a glass of tonic water with a slice of lemon

The Food and Drug Administration has banned the use of quinine to treat leg cramps. Although this drug has been available for centuries, the FDA has determined that it is far too dangerous to use for anything but malaria.

Quinine Dangers

The trouble is that some people are extremely sensitive to quinine’s toxic effects. This drug can cause headache, rash, ringing in the ears, nausea, dizziness and blurred vision.

The most serious reactions are rare but can be life threatening. Blood disorders can lead to hemorrhaging. Dozens of hospitalizations and two deaths are linked to quinine.

What about Tonic Water?

Clearly, quinine can be dangerous for certain people, but the FDA has not banned quinine from tonic water. Quinine gives this beverage its distinctive flavor. Either the FDA doesn’t consider tonic water a danger to public health or the agency worries about arousing the ire of millions of gin and tonic drinkers.

Because of this loophole, many people have discovered that drinking tonic water can help prevent muscle cramps. One reader related her experience:

“I suffered with nightly leg cramps until one magic day on the Greek island Santorini. I had gone on tour as a guest singer of the New York Choral Society. One free afternoon, a group of us went to a black sand beach where I swam. The only other member of the group who also swam was a New York trauma surgeon. I developed a cramp and was trying to walk it out when he told me about Schweppes tonic, which contains a very small amount of quinine.

“I couldn’t find any tonic on Santorini or in Athens, but as soon as I returned home I started drinking a large glass (diet, with cranberry) every night. It has worked for me for several years, but I definitely know if I skip a dose!

“I asked a pharmacist friend to search the literature to see if anything else contains a small amount of quinine. She couldn’t find anything and told me the dangers of using high-dose quinine. I have checked with my doctors and have heard nothing against my practice of drinking Schweppes.”

Tonic contains 83 mg. of quinine in a liter. An eight-ounce glass or tonic would only have about 20 mg of quinine, considerably less than the dose that used to be prescribed for leg cramps (200 to 300 mg).

Tonic Water Works for Muscle Cramps

Despite the low dose, however, many readers maintain that it works:

“My doctor recommended tonic water for nocturnal leg cramps. It works every time very quickly. In less than five minutes I get relief and can go back to sleep. I suffer NO pains if I drink half a glass before I go to bed.”

Even Tonic Water Has Some Hazards

Some people find even the small amount of quinine in tonic water can pose problems. These folks may experience ringing in the ears, rash, itching or blurred vision and should steer clear of tonic water altogether.

There are those who are so sensitive that even a little bit of quinine could prove life threatening.

“Quinine in tonic water proved almost fatal for me. Nighttime leg cramps have been an ongoing problem, so I bought a bottle of tonic water.

“On Saturday I had a 5-ounce glass before supper. Sunday morning by 9 am I was in the emergency room with a frightening skin reaction. I was hospitalized for many days and diagnosed with a dangerous blood disorder called idiopathic thrombocytopenic purpura (ITP). My hematologist said it was triggered by the quinine water.”

We have also heard from people who developed tinnitus after drinking tonic:

“I have just developed a hissing sound in my ears. The onset was very rapid! The doctor diagnosed it as tinnitus, but would give me no reason for the problem. He said there wasn’t anything I could do. I’ve noticed some days it is less disturbing than others but some nights it awakens me because it has become so loud.

“I was drinking large quantities of tonic water, which contains quinine, when this started. Do you have any suggestions to help me?”

The quinine in tonic is the likely culprit. Ringing or hissing in the ears can be a complication of quinine. Tonic water should be discontinued completely.

For such people, home remedies may be the best way to get relief from nocturnal leg cramps. Our Guide to Leg Pain has instructions on stretching as well as a range of remedies.

Join Over 65,000 Subscribers at The People's Pharmacy

Each week we send two free email newsletters with breaking health news, prescription drug information, home remedies and a preview of our award-winning radio show. Join our mailing list and get the information you need to make confident choices about your health.

