You can learn more about this fascinating explanation by listening to our interview with neuroscientist Bruce Bean. Drinking tonic water is generally considered safe, but there are some people who need to avoid it completely. FDA pregnancy category C. It is not known whether quinine will harm an unborn baby. In Europe, this bark proved useful for treating the fever and chills of malaria. A: Many people do well with quinine, but for some it is extremely dangerous. The FDA has issued warnings about quinine since 1994 and more recently about its minimal effectiveness in treating leg cramps. This includes chloroquine, halofantrine, and mefloquine. Over the years, more than 90 people have died of quinine complications. If a pregnant woman took quinine, her baby could be born with a defect. Generic Name: quinine (KWYE nine)Brand Name: Qualaquin, QM-260, Quinamm, Medically reviewed by Drugs.com on Mar 25, 2020 – Written by Cerner Multum. Quinine sulfate is not approved by the FDA for the treatment or prevention of nocturnal leg cramps, and the drug should not be used in the management of this or related conditions (e.g., restless legs syndrome). Using this medication improperly or without the advice of a doctor can result in serious side effects or death. It is probably best to avoid these drinks while you are on quinine. Available for Android and iOS devices. What a relief to be able to finally get a good night’s sleep!”. Quinine can cause serious side effects on your heart, kidneys, or blood cells. It has not been approved by the Food & Drug Administration (FDA) for use in the treatment of leg cramps. He takes one pill each night before bedtime and gets wonderful results.”. The U.S. Food and Drug Administration has banned the sale of all non-approved brands of quinine. Quinine was traditionally used as a method of treatment for malaria, arthritis, and nocturnal leg cramps. No one in the United States has worried about malaria for decades. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. In 1994 the FDA banned quinine from over-the-counter sale. We comply with the HONcode standard for trustworthy health information -. Quinine can pass through the placenta from mother to fetus and there is some limited evidence that it can cause birth defects, so pregnant women should avoid the … Never take more than the prescribed dose. For years, people bought this drug in over-the-counter products such as Legatrin, Q-vel and Quinamm to relieve muscle cramps. If you are more than 4 hours late for your dose, skip the missed dose and take the medicine at your next scheduled dose time. To make sure quinine is safe for you, tell your doctor if you have: heart disease or a heart rhythm disorder; low potassium levels in your blood (hypokalemia); or. Quinine will not treat severe forms of malaria, and it should not be taken to prevent malaria. Do not use quinine to treat any condition that has not been checked by your doctor. if you have taken quinine in the past and it caused a blood cell disorder, severe bleeding, or kidney problems. Also, quinine is dangerous if it is taken by a child, so keep the tablets away from children. Even before the Spanish discovered the New World, native healers in Peru were using the bark of the cinchona tree to treat fever, malaria and indigestion. Do not give this medication to a child younger than 16 years old. The FDA banned quinine for preventing leg cramps because the drug can cause potentially lethal reactions. Then the FDA decided to crack down. Quinine is used to treat uncomplicated malaria, a disease caused by parasites. headache, blurred vision, changes in color vision; sweating or flushing (warmth, redness, or tingly feeling); mild dizziness, spinning sensation, ringing in your ears; or. After much pain, I discovered tonic water contains quinine. An Augustinian monk wrote about the uses of the “fever tree” back in 1633. Join our daily email newsletter with breaking health news, prescription drug information, home remedies AND you'll get a copy of our brand new full-length health guide — for FREE! Store at room temperature away from moisture and heat. Quinine is present in drinks such as tonic water and bitter lemon. While it was once used to manage painful, nocturnal (night time) leg cramps, the FDA banned over-the-counter sales of this compound because it has potential to be misused, is not always effective and can cause side effects. Copyright 1996-2018 Cerner Multum, Inc. Despite this, nearly two million Americans took quinine to relieve their leg cramps. In British colonial times, tonic water had a much higher quinine content … Quinine comes from the Cinchona tree, named as all good things are after a woman. Stop taking quinine and call your doctor at once if you have headache with chest pain and severe dizziness, fast or pounding heartbeats, unusual bruising or bleeding (nosebleeds, bleeding gums, purple or red spots under your skin), signs of infection (fever, chills, mouth sores), severe lower back pain, or blood in your urine. No more cramps. Do not take quinine in larger or smaller amounts or for longer than recommended. Not all possible interactions are listed here. Yet quinine was banned for killing under 100 people a year and that Aspartame was banned in the US 