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Q. I have been drinking a liter or two of tonic water a week for nearly 25 years. Now I'm reading about risks associated with quinine. How much is too much? How much quinine is in tonic? What are the side effects? Should I stop drinking tonic water?
A. Quinine has been used medicinally to ward off malaria since the 17th century. The normal dose to treat malaria is 648 mg every eight hours for a week. A glass of tonic has roughly 20 mg, so you can see that there is a big difference.
Some people are so susceptible to serious side effects from quinine that they must avoid even the small amount in tonic water. For them, quinine may cause life-threatening heart rhythm disturbances, severe skin reactions and several blood-related complications. That is why the FDA banned quinine for treating leg cramps.
Since you have not experienced any complications for 25 years, it is unlikely that you need to give up tonic. A glass or two daily should not cause you problems.

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I, too, love the flavor of quinine tonic. I started drinking it in the mid-1980's and later realized that in the same time period I first noticed two developments: tinnitis and an irregular heart beat (currently being treated as Atrial Fibrillation). I don't drink any sweet soda, but I still love the quinine!
PEOPLE'S PHARMACY RESPONSE: QUININE CAN CAUSE TINNITUS. IF YOU EXPERIENCE THIS, YOU SHOULD PROBABLY GIVE UP TONIC.
Most tonic water on the market today contains no quinine. This has been the case for several years now.
I have been drinking at least 48 ounces or better of diet tonic for the past two years with no side effect. i ahve had my blood checked. I do not think it has harmed me in any way
I was a tonic lover and it was my social drink of choice. I consumed 1-2 bottles a week. An Indian doctor told me to be careful and not drink tonic, (maybe that was the one with quinine) since drinking it could cause vision problems and contribute to night blindness. I always thought my worsening night vision was just do to aging.
I gave up tonic, but wish I could enjoy it again.
Is there evidence to suggest night vision problems are related to drinking tonic with quinine?
Thanks.
A former tonic drinker
I just want to know what the positive & negative effects are towards drinking tonic water with quinine for people who have arthritis, I'm a bartender and one of my customers who suffers from arthritis says she drinks it all the time. And I was just wanting to know more about it before I tell my mother who is suffering from arthritis to start drinking tonic water with quinine. Thanks again, Rick.
Quinine is off limits for those of us with ITP (low platelets), as it can cause platelet levels to drop.
I drink a liter of tonic diet tonic water a day -- I love it. Mine says it has quinine in it. What kinds do not? I love the taste, but am a little concerned about the quinins.
All my life I have been told that tonic should never be drunk by children. Can you please comment on that?
My brother started drinking tonic water with quinine to help him sleep. He had lazy leg syndrome and could not sleep. Would this create any other medical problems? Says sleeps fine every night. Uses it one half hour before bed time and sleeps all night.
Is there any difference in the quinine content of the assorted bands of tonic water? Or do they all have about the same "roughly 20 mg" per glass? Or do they have just have flavoring without quinine?
Thanks for any information.
I have for the last year been drinking tonic water, every night about two small bottles and sometimes more. I loved it until recently I found that I was waking up in the night with terrible migraines. So thought I would give the tonic a miss for a while as I had heard too much quinine wasn't good.
To my amazment the migraines stopped, it's heaven. I did try again the other night just to test and the migrane returned. I really miss my tonic but not the migraine.
My husband is having the same problem, his leg twitching keeps him awake all night... how much tonic water does your brother drink nightly, and how long before starting did it take to work?....
Thx
Rhonda
Tonic water has about the same amount of sugar as any soda. (probably corn syrup, yech!) I drink vodka and tonic but I sure don't drink any extra tonic water.
I started drinking 4 to 6 oz of diet tonic water with quinine 4 mo. ago due to restless leg syndrome... I have not had even one incident since... I would normally SUFFER several sleepless nights a week. I haven't noticed any side effects... Why does this work so well?