  1. Lee
    usa
    Reply

    Hi. I suffered with some pretty bad leg cramps- the kind that cause you to give up on sleep and then the pain and soreness continues long after the attack and through to the next attack. I also had RLS and took some med for it but not anymore. I’ve tried a lot of remedies but the one that works best for me and has several great healthy side effects, one of which is improving arthritis symptoms, is coconut water. Coconut water has huge hydration properties and balances electrolytes- magnesium, potassium, sodium etc- also has calcium and a few nice phytonutrients; helps skin, memory and mood. As for cramps, coconut water is great but you have to drink one about each day- 12 oz. or more. In a pinch you can add a dash of quinine water. Try it. It may work for you too!

  2. David Wills
    Canada
    Reply

    Taking 450 mg of a high quality magnesium citrate not only stopped my leg cramps but also has the added benefits of (making you very relaxed, eases sore muscles from post workout,great sleep and softens and moistens bowel movements) also it has very low toxicity. Magnesium is often lacking in a lot of the soil in North America so even if you eat really healthy bio regional organic produce there is a high chance your Mag levels are still no where near optimal.

  3. J. van Niekerk
    South Africa
    Reply

    I have discovered by fluke that the day I eat grapes and the seeds as well, that night I have no cramps in my legs.

  4. Thom
    CO
    Reply

    It is also a great instant remedy for ticks / twitches.

  5. Margarita Oviedo
    austin
    Reply

    Great info, thanks for sharing

  6. Linda
    Baltimore
    Reply

    Scared using it, but it does work for me. I recently got the most horrible foot, calf and thigh cramps as a side effect of a cortisone shot in my knee. (Apparently, from online forums, this is not uncommon if you have Fibromyalgia, though the doctors I spoke to were clueless.) They were unbearable, and not only kept me up all night soaking them in hot water, but made me feel like I’d been beaten and left for dead for a few days after.

    I drank 2 bottles of tonic water and took 525mg potassium and magnesium and B-complex supplements. The cramps were gone the next day. They came back weaker a few days later when I stopped the treatment- disappeared again when I restarted, though I lessened the amount to 2 glasses of tonic. Soap and other remedies did nothing to help. The tonic and minerals does work. I wish they made tonic water without sugar or sugar substitutes. It tastes terrible anyway so what’s the point of sweeteners. Tolerable mixed with lime, OJ and vodka.

    • Mary
      Nebraska
      Reply

      Do you happen to get leg cramps if you drink wine? I get terrible leg cramps inside my leg if I drink wine. I did some google searches and found out it was the sulfites in the wine. I then had a cortisone shot in my shoulder and almost immediately got cramps in my feet and legs. Did more research and found out some or most cortisone shots have sulfites for a preservative. I finally found an organic wine with no traceable amount of sulfites. Drank it 4 nights in a row and no leg cramps at all. Don’t know if one can find a cortisone shot with no sulfites.

  7. Joni
    United States
    Reply

    I took Quinine for several years for leg cramps, but then they became prescription only. I took them by prescription but the price had gone from about $5 for 100 to $35 for a month supply by prescription. Then the pharmaceutical companies did studies on it and it is now $5 per pill.

    I got them by Rx from a pharmacy in Canada for about $40 for 100, but now they have gone up. Mine are so bad that I hate to go to bed knowing that if I move they will start up. I even get them around my ribs and back. Today my hands cramped so bad I could hardly comb my hair. I will get quinine water which I have used in the past. Also will put a bar of soap in my bed. I ordered some stuff from the Amish that is apple cider vinegar, garlic juice, and ginger juice. It works a little, but cannot afford to do that. May try making my own. Salt under my tongue helps and will see if I can find celtic salt?? No one understands how horrid this can be unless they have been through it. So nice to see people who understand. I also use some essential oil cream. Any port in the storm huh guys?

    • Naomi
      Leesburg, VA
      Reply

      Jpni,

      I am in total sympathy with your problems with cramps. And I agree with you–people who haven’t experienced this have no idea how painful it is. I suffered for years from horrible leg cramps at night several times a week, and not only at night, but sometimes during the day. I got cramps in my hands when I was driving, and even had them in my tongue! They would go on and on, for as long as 40 minutes. Excruciating. I took potassium and magnesium supplements but they didn’t help. I took quinine, at first by prescription from my local drugstore, then purchased from Canada after it was banned in the U.S., but I worried about having to take so much so frequently. When I moved to another town, my new doctor recommended that I try Mag-Tab SR, which is magnesium L-lactate dihydrate, available online from Niche Pharmaceuticals. The recommended dosage is one pill (84 mg), but I took 3 in the evening, and sometimes as many as 5 (my doctor was fine with that dosage). They absolutely work! I highly recommend them to anyone who suffers from this terrible affliction.