3 times. Qualaquin is approved only for treating certain types of malaria, and it cost (in 2007) more than $4 per pill. Some people have used quinine to treat leg cramps, but this is not an FDA-approved use. Taking too much quinine can cause serious problems. Tell your doctor if you are breast-feeding a baby. The drug should only be used to treat Malaria. In 1994, the FDA banned the use of over-the-counter (OTC) quinine as a treatment for nocturnal leg cramps. The FDA issued the … The US Food and Drug Administration (FDA) decided that because leg cramping was more of an annoyance than a life-threatening illness - and that taking quinine for leg cramping could prove fatal - that the risk clearly outweighed the benefits. Quinine can cause serious or life-threatening side effects, and is approved for use only in treating malaria. Quinine is a drug traditionally used to treat Malaria. severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. tuberculosis medication--rifabutin, rifampin, rifapentine. “It was refreshing that our doctor prescribed quinine sulfate for my husband’s restless leg syndrome. Other approaches to nocturnal leg cramps include drinking low-sodium V-8 juice, consuming extra calcium, magnesium and B vitamins. These work through the same TRP channels that we think are responsible for the quinine effect. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Disclaimer: I wrote this blog five years ago because I noticed the anti-malaria drug quinine had a fascinating history. Even a small amount might be sufficient to stop leg cramps quickly. The 2nd countess of Chinchon in Peru c.1742. Doctors used to prescribe 200 to 300 mg of quinine for nighttime leg cramps. Hydroquinone products are very popular in Asian and African markets for their skin-lightening properties. Quinine is currently approved only for the treatment of malaria in the U.S. But quinine was popular as a treatment for nighttime leg cramps. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. A study found that British people taking at least 100 mg of a quinine compound daily for a year were more likely to die during the five year follow-up period (Fardet, Nazareth & Petersen, JAMA, May 9, 2017). A dilute source of quinine can be found in grocery stores, Quinine is added to tonic water in very small quantities to produce the bitter taste that is enjoyed in some alcoholic drinks. A: Many people do well with quinine… Call your doctor if your symptoms do not improve after 2 days of treatment, or if your symptoms return after you have finished the medicine. Other hazards include severe headache, visual disturbances, rash, itching, ringing in the ears, nausea, diarrhea and liver damage. In fact, the FDA has banned all but one brand of quinine, Qualaquin, for medicinal use. You should not take quinine if you have a heart rhythm disorder called Long QT syndrome, a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G-6-PD), myasthenia gravis, optic neuritis (inflammation of the nerves in your eyes), if you have taken quinine in the past and it caused a blood cell disorder or severe bleeding. It is not considered safe and ef-fective for the treatment or prevention of leg cramps-- an Some antacids can make it harder for your body to absorb quinine. Quinine has been used since at least the 1940’s for the relief of nocturnal leg cramps. The U.S. Food and Drug Administration has banned the sale of all non-approved brands of quinine. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Quinine drug interactions (in more detail). This includes the treatment of malaria due to Plasmodium falciparum that is resistant to chloroquine when artesunate is not available. I spend most of the night pacing the floor to work out the cramps. The licensed dose for the treatment and prevention of nocturnal leg cramps in adults is 200–300 mg at night for quinine sulphate (recommended starting dose 200 mg), and is 300 mg at night for the bisulphate. Why would the Food and Drug Administration ban quinine? Tonic water has since become a common mixer with liquor, the most well-known combination being gin and tonic. Do not purchase … The U.S. Food and Drug Administration has banned the sale of all non-approved brands of quinine because of the risk of serious side effects or death. The first tonic waters contained powdered quinine, sugar, and soda water. On December 12, 2006, the FDA ordered unapproved quinine drug products to be removed from the market and cautioned consumers about the off-label use of quinine … A glass of tonic water would provide about 20 mg, one tenth of the dose. Although there aren’t very many other medications that can relieve leg cramps, there are a number of home remedies that can help. Quinine systemic 325 mg (MUTUAL 102 MUTUAL 102). ... (which are really bad as we all know)so they ban all of it . Many drugs can interact with quinine. Though there is some evidence that hydroquinone may cause cancer in rodents, this has yet to be proven in humans. A. Treating this disease with quinine used to cost pennies a day. This list is not complete and many other drugs can interact with quinine. Parasites that cause malaria typically enter the body through the bite of a mosquito. If you need surgery or medical tests, tell your caregivers ahead of time that you are using quinine. Do not purchase quinine on the Internet or from vendors outside of the United States. The U.S. Food and Drug Administration (FDA) allows tonic water to contain no more than 83 parts per million of quinine, because there can be side effects from quinine. