man with leg cramp, muscle cramps disappear

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. 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.

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  1. John S
    Toronto, Canada

    I get night leg cramps 5 to 10 x a month for 4-5 years. Now 73 y old. Recommend 1) drink plenty of water thru evening to flush electrolytes (salts) out. Eating salty potato chips b4 bed guaranteed to give cramps! If woken with cramps take a pee and drink more water! Works well for me. Sometimes takes 2 trips to b room but no more for rest of night. 2) head to fridge and drink pickle juice. sweet style bread and butter Bicks pickles are my favorite. But even plain or malt vinegar and some sugar and water will work 75% of time cramps will stop within a few seconds. Tested by football teams to work. Studies say pickle juice hitting throat will send signal to brain intercepting cramp signal. Whatever the reason, it works for me. Just google it! 3) fortunately in Canada we can buy via prescription 90 tabs of quinine sulfate 200 mg for $40 at drugstore. Never had adverse effects though my dr did say it rarely might have some. Look for symptoms as with any drug. Tabs take effect quickly and you get back to sleep for rest of night easily. It’s my 3rd choice as I prefer to avoid meds when possible. BTW one would have to drink MANY MANY bottles of tonic water to equal one 200 mg tab Probably drinking any salt free liquid will flush salt out, as per item 1. Ps can’t believe putting soap under sheets would have any effect except for a psychological “positive attitude” influence. If it works, stay with it!
    Best wishes – it’s a nasty problem.

  2. Chris

    I just want the people who decide what’s good for us to suffer from leg cramps like I have. I don’t get them often but the only thing I’ve found that cures them is quinine. None of the remedies on the market today do a bit of good. My legs cramp so hard that I’ve scared the crap out of my wife because I wake up screaming in pain. It’s 4:04AM and I’m awake because of cramps. Used to be If I got a cramp I’d take one tablet and in about 10 to 15 minutes it would start to settle down and by 20 minutes it was gone as if it had never been except that the muscle that cramped hurt for days afterward.

    I’ve tried every over the counter med still available. I’ve tried taking calcium, magnesium B complex, multivitamins, D3, A, all together, and eating bananas and several things that I’ve read on the internet and none of them work. I’m not offering anything to try because nothing works except quinine. I took maybe 5 pills a year. I can have no empathy for the busybodies who decide that they know what’s best. Everybody is different. They make no allowance for that in their “we know what’s best” control freak minds. The federal government needs to butt out of our personal lives.

  3. Henry
    Silsbee texas

    I am interested in the soap solution, But sleeping an chunks of soap under your sheet painful?

    • Daniel E W

      There is plenty of evidence, and not just anecdotal, that quinine relieves muscle cramps. It is possible that it has little ability to prevent the cramps, but so what. Take it when you have a cramp. Obviously the decisionmakers at the FDA do not suffer from leg cramps otherwise they would not have made such a poorly informed decision. Agreed that some people have reacted adversely to quinine, even died, but you can say that about many prescription drugs.

      Cochrane Database Syst Rev. 2010 Dec 8;(12):CD005044. doi: 10.1002/14651858.CD005044.pub2.
      Quinine for muscle cramps.
      El-Tawil S1, Al Musa T, Valli H, Lunn MP, El-Tawil T, Weber M.
      Author information
      Update in
      Quinine for muscle cramps. [Cochrane Database Syst Rev. 2015]
      Muscle cramps can occur anywhere and for many reasons. Quinine has been used to treat cramps of all causes. However, controversy continues about its efficacy and safety.

      To assess the efficacy and safety of quinine in treating muscle cramps.

      We searched The Cochrane Neuromuscular Disease Group Register, The Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 3, 2010), MEDLINE, EMBASE and reference lists of articles up to July 2010.

      Randomised controlled trials of people of all ages with muscle cramps in any location and of any cause, treated with quinine or its derivatives.

      Three authors independently selected trials for inclusion, assessed risk of bias and extracted data. We contacted study authors for additional information.