  8. Linda
    Fla.
    Reply

    I have severe RLS and heard of drinking tonic water for relief. I have tried it for the last 4 days and much to my surprise it is helping a bit. I am concerned about what the side effects may be and how much is too much to drink each day. Any feedback would be great.

  9. Richard
    Australia
    Reply

    I have suffered from RLS for a few years and it seems to be getting worse. My doctor prescribed Pexola, it’s a Parkinson’s medication. They don’t know why it works but it does. However, l need to time it perfectly as it takes a while to work and only helps for a short time.
    I’m going to try the tonic water, as it might suit my situation better.

  10. BaliRob
    Bali
    Reply

    FIRST OF ALL – QUININE SULPHATE IS DANGEROUS – the FDA researched 93 deaths conclusively occurring through long-term usage.

    I, myself, now have Tinnitus, Kidney Damage and Congestive Heart Failure after taking 500mg per night for nocturnal leg cramps for eight years. Specialist here thinks that the kidney damage was caused by the Quinine.

    My leg cramps are so painful and damaging that I fell unconscious during one attack (having had slightly less painful attacks previously) fell face forward onto a chair and did not come to for some five hours.

    After coming off Quinine I have taken Magnesium, Magnesium Citrate and another Mag (cannot remember) with pretty good results until I had to take
    Lasix (water tab) for my CHF. I was also on Simvastatin at the time and the effect caused the most painful cramp in BOTH legs (hips down to toes) such that I became sick, had stomach trouble and became semi- conscious. I was totally paralysed for two hours. The attack had torn both calf and thigh muscles in my left leg and I was unable to walk properly for nearly a month.

    Yet still I will not return to Quinine. For some very bad attacks I have found table salt to halt the process and, if lucky, bring the muscles back to their relaxed (normal) state. I have not tried the soap or mustard remedies – the mustard for me would be rather distasteful for me as I have hated it for over 60 years.

    As you can understand I go to bed each night fearful of the next attack especially as I have to take Lasix as and when required – tonight it will be an unwrapped bar of Cussons Imperial Leather between the sheets – wish me luck.

  11. Ruth B. Agar
    Mpls., Mn., 55410
    Reply

    I was warned about quinine so have not used it for many years. I just tried the soap, for finger and hand cramps and by gosh, it worked! I begin having seriously painful craps in legs, thighs, etc. several years ago. I decided that over-the-counter sedatives might be the culprit. I stopped all of that, got a mild prescription drug, and the cramps stopped – most of the time. Now, they seem to be related to several things: I cannot drink red wine, or eat red grapes – I will suffer severe cramps throughout the night. A little beer is ok. I stay away from alcohol almost entirely now. Using my hands, driving for long distances, standing on a cold floor for a long time will also bring on the cramps also. I focus on staying hydrated, but sometimes fall short. I will probably stock a bottle of Tonic Water – to have on hand just in case. Enjoyed all the comments.

    • JT
      Timbuctu
      Reply

      Ruth,
      First, read the info on this site: spacedoc.com. Lots of info about statins and their unpublicised side effects. Also – lasix and its effect on electrolyte balance – sodium and potassium losses in particular. I consume plenty of salt and take 600mg potassium gluconate each day – no cramps. If I take docs advice and reduce salt, the cramps come back – same day. Both sodium and potassium always in correct range in blood work. I will not take ANY statin ever again after personal experiences. Check out that site.