I have had leg cramps for about a year. My calf muscles ached and would cramp if I rolled over in bed and I would have to quickly get out of bed and put my weight on my feet to stop the cramp. Also while sitting in a chair and bending my left leg across my right knee, the tendon would sometimes tighten up and would instantly become very painful. I would have to uncross the leg quickly.
I had read somewhere about quinine being used for leg cramps and bought a bottle of Schweppes Tonic Water. I drank approximately 8 oz. and forgot about it. After two days I noticed the muscles functioned properly and wouldn't cramp in any positions. The aches are also gone. I hope they stay gone.The relief is great! Fortunately I wasn't aware of the possible side effects when I drank the Tonic Water.
Started drinking tonic water about a month ago for leg cramps. Had them terribly @ noc, would wake me up several times a night and I would have to get out of bed and walk around to get rid of them. My legs would feel like I had walked a marathon the next day SORE SORE SORE. Since I started drinking the tonic water with the quinine (calorie free), my lets cramps have gone. I missed drinking it for 2 days and had cramps return that night. I will drink it daily until I see adverse reaction to it. Sleeping all night is wonderful!
Since the definition of "tonic water" is water flavored with quinine, whatever you think tonic water is, is definitely not that. Good luck trying to find something called "tonic water" that doesn't have quinine.
Let me know what you find out. I have been drinking a splash of tonic water with my water to see if it helps my arthritic knees.
Would quinine in tonic water could contribute to my wife's cistititis?
I started drinking tonic water with quinine and was amazed how well it works toward my leg cramps. I only drank 4 ounces every other night, its amazing the results.
Actually, a lot of tonic water today does indeed contain quinine, but in very small amounts (83 mg/L is the maximum amount by law). Look on the bottle- many brands that I have encountered (including big names such as Canada Dry) have labels that come with the advisory "CONTAINS QUININE". You can also hold the bottle under a black light. If it contains quinine, it will glow.
Is there something else that's safe for RLS? My husband does suffer some nights worse than others from this. Is there a mineral deficiency? Is it caused by some certain foods?
PEOPLE'S PHARMACY RESPONSE: THERE IS SOME EVIDENCE THAT CORRECTING AN IRON DEFICIENCY COULD BANISH RLS: http://www.peoplespharmacy.com/2009/09/07/iron-supplements-vs-restless-legs/
ALSO, SOME PEOPLE REPORT THAT TAKING MINERALS SUCH AS CALCIUM, MAGNESIUM OR POTASSIUM HELPS THEM.
I wonder why none of us has reported the amount of alcohol added to our quinine drinks.
Gora
For most of my life I have had occasional leg cramps in my calves at night...most noticeably during pregnancy. I can CAUSE a cramp in my toes by holding them strongly flexed downward for a few seconds. (I am 61..just did it right now to check if I can still do it--I can--and used to do it quite frequently as a child.) Last year I began to have HORRENDOUS cramping of my hamstrings. This is really a miserable occurrence, as the usual jumping out of bed and stretching your calf is relatively easy...stretching your hamstrings (where your heel is brought toward your buttock forcefully) is difficult at best and almost impossible when you waken in agony and cannot even think clearly!
I nearly fell down the stairs trying to find somewhere to stretch my knee out. A friend told me about drinking tonic water "with quinine". I had no idea of the dosage or why it worked. However, it has worked LIKE A CHARM ever since, and I no longer have any leg cramps. I drink about 3 to 4 oz of diet tonic water with quinine about three to four times per week at night, usually mixed with unsweetened pomegranate juice... neither taste very good to me, but it's great when combined! I have been drinking it for more than a year, with none of the side effects mentioned. Hope this helps others.
I have been drinking tonic water and I still don't know if it is bad for me, and it is my first time drinking it, so I would like some help, because I also don't know how to put up questions so I want to know if tonic water is bad to drink and if i should still drink it even though I have arthritis??? just those two questions?
