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Why Can You Buy Quinine in Canada But Not the US?

Canadian and US health regulatory agencies have dealt differently with quinine pills. As a result, you can't buy them in the US.

If you suffer from nighttime leg cramps, you may have spent some time looking for treatments to prevent them. If you are old enough, you may remember a time when you could buy quinine tablets to treat your leg cramps. That is no longer possible in the US, as one reader noted.

Why Can’t You Buy Quinine Pills Any More?

Q. I have read your warnings about quinine and I think you are totally off base. For years, I have taken quinine a few times a month for leg cramps. Nothing else my doctor recommended worked.

When the FDA banned quinine for leg cramps, I was really in a jam. The leg cramps were very disruptive.

There are some low-dose over-the-counter quinine pills in Canada. Why can I buy quinine pills there but not in the U.S.? The amount of quinine in tonic water is not nearly enough for me.

FDA Is Concerned About Quinine Side Effects:

A. The FDA banned the use of quinine for leg cramps more than a decade ago. That was because it can cause life-threatening blood disorders.

It is possible to buy quinine tablets in Canada, but we would advise you to discuss your plan with your physician. Quinine can also cause digestive upset, ringing in the ears, headache, blurry vision, skin rash and irregular heart rhythms.

You are not the only person who is upset by the FDA’s decision. Several years ago, we heard from another reader with a similar dilemma.

Lost Without Quinine:

Q. I am devastated that quinine is no longer available. I have taken it safely for decades to reduce leg cramping, especially at night. Since I ran out and cannot get more I have a terrible time sleeping. I spend most of the night pacing the floor to work out the cramps. Why would the FDA ban quinine when it is the only thing that works?

A. Many people do well with quinine but for some it is extremely dangerous.

One reader wrote:

“I took quinine for nighttime leg cramps. At that time, I was working for a physician who said quinine might help and wrote me a prescription.

“I took one pill and within a couple of hours, I was deathly ill, not knowing what was going on. My doctor sent me immediately for blood work. My liver function results were worse than my husband’s when he died from liver cancer. It took more than two weeks to get my body back on track. I would not recommend quinine to anyone.”

The FDA reasoned that leg cramps are not life threatening but some reactions to quinine are. Consequently, the agency decided this drug offers more risk than benefit. After making it impossible to buy quinine without a prescription, the agency ultimately banned doctors prescribing it for anything other than malaria. Apparently, HealthCanada came to a different conclusion and has left quinine on the market there.

Managing Your Leg Cramps When You Can’t Buy Quinine:

There are, unfortunately, no other approved medications for leg cramps. People with nighttime leg cramps may benefit from home remedies. Tonic water, which contains some quinine, is one option. Others include yellow mustard, HotShot, low-sodium V-8 juice or soap under the bottom sheet. More details on these and many other remedies are available in our Guide to Leg Pain.

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About the Author
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. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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