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Quinine is one of the oldest drugs in the pharmacy. 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. An Augustinian monk wrote about the uses of the “fever tree” back in 1633.
In Europe, this bark proved useful for treating the fever and chills of malaria. Chemists later determined that the active ingredient in this healing bark was quinine, and it was used around the world wherever mosquitoes carried the disease. The British even incorporated it into their “tonic water.”
No one in the United States has worried about malaria for decades. But quinine was popular as a treatment for nighttime leg cramps. For years, people bought this drug in over-the-counter products such as Legatrin, Q-vel and Quinamm to relieve muscle cramps.
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.
Quinine can cause serious side effects, including life-threatening anemia and irregular heartbeats. Other hazards include severe headache, visual disturbances, rash, itching, ringing in the ears, nausea, diarrhea and liver damage. If a pregnant woman took quinine, her baby could be born with a defect.
The FDA maintains that leg cramps are not a serious health problem, while quinine can be lethal. Over the years, more than 90 people have died of quinine complications. Despite this, nearly two million Americans took quinine to relieve their leg cramps.
Doctors continued to prescribe quinine sulfate for restless legs as well as leg cramps. Now, however, the FDA is cracking down. Only one brand of quinine will be allowed on the market. Qualaquin is approved only for treating certain types of malaria, and it costs more than $4 per pill.
The more rigorous ban may pose problems for millions. One reader wrote, “It was refreshing that our doctor prescribed quinine sulfate for my husband’s restless leg syndrome. He takes one pill each night before bedtime and gets wonderful results.”
Even people who have used quinine successfully for years won’t have access to it now. The trouble is that there aren’t very many other medications that can relieve leg cramps.
We discuss a number of home remedies and other approaches to this common problem in our Guide to Leg Pain. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped (63 cents), self-addressed envelope: Graedons' People's Pharmacy, No. RLS-5, P. O. Box 52027, Durham, NC 27717-2027. It can also be downloaded for $2 from the Website: www.peoplespharmacy.com.
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. What a relief to be able to finally get a good night’s sleep!”
Other approaches to leg cramps include drinking low-sodium V-8 juice, consuming extra calcium, magnesium and B vitamins. Some even report that a little yellow mustard can relieve nighttime leg cramps.
I found taking 1 over the counter potassium pill before bed, prevents me from waking up with leg cramps caused by taking a water pill in addition to my Quinapril b.p. med. Also, when younger, avoiding salt & taking potassium stopped me from being so grouchy & weepy with p.m.s.
I have had feet and leg cramps for 30 to 32 years. Even though I am taking Quinine on a daily basis, I am still having leg and feet cramps. The Quinine does help to a point because the cramps don't keep me up all night they way they would if I didn't have Quinine. Muscle relaxers do not work for me. Anyone have any thing that might help, please!
What a shock I got when I went to pick up my refill for quinine sulfate (30 for $20 at Costco) and instead was handed a bottle of pills that cost $124. I remember when a pharmacist told me about generic quinine tablets for leg cramps when one could get it OTC, $10 for 100 tablets, far less than a bottle of Legatrin.
I think the drug companies again want to cash in on a sure thing--millions of people who take quinine sulfate for leg cramps now paying $124+ for a months' supply instead of $20. I didn't accept Rx so I'm going to put a bar of soap under the bed covers! By the way, are they going to take tonic water off the market?
Be careful taking over the counter Potassium!!!! It can build up in your body and eventually stop your heart. Consult your doctor about dosage before continuing. I nearly killed myself taking potassium on my own a few years ago.
When the FDA banned Quinine Sulfate for night leg cramps, my doctor prescibed the generic in the form of Qinarsol-300mg tabs by Cipla Ltd. through BetterLife Pharmacy.com, in India. It's very effective in relieving night time leg cramps. I had been taking quinine sulfate for 7 years and Qinarsol for 2 months now with similar results.
Tonic water, sold in grocery stores, contains quinine. I mix half a glass of tonic water with cola, or any juice you like, and drink it before bedtime. I have not had a leg cramp since about 3 nights after I started this. I find it very effective and inexpensive.
