is based on the well-studied and closely related quinoline drug, chloroquine. This model involves the inhibition of hemozoin biocrystallization in Heme Detoxification pathway, which facilitates the aggregation of cytotoxic heme. It means it interfere with the parasite’s ability to digest haemoglobin and Free cytotoxic heme accumulates in the parasites, causing their deaths. ( Ref : Wikipedia).
Quinine accumulates in the lysosomes of the malarial parasites and interferes with essential processes ultimately leading to the death of the parasites. Quinine is effective in malaria caused by Plasmodium vivax, Plasmodium malariae and Plasmodium ovale. However, Plasmodium falciparum which causes cerebral malaria is resistant to this drug.