  12. Caw
    Reply

    A few decades ago (really), I used to frequent the bars after work. My drink of choice–vodka tonic. My ears rang (tinnitus) all the time. After I stopped drinking all that tonic water (and vodka) in the bars, the tinnitus resolved. I didn’t connect the dots until many years later when reading about the side effects of quinine to treat malaria. Keep in mind, though, that I drank a lot of tonic water. I doubt there would be side effects with small amounts, but if you develop tinnitus, it may be an indication that you should reduce your consumption.

  13. Mark Bertneskie
    Vernon, N.J. 07422
    Reply

    Booze and cigarettes: legal, subsidized, freely available… Damn the personal and public health for corporate profit… Quinine and Tryptophan: illegal, penalized, and highly unavailable… Damn the personal and public health for corporate profit…

  14. Marilyn
    Reply

    The taste of Quinine water is hard to handle. I have RLS & Cramps so I squirt a little of that water flavor people are using called “Mio” and much easier to drink.

  15. Marilyn
    Reply

    I also suffer from RLS & cramps some nights. Someone told me about Quinine water and I had a hard time drinking it. But added that little squirt of that water flavoring called “Mio”. that did the trick.

  16. jannell
    sacrameno, ca
    Reply

    A few mouth fulls of Tonic water with Quinine or pickle juice are the only 2 cures my daughter and I have found for leg cramps and restless (jumpy) leg syndrome. Just beware of the salt in the pickle juice if salt is a problem for you.

    • John
      Hanover, PA
      Reply

      I have suffered with nocturnal leg cramps for years and use tonic water occasionally but I have found that putting a bar of soap (without the wrapper) in my bed between the sheets has helped tremendously. How or why it works is beyond me, all I know is it works. No leg cramps for months!

    • Edward
      Aurora, CO
      Reply

      One cap full of White Vinegar before bed each night stopped my severe Leg Cramps…

  17. BLT
    Reply

    Tonic water is the ONLY way I have found to releave the killer cramps that I get on infrequent occasions. It works almost instantly. I do not drink the tonic water to prevent cramps because they occur randomly.

  18. ETS
    Reply

    I’ve been suffering with horrible, excruciating leg cramps. Nothing much seems to work and if they get too bad I end up in a tub of hot water. On a recent visit to the doctor she has suggested the tonic water w/quinine. I had a cramp last night and I drank 12oz of tonic water. I can’t really say if it helped because the cramp did not go away right away; however, I’m going to give it a try for 6 nights (6pack) and see if it helps to prevent. At this point I’m willing to try just about anything because I suffer so bad. I don’t wish this on anyone, but to know I’m not suffering alone helps to ease my mind.
    People’s Pharmacy response: The quinine in tonic water can act as a preventive. For quick relief, try a sip of pickle juice or swallowing a teaspoon of yellow mustard:
    http://www.peoplespharmacy.com/2014/07/28/leg-cramp-remedies-are-as-close-as-the-fridge/

    • Diane
      Florida
      Reply

      Several friends have this problem, one says that drinking pickle juice caused her blood pressure to elevate. I am looking into the Schweppes tonic water/w quinine, half a cup before bed. But will need to monitor how it affects me. A man friend has them really bad, he works on ladders and on his feet all day, so I am trying to get info for all of us.

  19. cwf
    Reply

    I am a social person and love a good gin and tonic with a slice of lime…I believe the tonic water in my drink has been the cause of my reoccurring hive condition. Doctor’s prescribed prednisone for the hives. Prednisone is the only med that will stop hive attacks and make them go away..
    cwf

  20. Nvh
    Reply

    Been using it for years. Just a sip or two and cramp subsides immediately. Tonic water is a Staple in our home. My husband takes it when needed also!

  21. Viv D
    Reply

    For years I’ve been drinking lime juice daily which has prevented leg/foot cramps up to now, but lately I’ve had a few cramps again. After reading these comments I will try tonic water plus lime – hopefully the double whammy will work!

  22. Elaine
    Reply

    I too use Tonic water for occasional leg cramps. But, I discovered it is good for stomach cramps related to the flu or other viruses. Two years ago there was an intestinal virus making it’s way through the family and in-laws. Some had cramps so bad the doctor phoned in pain meds for them.
    I remembered the Tonic water and asked my husband if he would bring me a glass. Well, he did and on ice. I sipped the water and had only two very mild stomach cramps. That was it. I think this flu season I will try an ice tray with frozen Tonic water in it for ice chips for a sick stomach and see how that works.
    I would like to see how this works for menstrual cramps as well. Fortunately my daughter doesn’t have cramps and I’m passed that stage in life.