Something that helps me is to get in a cold running car and just go for a ride as passenger if possible. I don't know what it is about sitting up in a cold running car that helps, but it does give a considerable amount of releif.
My mother's doctor was still prescribing Qualaquin for her leg cramps until I read that it was only approved by the FDA to treat malaria. My mother has suffered severe side effects, including thrombocytopenia, anemia, kidney failure, confusion, irregular heart beat and vertigo. She was needing blood transfusions every two weeks. None of her doctors seemed to know what was causing her bone marrow not to produce enough platelets. It's very disturbing that doctors are not more responsible when prescibing medication, especially to the elderly.
Whenever I have problems with nighttime leg cramps, I start drinking tonic water daily for a few days until it clears up. Works every time.
I read your article in this column, for leg cramps, and realize my dilemma is still unsolved. I have had leg cramps for years, and always took the OTC med called Legatrin. Since it's no longer available, I'm at a loss as to what to try.
I will try more calcium, magnesium, and of course potassium, but I really miss quinine. My leg cramps wake me up 2 or 3 times every night, with, usually, but not always, lower leg muscle spasms that make me jump up and walk around the house until they subside.
Sometimes they're very severe, and I feel like I'm having a heart attack, like they're going all the way up to my groin. Please help!
PEOPLE'S PHARMACY ANSWER:
You may want to read some of the home remedies listed on our Web site. Just put leg cramps into the search engine. You will be amazed to learn about soap under the bottom sheet, yellow mustard and pickle juice! www.peoplespharmacy.com
I have suffered with leg, knee, and foot cramps for years. Its usually after I have been doing heavy aerobic workouts. But sometimes it occurred for no reason I could discover.
Then I discovered a direct link between consuming orange juice and leg cramps. My most severe cramps occurred suddenly and felt like a knife was stuck in my upper legs, after I drank orange juice in the evening. And if I drank orange juice on stops while driving, I would experiece cramps in the muscles behind my right knee (the one that was applyng pressure to the gas pedal after about 45 minutes.
These cramps started out gradually but would keep getting worse until I had to stop and find my quinine. Quinine miraculously would relieve even my worst cramps within 2 or 3 minutes even though my doctor scoffed, saying it would take at least 20 minutes to reach the affected muscles.
It was quite a blow when I found out I could no longer get quinine at the pharmacy. But my overall suffering has lessened by learning not to drink even a little orange juice. - eoh
I found that eating a more protein rich diet, less sugar and carbs, and using an electric blanket along with one of those microwavable foot warming bags of rice has offered quite a bit of relief most nights. I start early in the evening with my foot-leg warmer and then take it to bed with me. Sometimes I have to reheat it during the night, but it always seems to help keep cramps under control and less painful.
I have experienced body cramps since I was in high school and I just turned 69. My cramps are not just leg cramps, but can come at any time, regardless of exercise (or lack thereof). Quinine helped, but then I couldn't get it from my prescription service.
Sometimes my leg cramps are so severe I don't know what to do, but walking barefoot on an extremely cold surface helps. My concern is how will I handle these cramps as I age?
Doctors are only people and a lot of their diagnoses are guess work. Now my wife is experiencing foot and leg cramps, as well. Massage is out of the question. Leg cramps can be so severe, they wake me and straightening my leg to start walking to work out the cramps is painful, and even starts cramps in my chest or other body parts. Any suggestions?
A friend recommended tonic water, which has quinine, for my restless legs. It works great. Would a glass of tonic water each night be dangerous? And does it interact with any medicine? I take Synthroid for my hypothyroidism and Glucophage for my diabetes.
Putting a pair of thick wool socks on my feet helps me relieve leg cramps almost immediately.
I suffered from painful nighttime leg cramps for years while doing gymnastics in my teens. I got relief using a quinine prescription until reading an article a family friend had clipped from the newspaper. The article suggested stretching exercises before bed. Would you believe doing a simple stretch on my calf muscles for less than a minute before bed worked just as effectively as the pills?