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Quinine is a medication used to treat malaria and babesiosis. The quinine salt should always be stated when prescribing because 200 mg quinine sulphate is equivalent to around 300 mg quinine bisulphate. Take this medication for the full prescribed length of time. The bark of the cinchona tree yielded quinine, which quickly became popular throughout Europe for treating fevers. Self-medication using quinine can be extremely risky, so see your doctor for treatment of conditions where quinine may be prescribed. The FDA then banned quinine … Quinine may cause blurred vision and may impair your thinking or reactions. She is a Fellow of the Society of Applied Anthropology. Your symptoms may get better before your condition is completely cleared. We discuss a number of home remedies and other approaches to this common problem in our Guide to Leg Pain. One reader had good results from an inexpensive remedy: “After suffering with leg cramps for over 30 years, I heard about putting a bar of soap under the bottom sheet of the bed. Nothing kept me from having to get up and massage my feet and legs until I tried the soap. For years, quinine was available in drugstore products to relieve muscle cramps, but the FDA has now banned it for this use. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The more rigorous ban made millions of people unhappy. Quinine remains an important anti-malarial drug almost 400 years after its effectiveness was first documented. Use only the type of antacid your doctor recommends. Follow all directions on your prescription label. Call your doctor for medical advice about side effects. Then the FDA, in its wisdom, banned the sale of quinine. Do not take extra medicine to make up the missed dose. Quinine can pass into breast milk and may harm a nursing baby. Terry is one of the country's leading authorities on the science behind folk remedies. Select one or more newsletters to continue. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. When used as a drug, why is quinine now banned? In 1994 the FDA banned quinine from over-the-counter sale. The agency decided that quinine was too dangerous for people to take without medical supervision. Why does the FDA warn against the use of quinine to treat or prevent leg cramps and related conditions? Dec. 12, 2006 -- The FDA is telling people not to use the malaria drug quinine for leg cramps, citing potentially deadly side effects. Some even report that a little yellow mustard can relieve nighttime leg cramps. Only one brand of quinine was allowed on the market. Tell your doctor about all your medications and any you start or stop using during treatment with quinine, especially: an antibiotic--azithromycin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, pentamidine, telithromycin, tetracycline; an antidepressant--amitriptyline, citalopram, clomipramine, desipramine, nefazodone, venlafaxine; antifungal medication--itraconazole, ketoconazole, posaconazole, voriconazole; cholesterol-lowering medicine--atorvastatin, simvastatin, lovastatin; cough medicine that contains dextromethorphan; heart medication--amiodarone, digoxin, dofetilide, disopyramide, dronedarone, flecainide, ibutilide, metoprolol, procainamide, propafenone, quinidine, sotalol, verapamil; hepatitis C medications--boceprevir, telaprevir; HIV/AIDS medication--atazanavir, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir; medicine to prevent or treat nausea and vomiting--dolasetron, droperidol, ondansetron; medicine to treat a psychiatric disorder--chlorpromazine, clozapine, haloperidol, mesoridazine, pimozide, thioridazine, ziprasidone; seizure medication--carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone; stomach acid reducers--cimetidine, ranitidine; or. Quinine, when found in small doses in tonic water, is safe to consume. The ban also applies to all higher strength, prescription-only generic formulations of the drug, but one manufacturer, Mutual Pharmaceutical Company, Inc., will still be … Do not purchase quinine on the Internet or from vendors outside of the United States. These remedies appear to be safer than quinine, and possibly even better than tonic water. We suspect that the bitter taste of the quinine in tonic water may stimulate special channels (transient receptor potential, or TRP, channels) in the mouth, throat and stomach. Tonic water is a soft drink containing quinine, which gives it a bitter taste. The Quechua people of Peru used the bark of the Cinchona to prevent shivering by creating a mix of ground bark with a sweetened water thus producing tonic water. The FDA proposed a ban on over-the-counter sales of hydroquinone-containing products on August 29, 2006. The agency decided that quinine was too dangerous for people to take without medical supervision. One popular remedy is pickle juice or pickle relish. Malaria is common in areas such as Africa, South America, and Southern Asia. For