PEOPLE'S PHARMACY RESPONSE: ARTHRITIS SHOULD NOT MAKE A DIFFERENCE. TONIC WATER IS SAFE IN MODERATION (LESS THAN A LITER DAILY) FOR MOST PEOPLE. BUT THOSE WHO ARE SUSCEPTIBLE TO QUININE CANNOT TOLERATE ANY.
Several years ago, I went through a rough time with cancer and high dose chemotherapy, followed by a stem cell transplant. I am happy to say, the cancer is gone, but the leg cramps were so severe that they would make me sob with pain. I was told to try tonic water with quinine, could not drink enough of the stuff to make the cramps go away. I no longer have severe cramps, primarily because I try to stay hydrated.
I think a lot of people who drink the tonic water don't experience relief from the quinine, but rather from the fluids. When I get the occasional cramp, I take a tbsp of baking soda in a glass of water, stir and drink it down. Cramps go away in around 10 min.
I've had nocturnal leg cramps for 30+ years as my Mother did all her life. I have tried a zillion fixes (horse chestnut root (works well), b complex, extra fluids at night) and nothing works for long. I started drinking tonic water w/ quinine the last 2 months and have slept like a baby every night - not even a twitch.
I have atrial fib have had for years also have drank tonic water for years. Recently my doc. tells me I am stage 3 kidney disease. I am age 72, is there a large amount of salt in tonic, I have a very small urine stream when I drink tonic before bed, please tell me your thoughts as to what is going on? bud
I have been drinking a small bottle of tonic w quinine for several years, to alleviate my restless leg syndrome.... I now have tinnitus, and have just learned that this can be caused by quinine. I do not know what to do now, for my restless leg syndrome which can keep me from sleeping. OR if my tinnitus which has caused very loud ringing in my ears, will go away if I stop the quinine. HELP
PEOPLE'S PHARMACY RESPONSE: IT IS LIKELY THAT YOUR TINNITUS WILL IMPROVE IF YOU STOP THE TONIC WATER, IF THAT IS WHAT BROUGHT IT ON. THERE ARE SOME OTHER APPROACHES TO RLS; A FEW ARE PRESCRIPTION DRUGS, BUT THEY CAN HAVE SIGNIFICANT SIDE EFFECTS.
HAVE YOU TRIED PUTTING SOAP UNDER THE BOTTOM SHEET? IT DOESN'T WORK FOR EVERYONE, BUT IT HELPS SOME PEOPLE. IT IS ALSO INEXPENSIVE AND WILL NOT CAUSE TINNITUS OR OTHER SIDE EFFECTS.
I have suffered with restless leg syndrome (which I call "jumpy legs") all my life (I'm 58). When I was in my 20s, my doctor gave me quinine pills (325 mg); quinine works miraculously (like a warm glow in the legs) within seconds and I never had any side effects that I noticed. I also noticed that I did not have jumpy legs when I was taking quinine preventively for malaria when traveling in Africa. Later doctors wouldn't give me any, I guess because the side effects became known.
Luckily, however, when I was 38 I found out what caused jumpy legs, in my case at least. It is a response to certain foods eaten during the previous day. If I just take a tiny bit (less than a teaspoon) of the pesky food/s before bedtime, I will not have jumpy legs and can go to sleep. Like with quinine, the relaxing effect occurs within minutes. Since then, there is almost never a time when I can't get rid of the jumpy legs with my food cure. I'd still like to have the quinine for emergencies (like if the food isn't available to me before bedtime, as when traveling, etc.), but my doctor won't give me any and I have been able to live without it.
There's not much point in stating the particular foods that affect me, because probably they are different for everyone. There also doesn't seem to be any relationship between them or any common denominator. But in case it helps anyone, in my case they were milk (not any milk product, just milk itself); microwave popcorn (the popcorn or the other ingredients, I don't know); beer, and rum. Since menopause some other things have become problematic: soy (for which I take a half teaspoon of soy sauce), tomatoes (use catsup), and some nuts, for example. It took me a year to figure out that some new foods were causing problems, and it's a lot more trouble than when my only regular cure was to drink a tablespoon of milk, but taking a small dose of each item before bed still works. However, I notice that the calming effect takes several more minutes than when I was younger and requires a slightly larger dose.