      We identified 23 trials with a total of 1586 participants. Fifty-eight per cent of these participants were from five unpublished studies. Quinine was compared to placebo (20 trials, n =1140), vitamin E (four trials, n = 543), a quinine-vitamin E combination (three trials, n = 510), a quinine-theophylline combination (one trial, n = 77), and xylocaine injections into the gastrocnemius muscle (one trial, n = 24). The most commonly used quinine dosage was 300 mg/day (range 200 to 500 mg).Compared to placebo, quinine significantly reduced cramp number over two weeks by 28%, cramp intensity by 10%, and cramp days by 20%. Cramp duration was not significantly affected.A significantly greater number of people suffered minor adverse events on quinine than placebo (risk difference +3%, 95% confidence intervals 0% to 6%), mainly gastrointestinal symptoms. Overdoses of quinine have been reported elsewhere to cause potentially fatal adverse effects, but in the included trials there was no significant difference in major adverse events compared with placebo (risk difference 0%, 95% confidence intervals -1% to 2%). One participant suffered from thrombocytopenia (0.12% risk) on quinine.A quinine-vitamin E combination, vitamin E alone, and xylocaine injections into gastrocnemius were not significantly different to quinine across all outcomes, including adverse effects. Based on a single trial comparison, quinine alone was significantly less effective than a quinine-theophylline combination but with no significant differences in adverse events.

      There is moderate quality evidence that quinine significantly reduces cramp frequency, intensity and cramp days in dosages between 200 and 500 mg/day. There is moderate quality evidence that with use up to 60 days, the incidence of serious adverse events is not significantly greater than for placebo in the identified trials. Further research is required on the optimal dose and duration of use, and also on alternative treatments.

      Comment in
      [Quinine is effective in prevention of muscle cramps]. [Praxis (Bern 1994). 2012]
      PMID: 21154358 DOI: 10.1002/14651858.CD005044.pub2
      [Indexed for MEDLINE]
      Share on FacebookShare on TwitterShare on Google+

  4. Maria
    Leesburg, Florida

    I’m also a victim of night muscle cramps on both of my legs, calves, feet , my toes and sometimes my hips. I have tried Quinine tonic and it works fine. But I have Acid Reflux and it affects my stomach. I keep reading about bars of soap under the bed sheets.

    But no one is really saying how to go about doing this. Those of you who are using the soap method, please send information. I’m interested… It sounds too simple for it to work. But I’m willing to try anything that will hep me get rid of these leg cramps.
    Thank you,

  5. Anne

    For the soap remedy, is there a specific type/ingredient/brand? I heard one woman say she places a small sliver in each sock every night. What is the proper way to use the soap? I get cramps mostly in my calves and feet; had one in my thigh and one in my ankle bone area that were pretty terrible. I usually take Hyland’s Leg Cramp tablets, Formula 303 and use the Hyland’s cream, but I’m looking for a natural and cheaper remedy that I can take or use everyday to help prevent them in the first place.

    I will also try the tonic water with cranberry or orange juice.

    Thanks to all of you for the suggestions! I hate that there are this many people suffering from this. :-(

  6. Pam

    I’ve been plagued with leg cramps/Charlie horses for hears and have tried everything that anyone suggested, including Doctors, without results. I went to a natural path that concocted tinctures, also had a compounding pharmacy make up special formulas for me and nothing!!! I literally quit sleeping and walked the floors most of the night to prevent cramps. Recently my new family dr said try buying a six pack of small tonic waters and drink one each night before bed. I haven’t had a problem since! I find that I have to drink at least six ounces because I’ve tried less and I will still have the twinges or beginning of cramping that will wake me up. I’m very happy with this discovery!

  7. Don

    To get low dose quinine, just buy diet tonic water at the market.
    take 4 oz before sleeping. Only costs a dollar for a big bottle.

    Many folks get leg cramps in bed because they stretch with their knees bent. Always straighten your legs before stretching. Toes toward knees. Push through heels. Enjoy a cramp free stretch every time.