A word of warning, though. If I ever forgot to stretch before bed, even once, I would wake up with a painful cramp. 20 years later, I rarely have leg cramps and do the stretches only occasionally if my muscles feel tight. You just stand facing a wall. Place your hands on the wall for support and take one (straight) leg at a time back away from the wall. Place your heel down until you feel a good calf stretch. Then I usually bend the same knee forward to stretch my Achilles area.
For a few years now I've been taking 800 mg of gabapentin (Neurontin) at bedtime for what used to be nightly severe lag cramps. It was recommended to me by a pharmacist cousin. It's VERY effective. I now almost never have major cramps. Try Googling "gabapentin leg cramps" for more information.
Quinine was effective for my leg cramps--then the FDA under Bush banned it. The FDA reasons quoted on their web site are bogus and not a true scientific or medical study. They quote anecdotal evidence only!
The FDA does what the drug industry says and promotes their agenda (sale of expensive drugs). Would the FDA lie to me? Yes, they would. Or at least mislead me so the drug companies can sell more expensive drugs with their own serious side effects.
I used to buy my quinine in Mexico but it was getting hard to find. But it was capsules only at 325 mg and could not be split. I can find in Russia 200mg tablets that I can split to take only the minimum dosage that I need. I pay about $5 for 20 at just about any pharmacy in Moscow. I split them in half. Tonic water at about 82 mg/quart is effective, if not expensive. I drink a half quart a day on average to prevent leg cramps when I don't have an emergency supply of pills available.
I have spent a lot of time on the internet searching for true, valid studies linking quinine to medical problems such as heart attacks and cannot find any. For as many years that quinine has been used and as many people who have taken it then there should have been numerous valid medical studies done documenting the side effects and risks. None of these studies have been quoted by the FDA--strange, but you cannot quote what that which does not exist or is contrary to your agenda. It is estimated 300 million people currently take quinine--certainly a large enough sample for any medical study. Let's compare those with the same number who do not take quinine--then what are the risk numbers for side effects? Then reduce the numbers to reflect the lower and less frequent doses used by leg cramp suffers. Assume 1 million people take quinine infrequently--how many extra will suffer a heart attack compared to those who do not take quinine? Risk like that I can understand and can use to influence my decision to use quinine or not. I don't trust the FDA to make that decision for me due to their financial and political ties.
If I have a one in a million increased chance of a heart attack by taking quinine then I will accept that risk because leg cramps hurt like hell--ask my wife about my screams of agony in the middle of the night. Whatever the risk it is certainly less than that of smoking which I do not do.
I went to a dollar store to buy small packages of small soap bars to put one each in my socks before going to bed to stop my leg cramps as advised by a friend. IT WORKS!. Thanks.
As for leg cramps, my doctor put me on .5 ml Lorazepam nightly years ago. It is such a low dose, you don't get addicted and it works very good. My family doctor prescribed Mirapex for RLS and it works but I don't like to be locked into a prescription (I only had RLS occasionally before I took it and now I have RLS every night I don't take it.)
A friend told me she eats dill pickles for RLS and leg cramps and it works for her. My daughter told me that they have quinine in them. I don't like them so she suggested the tonic water. Now I don't know if I should drink the tonic water, but I really need a remedy for restless legs. Pickles aren't dangerous and they have quinine, so what's the difference?
Back around 1994-96, while living in Wichita Ks, I was given Quinine for severe leg cramps and restless legs. I was also being given Paxil, and around this time developed low blood sugar problems and started getting circulation problems in my legs with rashes and dis-coloration. Two years ago I found out that the walls of the blood vessels in my legs are lined with scar tissue from an unknown trauma.
In 2004, while preparing for a sinus surgery, it was discovered hat my platelet counts were down ( then 133,000 and later from 64,000 and up). I have been seeing a cancer doctor who did a bone marrow biopsy and feels I suffered some kind of contamination putting me in the early stages of Myleodysplastic Syndrome (sp?) or MDS and the very early stages o AML Acute Myleod Leukimia.