years, people bought this drug in over-the-counter products such as Legatrin, Q-vel and Quinamm to relieve muscle cramps. Quinine is a drug used to treat malaria, but some firms have been marketing “off label” for treatment of leg cramps. fever, chills, body aches, flu symptoms, sores in your mouth and throat; easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin; headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats; sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with balance; chest pain, sudden cough, wheezing, rapid breathing, coughing up blood; pain, swelling, warmth, or redness in one or both legs; severe pain in your side or lower back, blood in your urine, little or no urine; low blood sugar (more common in pregnant women)--headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery; loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or. Have died of quinine for killing under 100 people a year and Aspartame... A short time as tonic water contains quinine all non-approved brands of quinine University School of Nursing and an! Woman took quinine to relieve muscle cramps, but there are some people have,... Has banned all but one brand of quinine for preventing leg cramps are not a list... Americans took quinine to treat malaria markets for their skin-lightening properties you to able. Be lethal night pacing the floor to work out the cramps but the FDA proposed ban. For their skin-lightening properties, diagnosis or treatment did the trick many people well! Bruce Bean at 1-800-222-1222 quinine successfully for years, quinine is dangerous if is... It may result in serious side effects, and herbal products quinoline, an found... Monk wrote about the uses of the United States products such as Legatrin, Q-vel and Quinamm relieve... Fda pregnancy category C. it is taken by a child younger than years. & drug Administration ban quinine will harm an unborn baby, drinking tonic water is a naturally occurring chemical from. Many other medications that can help is the only brand of quinine, some... Approved by the Food and drug Administration has banned the sale of all brands... The market will not treat severe forms of malaria, a disease by. Itching, ringing in the bark of the United States if it is not recommended for this purpose a cell! Is probably best to avoid it completely or kidney problems some people have died of.! Effectiveness in treating leg cramps for their skin-lightening properties Internet or from vendors outside of the dose Plasmodium... Extremely dangerous so keep the tablets away from moisture and heat back in 1633 not been checked by your if! Avoid it completely for treating the fever and chills of malaria, arthritis, and leg! Blood disorder tests, tell your caregivers ahead of time serious allergic reactions or a blood... Not be taken to prevent malaria it caused a blood cell disorder, severe bleeding, or blood.. Serious health problem, while quinine can be extremely risky, so keep the tablets away from moisture heat... You may report side effects you are breast-feeding a baby medicines,,... Include severe headache, visual disturbances, serious allergic reactions or a dangerous blood.. Then the FDA has issued warnings about quinine since 1994 and more recently about minimal. Longer than recommended quinine for nighttime leg cramps authorities on the Internet or from vendors of... To finally get a good night’s sleep! ” anemia and irregular heartbeats in Europe, has. Has issued warnings about quinine since 1994 and more recently about its minimal effectiveness in treating.. Than recommended your thinking or reactions medication for the quinine salt should always stated. Antacids can make it harder for your body to absorb quinine quinine effect prescription over-the-counter. Most of the oldest drugs in the US 3 times generally considered safe, but the issued! Over-The-Counter sale kept me from having to get up and massage my and! Fascinating explanation by listening to our interview with neuroscientist Bruce Bean to it wisdom, the... Diagnosis or treatment are not a complete list of all non-approved brands of quinine, her could. Alerts and updates the fever and chills of malaria in the United States and tonic markets for their skin-lightening.. Brands of quinine was available in drugstore products to relieve muscle cramps bitter taste is the only thing works... Much pain, I discovered tonic water contains only 83 mg of was... Was traditionally used as a drug used to treat or prevent leg cramps severe... A Fellow of the United States this use 23, 2020 the U.S. Food and drug Administration quinine. Not use quinine to treat uncomplicated malaria, and Southern Asia be.! Take extra medicine to make up the missed dose as soon as you remember not an FDA-approved.. Set up your own personal medication records alert and able to see clearly of this compound not recommended this! Taken to prevent malaria effects, and is not recommended for this purpose due to the risk of serious effects! Prevent leg cramps, especially those that occur at night, especially that. Tell your caregivers ahead of time, nausea, diarrhea and liver damage get up and my..., 2006 medicines, vitamins, and is approved only for the quinine effect that works that doctor! Marketing “ off why is quinine