    • Ev W

      A few years ago there was a product on the market called Quinamm. It was manufactured by Merrell Labs. It appeared to be pretty effective for nocturnal recumbency leg cramps.

      FDA pulled it off the market.

      Perhaps some low cinchona bark and aminophylline combination might work?

  8. Karen

    Well, I have horrible leg spasms that make me to contort and bend my body continuously, in every direction, just to get a second of relief. It still doesn’t work or go away for hours or sometimes, days. :/ I will jerk, jump, pulsate and throb and the bad thing about it, it is not only in my legs but my whole body.

    I have found ONLY one solution to my problem that makes them go completely away, but in some states it is not legal. Just taking one hit off of a joint does the trick and I am not joking either. I’m not the kind to smoke weed either or do that, but hey…when you deal with spasms, due to nerve damage, I was willing to try anything to make them go away. What happened was, I was so miserable one night and my friend told me about it and happened to have some with her.

    I told her that I was willing to try it and that is the end of the story. Done and over with..not having to find any other solutions because that worked for me.

    • Marilyn

      Can you please tell me, what was the item work for you???
      Thank you.

  9. Judith M

    I’ve had RLS for years and tonic water used to work for me. Not so much anymore. I had a left knee replacement 2 months ago and now the cramping seems to zero in on my left leg (of course). I’ve tried mustard, bananas, Hyland’s with quinine, massage with Rosemary oil, and onward. Both of my doctors have nothing to offer and avoid muscle relaxants. The Hylands helps a little but seems like I still have to get up and walk.

    The FDA is a cruel agency for outlawing this remedy. Cramps cause real suffering for millions. It’s all about money and those big pharmaceutical corporations. Buy it wherever you can. It also called Cinchona. Thank goodness for the internet.

    • bill

      My cramps are mostly in my feet, I take just about every product, and then I take 1/2 cap of Cal 600 mg/D3 800mg and go to sleep. I don’t like it too much, read about the side effects. Sometimes I wake up with a little cramp and take a brand-name capsule. I might try the soap in bed, if I find out how.

  10. Kelly

    FYI, there is quinine in tonic water.

  11. jj

    I remember taking Q-vel it was so nice I kind of got addicted to it.

  12. Cindy

    I had suffered back cramps when I went to bed. After researching, I found that a lack of Magnesium (a vital mineral in a small amount is needed by the body) can cause muscle cramps. Magnesium is available from only a few foods, some that I don’t eat. It is also one that is not tested in labs unless specifically requested.

    I purchased Magnesium Oxide (research shows only 4% absorbed daily) OTC at Walmart and within 2 days, muscle cramps were gone. I reviewed my dosage (250 mg a day) with my Doctor and he approved. Just warned me not to take more due to high amount of negative side effects. Magnesium is not water soluble like B vitamins so it stays in your body up to 30 days. I did stop taking it for a week and the cramps returned. I now take it every other day with food and have no more cramps.

  13. Bea
    Brandenburg, KY

    I too have severe leg cramps, in fact they wake me up most nights and my calf muscles are sore for days. Two days ago I had two cramps one right after the other in my left leg and another one in my right leg. I can’t take quinine because my cardiologist forbids it, I have a pacemaker and it is the kind that if my Energizer bunny quits I quit but before this I drank quinine water, you know the type used to make a gin and tonic. It works and as far as crooked FDA is concerned they don’t bother it. My doctor at that time told me to have a gin and tonic every night before bed and I wouldn’t get cramps, I told him I didn’t like gin but I actually learned to chug the quinine water down and I didn’t get cramps. Forget to take it and get a cramp, just grab a quick swig and the cramp will be gone in a few minutes.

  14. Dayna F

    Think of all the new drugs that have more side effects than what you take them for and are legal. Also how many law suits because of them! Why havn’t I heard the same about Quinine? How lame is that?