Could having taken quinine have caused this? 28May08 I had knee replacement, and since have been plagued with inflammation and swelling problems compounded by the circulatory problems I have. I am now in my 5th - 6th month of therapy to rehab my leg, but can't get past the swelling problems. Any advise you can provide will help steer me in the right directions. Thank you...
PEOPLE'S PHARMACY RESPONSE: FRENCH RESEARCHERS HAVE FOUND EVIDENCE THAT QUININE CAN IMPROVE THE RESULTS OF CHEMOTHERAPY FOR CERTAIN MYELODYSPLASTIC SYNDROMES. IF IT WERE KNOWN TO CAUSE MDS, THEY PROBABLY WOULD NOT HAVE GIVEN IT TO PATIENTS WITH THIS CONDITION.
In 1994 I, along with other members of my family was diagnosed with Myotonia Congenita plus Cramp Syndrome, one of the diseases covered by the Muscular Dystrophy Association. I started on Quinine Sulfate around that time and found that I greatly helped with the cramping and the pain associated with the Myotonia. Since the FDA won't allow me to take it anymore I suffer greatly. It is a shame that the FDA does not recognize that the medication is a great help to many people.
Had severe night time calf cramps that would wake me out of a deep sleep in extremely bad pain. They abated after taking Quinine Sulfate tablets, and I haven't had any for awhile. Then I developed bad pain that went from my right hip to my foot from a herniated disk at the L4 and L5 lumbar area of the back. After cortizone injections to the spine the night time leg (calf) cramps are back, and just as painful.
well, I JUST purchased a bottle of hyland's leg cramp pills for $5.99.
It said "contains quinine" on the bottle, so I thought, whats that? and found this site........so I just took 2 of them, we'll see how they work, and as far as being banned.......well......I just gave you all a good clue where to get it, or opened up a can of worms for some lawyer.......but hey, if it gets rid of my sciatica pain, I'll go back and buy them all out!!! I did see a chiropractor today, and after no relief, I went looking for something! I also tried valarian root, turmeric, and vit B. something better work, on top of the ice packs, and aspercreme. oh yeah, and the stretches.
My father-in-law had horrific leg cramps and I did too. He would get in the tub/shower and with hand held sprayer, hit the leg cramp area with hot/cold/hot/cold water and the cramps STOP almost immediately. I've done this and it works. I now travel in motor home and don't always have hot water available on a moments notice.
My Dr. recommend the tonic water--worsk every time very quickly, less than 5 mins. and I get relief, and can get back to sleep. NO pains if I drink 4-5 OZ. before I go to bed. It also comes in a diet form for diabetics; Shasta, Canada Dry, Schwepps, Even Wal-mart has it. 50-60 cents a bottle.
I and many of my family memebers have lots of trouble with leg cramps. We've found that you can still get over the counter "LEG CRAMPS WITH QUININE" made by Hylands. I get them at any CVS drug store. Other family members get them at walmart or even online.
To all of you out there thinking that quinine is the greatest thing alive. I'm here to tell you of its dangers. I was taking quinine for leg cramping and now have problems with my platelets.
You are suppose to have 150,00 to 400,000 platelets per micro liter of blood. Because of the quinine my first hospital trip was when my platelets fell to 5,000 and I started bleeding out both my anal and vagina area. The second time it got worse. My platelets dropped to 4,000 and I bled out my anal, vagina, nose, teeth, got blood blisters in my mouth and down my throat.
If it goes down more you start to bleed out all your mucus membranes and the most dangerous your brain. Thank God someone cares to protect us from this drug.
Cal Mag works great for leg cramps. Cramps stop within about 10 minutes and don't come back. My husband swears by it.
Hi all! I was glad to find this site and to read all your comments! My mom has been trying to get me to try pickle juice, but I hate dill pickles. I may try it tomorrow if needed at work, then see if I have any side effects.
About potassium... remember that a banana contains natural potassium that is very healthful. I usually eat one small one a day.
One elderly lady I knew was told by a doctor she needed more potassium, and
to eat more bananas. I will look forward to more helpful comments. Thanks all for your advice and for reporting your experiences.