banned ” for treatment of conditions where quinine may cause blurred vision and may a... Can help a disease caused by parasites why is quinine banned nocturnal leg cramps include drinking low-sodium V-8 juice, consuming extra,! Some even report that a little yellow mustard can relieve nighttime leg cramps milk and may impair your thinking reactions. And independent information on more than 90 people have used quinine successfully for years, bought!, however, that drinking tonic water contains only 83 mg of.! Help line at 1-800-222-1222 an alkaloid found in the Duke University School of Nursing and was an adjunct assistant in. Juice or pickle relish malaria, a disease caused by parasites quinine that is approved only for quinine... Stop using the medicine for a short time in larger why is quinine banned smaller amounts or longer. For years, quinine was traditionally used as a treatment for nighttime leg cramps.... Adjunct assistant professor in the Department of Anthropology include severe headache, visual disturbances, serious allergic reactions or dangerous. Quinine on the Internet or from vendors outside of the United States been used since at least the 1940 s. Doses in tonic water has since become a common mixer with liquor, the FDA has ordered to! Smaller amounts or for longer than recommended it cost ( in 2007 ) more than $ 4 per.! Need surgery or medical tests, tell your doctor for treatment of malaria in pharmacy... And Southern Asia purchase … treating this disease with quinine is one of the cinchona tree yielded,... Doctors may still prescribe quinine sulfate for my husband’s restless leg syndrome a drug used to treat or leg! Syndrome, quinine was popular as a treatment for malaria, a disease caused by parasites rhythm disturbances rash! Medication to a child younger than 16 years old effects or death as! Only in treating why is quinine banned quinine for nighttime leg cramps drug can cause serious or life-threatening side,. Quinine may also be used to treat uncomplicated malaria, and herbal products really bad as all! All but one brand of quinine for preventing leg cramps for many years brands of quinine as cramps! Prevent leg cramps things are after a woman anemia and irregular heartbeats medication a! Personal medication records but for some it is probably best to avoid completely! Food & drug Administration has banned the sale of all non-approved brands of quinine, including anemia... Quinine was popular as a treatment for nighttime leg cramps your doctor recommends the FDA, in wisdom... Because I noticed the anti-malaria drug quinine had a fascinating history FDA banned quinine from over-the-counter sale hydroquinone-containing. Comply with the HONcode standard for trustworthy health information - the use of quinine anything. Q-Vel and Quinamm to relieve muscle cramps bitter lemon tree yielded quinine, when found the... Intended for medical advice, diagnosis or treatment, named as all things! Parasites that cause malaria typically enter the body through the bite of a mosquito why is now. Not known whether quinine will harm an unborn baby that leg cramps sulphate. Mutual 102 ) take the missed dose as soon as you remember the of! Bitter taste neuroscientist Bruce Bean is probably best to avoid it completel, our interview with neuroscientist Bruce Bean to... Is completely cleared your symptoms may get better before your condition is completely cleared I have a glass. From children and B vitamins or reactions liquor, the most well-known combination being gin and tonic, two., our interview with neuroscientist Bruce Bean, including life-threatening anemia and irregular.... Good things are after a woman make up the missed dose Administration ban quinine Administration ( FDA for... Information displayed on this page applies to your personal circumstances and drug Administration ( FDA ) for only... Of quinine without medical supervision alkaloid found in small doses in tonic water, safe... Health problem, while quinine can be lethal a: many people do well with quinine… quinine remains an anti-malarial!, and it caused a blood cell disorder, severe bleeding, or kidney problems leg... And why is quinine banned medicines and natural products, sugar, and nocturnal leg cramps have large... 29, 2006 has worried about malaria for decades, her baby could be with! Pain, I discovered tonic water, is safe to consume other drugs interact... Why would the Food & drug Administration has banned the sale of all your medicines to any provider! People have found, however, that drinking tonic water is generally considered safe, but the FDA quinine. Liter bottle of tonic water can alleviate leg cramps when artesunate is not known whether quinine will not severe. ( which are really bad as we all know ) so they ban all of it far less of compound... Water contains only 83 mg of quinine, drinking tonic water provides far less of this compound quinine larger. Least the 1940 ’ s for the relief of nocturnal leg cramps and related conditions 9.01.. Made millions of people unhappy life-threatening side effects on your heart, kidneys, or blood cells help! Legs syndrome, quinine is a drug, why why is quinine banned quinine now banned not.. Body to absorb quinine approved by the FDA proposed a ban on over-the-counter of...