  15. Fred

    Have any of you had experience with quinine waters used for neuropathy in your feet and legs? It was recommended to me by an acquaintance.

    • Laurie Sue Larson

      If it works they don’t want us to have it!

    • Linda

      Fred, I totally agree with you. Seems as if getting up every night with those painful cramps would be more of a strain on the body especially as an older person . Although I am in good shape my heart can take it. I can’t imagine that others may not be in good shape for whatever reason. When the cramps attack I jump out of bed and I know my heart racing in million miles a minute I’m losing sleep which also can’t be good but one quinine pill a night is going to give me all the side effects.

  16. Carolyn
    Washington state

    We have friends in Arizona that the husband gets cramps in his legs & back ever since he had back surgery & they fused a couple of vertebrae. Quinine is the only thing that helps. Dr’s have prescribed different pain meds but they are just dosing him & he can’t think clearly. Quinine doesn’t work that way. They take a trip to Canada once a year & go to a Dr there & he writes out a prescription for enough Quinine to last about 1 year. Then they go back again when he needs more. He was getting 7-9 cramps per evening/night. Now he gets very few & they aren’t very bad like when he doesn’t take the quinine.

  17. Anthony
    Rhoe Island

    For a very few who have abused quinine, the almighty FDA has told all of the severe leg cramp recipients that we can no longer purchase it. This is indicative of the Judge who can deliver a verdict without a jury. Who are they to tell us what is good for us, when in fact we’ve used it for years. How long must we suffer with this malady before someone with common sense says it’s allowable. It’s our life, must we be told how to live it? The Third Reich is long gone. I have used Quinine tablets for years without any problems for this ailment, now I’m told I can no longer purchase it.

    • Terry Graedon

      Quinine is not a drug of abuse, but some people ARE extremely sensitive to it and may have life-threatening reactions. That is why FDA has restricted quinine only for treating a serious disease: malaria.

      • Laurie Sue L.

        90 people over how many decades?!!!! Rediculous! It obviously wasn’t making them enough money so now it’s only for malaria at $4.00 a pill! Now they’re making money hand over fist, right?

    • manley

      There is hardly a pharmaceutical product that doesn’t have side effects, and many common remedies can be deadly for some people. Think of all the FDA approved well-known and widely-prescribed drugs that have been taken off the market because of the disastrous side effects. Even aspirin can kill. I can’t help feeling that quinine, a cheap natural drug, was taken off the market so that big pharm could cash in on their substitute product. Big moneyed corporations can exert much pressure on government agencies like the FDA.

  18. Terri

    I used to get leg cramps and cramps in my feet and toes. I asked a pharmacist what I could do and he suggested Quinine. No prescription was needed, he just sold me a bottle and I took them as needed – until one day I had a headache and the only thing in the office to take was aspirin. I was never told that I shouldn’t take aspirin and quinine in the same day – I wound up in the hospital with NO platelets. Even after a transfusion – I still had NO Platelets. Had I been in an accident, I would have bled to death immediately. So, if you use quinine in any form or fashion – DO NOT take regular aspirin.

    • Terry Graedon

      We could not find this interaction listed, but quinine alone can cause thrombocytopenia (loss of platelets). This can be a very serious condition.

  19. linda
    ct. 9/24/2016

    I found a pharmacy in n.y. where I got my quinine pills from and i’v been taking them for years with no problem.

  20. Barbara
    New York

    Quinine is only thing that works for my mother. She has cramps almost daily for several hours at a time. The cramps are on her face ribs arms legs and hands. Been to several specialists still no relief. She cannot get quinine anymore because it is illegal. If you can help please email me. I am desperate!!!

  21. Mady
    Henderson, NV

    The above comments are very interesting. Now here is my ‘take.’…
    I have been using soap on top of the bottom sheet for years. Amazingly, I rarely get thigh cramps anymore. I even take a bar of soap when on vacation. Also, I advised my pregnant daughter-in-law about this cure. It worked wonders on her , too. What amazes me is the fact that I have recommended this cure for probably 100 people, or more. So many people have refused to try it because it sounds ‘silly.’ Some people are stupid!!!
    Also, I have tried quinine cocktail mixer. Works quite well.