I regularly take iron, calcium, magnesium, etc. as dietary supplements, but have not noticed that they do any good for jumpy legs.
So if you have jumpy legs regularly, start with the foods you eat regularly and begin experimenting. If you get them only occasionally, experiment with foods you just ate that day. You might have to go back as far as 24 hours to find the culprit. It's tedious, but well worth it.
SH
I thought I would try tonic water because my brother in law swears by it. I have really bad cramps in my legs at night when I have sweated during the day. I tried 4 oz for 2 nights and the second night I awoke with a concerning heart irregularity. It felt like 2 balloons were fighting it out in my chest and lasted about a minute. I went on in to the ER and everything checked out with EKG and electrolytes so I would say it didn't cause me harm. I didn't like the implications, so I won't be using tonic water again.
I have been drinking tonic water 16 oz every night for severe muscle cramps for 2 months... The cramps are gone but tennitis started 2 days ago. I am afraid to stop the tonic water or horrible cramps will come back.. but will this tennitis become irreversible?
What is the mechanism in the quinine that causes ear ringing?
PEOPLE' PHARMACY RESPONSE: WE CAN'T TELL YOU THE MECHANISM, BUT QUININE IS KNOWN TO CAUSE TINNITUS. PLEASE STOP NOW.
I have been drinking diet tonic water for about 6 months and love it. I now have a major problem with vertigo. Is it possible tonic water could be the problem?
I drink about 4 litres of diet tonic water each day. Am hooked on it but have been more anxious than usual. Could this possibly be related to the quinine?
I work in a hotel and have never been one of the drinking crew, always have a glass of bare tonic. Usually through the week days average about one rather large glass each day.
My reason for the post is that six weeks ago I underwent spinal fusion and have been on OxyContin ( a slow release morphine ). I had my first night out last night, a whole two hours upright which was a big deal for me. Anyway I Googled alcohol and morphine and obviously it was not worth risking even one glass of alcohol with all of the possible side effects, so I just drank two glasses of tonic. But within half an hour of getting home I had really severe scary stomach cramps that abated after a few visits to the bathroom. I still feel unwell today and am back in bed, didn't even want to take my dose of morphine this morning to help clear my belly.
It seems so immediately related I will not be drinking it again when I expect to return to work in a few weeks. Anyone else have similar happen?
I've suffered from RLS for almost 20 years. For approximately 8 years now I've been taking a prescription drug called Mirapex - used for a variety of issues. The dose has needed to be increased over the years but it works wonderfully so long as I take it on schedule. It seems to take 2-3 hours to work into my system.
If you are concerned about drinking tonic water for leg, foot or toe cramps try a nice size spoonful of mustard. I just read about this somewhere on the net and it is a miracle... it works almost instantly, also apple cider vinegar helps but I really think the mustard is the fastest and best. I now take the little mustard bags with me even when I travel, keep them by the bed. Good luck for sweet not cramping dreams!!
I drink tonic water that has quinine, I drink about a 1 qt 1.8 fl oz a day. What problems am I looking at down the road with my health?
I work 12 hours 4 days a week and my legs sometimes my feet would get cramps. The ones that will make you cry!! I started drinking Mixer tonic water with quinne. This stuff works now I just get 1 cramp maybe 1 time a week. I was in pure hell thanks to this stuff I can sleep and go to work and feel good. Big Shep
Hello
I just wanted to know tonic water will help with back spasm. I have the spasmed that will make you cry. The first time was yesterday and I could not sit down and when I got up it was very painful. My husband went to the store and bought me some tonic water. I took a few swallows and was able to get to sleep. I just wanted to know if I was tripping or does the water really work?
I have ITP and just started to drink tonic water. Is it really a fact that I should not drink it at all because of the quinine?