  23. Dane C.
    Reply

    Twas good info scared my wife from drinking, I have drank it so long why stop?

  24. SJB
    Reply

    I was told about quinine in tonic water by a friend last week after suffering very bad cramp in my calf, which left my calf permanently painful. The pain disappeared almost immediately after drinking a couple of glasses of tonic water.

  25. Eileen P.
    Reply

    I began having leg cramps at night after having peripheral neuropathy. I mentioned it to a friend and he gave me an eight ounce bottle of tonic water telling me it will relieve the cramps quickly. That night I had a bad cramp and took two sips, within a minute the cramp stopped. Toward morning had another cramp, took another sip of tonic water, like magic, cramp gone almost instantly.
    Now I hear it will interfere with my thyroid medicine and cause other problems. Does anyone know how many people drink gin and tonic as their favorite drink? I know several and nothing bad has come of it. I will continue to take a sip or two if I have leg cramps and doubt that little will interfere with my thyroid medicine.
    I would think that the FDA would remove quinine from shelves and some other govt agency would ban it from being added to tonic water were it really dangerous. Of course I am saying this hoping I am right since leg cramps are the most painful thing I have ever endured.

  26. YS
    Reply

    No wonder I feel better after drinking tonic water and after a week I’m so refreshed and clean. However, quinine tastes awful, raccoon *beep* really. :/ The first time I drank the tonic water that stated it had quinine I felt like I was drinking the green NyQuil. :P My face surely contorted with disgust. I know use an acai water flavoring to cancel-out that medicine bitter (bitter can’t described how awful this tastes). I know that quinine is good for me because after drinking the 12 oz bottle I don’t get the leg issues I always suffer from (retained fluids, inflammation/swelling, cramps, sleepiness, numb feel). The leg issues that causes for concerns are no more… thank goodness. I feared I would have to go under the knife and out up my legs to relieve the pressure from the inflammations and trapped fluids. Anyways hold my taste buds and nose, down the hatchet it does, one nasty quinine tonic water will definitely keep the surgeons away.

  27. Jason
    Reply

    Hi Joy, I am currently being investigated for unexplained Syncope (Fainting) I am not on any other medication i.e. statins and the only change in my diet in the past 6 months has been drinking Tonic Water on a daily basis. You mentioned you have had experience of fainting, how did you diagnose the cause as being the Quinine? Thanking you in advance

  28. lynnie
    Reply

    I recently have been having leg cramps and my doctor suggested to try tonic water and the very first glass I drank immediately brought relieve to the pain on both my legs. Taking a glass just before bed helps you to have a peaceful sleep also.

  29. S. Adams
    Reply

    What your friends really need are electrolytes. The easiest way is adding celtic salt (which will be grey in color) to the water they drink. And not to become dehydrated.

  30. Paul the Roman
    Reply

    actually my experience with RLS also found relief from a glass of tonic water. Depending on how severe the attack is I can usually damp down the RLS feeling by having a tumbler full of quinine water.
    Tryptophan also used to be effective but as you may know this harmless amino acid is no longer available due to the misguided diligence of the FDA which banned it after a scare caused by a contaminated batch made its way to health food shops.
    I believe that the FDA practice of banning certain natural compounds in spite of their obvious therapeutic benefit is a direct result of influence by corporate pharmaceutical companies, which after all practically run the FDA, in order to eliminate competition in the OTC market. So much for America’s free and open market place, eh?

What Do You Think?

We invite you to share your thoughts with others, but remember that our comment section is a public forum. Please do not use your full first and last name if you want to keep details of your medical history anonymous. A first name and last initial or a pseudonym is acceptable. Advice from other commenters on this website is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. Stopping medication suddenly could result in serious harm. We expect comments to be civil in tone and language. By commenting, you agree to abide by our commenting policy and website terms & conditions. Comments that do not follow these policies will not be posted.