    • Cindy

      Hyland Leg Cramps with quine is sold today over-the-counter at GNC stores. You can also order it on line at many sites. If the FDA banned the product, it is not affecting this brands sales. Purchased it in the last week with no problem.

      • Terry Graedon

        Hyland makes homeopathic products. That means the dose of quinine in the tablets is low.

        • Cindy

          I have had negative side effects from this product (Hyland Leg Cramps PM). I have very vivid, long dreams–not necessarily a bad side effect, but noticeable. Mainly I have sleepiness, ear ringing in a “throbbing” cadence, dizziness and slight confusion. The product worked very well–1 thigh cramp in 4 weeks–but the side effects are unbearable. I will try the soap bar treatment.

  22. Markus

    I have had serious nighttime leg cramping intermittently for a number of years. What I’ve found works to relieve them is eating half a frozen banana. Alternately, using a powerful hand-held massager on the cramping muscle helps stop the cramping. I have not determined any reliable preventive regimen. Maybe the tonic water will be the ticket. I’ll try that. I like to mix it with orange juice, or drink it straight.

  23. Markus
    Northern California

    Big Government steps in again to save all the ignorant little people. So now you can’t get quinine for medicinal purposes, but you can still buy tonic water for cocktails and bitter drinks. Obviously the makers of tonic water aren’t getting their quinine from the pharmacy at $4.00 a pill. So where can I get it to make my own tonic?

  24. Sonny
    Las Vegas, NV

    Dill pickle juice, yes, pickle juice. Leg cramps waking you up? About 2 oz will relax the muscles in under 10 minutes.

  25. Octobyra

    I have posted a number of comments about leg cramps that have been torturing me for the last 12 years. I only get them when I do physical work that involves me bending at the waist, which is most of the work I do. They hamstring cramps had been so brutal at times that I began thinking about checking out altogether. I visited more than 12 different specialists — neurologist, 3 neurosurgeons, acupuncturist, chiropractor, vascular surgeon, etc. Two months ago I decided to have neurosurgery (a foriminotomy at L5) on the chance that my cramps were being caused by a pinched nerve in my lower back.

    Well, it did not work. I continue to get the cramps at night, 12 to 18 hours after a few hours or less of physical work. BUT I JUST DISCOVERED SOMETHING THAT WORKS TO GET RID OF THEM INSTANTLY!!! In all the years I’ve been reading about this horrendous problem, I have never read about this quick solution. HERE IT IS: If I straighten my cramped leg and raise it up and back over my head, so as to stretch my hamstring to the max, the cramp dissipates in one or two seconds !!! It works every single time for me. The hardest part is kicking the blankets out of the way with my right leg so that I can raise my left leg up and back (the cramps are always in my left leg). If only I’d discovered this 12 years ago. Now here is my question: Does this work for any of you folks?

    • Sandy
      S.Windsor, Ct

      I just tried it and it worked imediately. Wow, that is awesome. Thanks for the advice.

    • Marilyn

      You are very lucky, because you can raise your leg up and down all over your head, WOW!! Good for you!! I am 81 and CANNOT DO IT. I am drinking ONLY SOMETIMES the Tonic Water with Quinine, I like at very much, but give me VERY BAD pain to my stomach.
      Like to buy the Quinine Pills.

  26. Mary B.
    Argyle, TX

    Since quinine tablets are so expensive my doctor suggested that I drink about 4 ozs of tonic water each night to relieve my severe night leg cramps. I mix it with cranberry juice to make it taste better. Since I’ve been drinking this my leg cramps have gone away.

  27. Diane W.

    Easter Sunday 2014 after working several hours I came home around 3:00 p.m. after being home my legs started with restless leg syndrome. I have had it in the past but did not have anymore of my prescription left. I decided to go to Walmart to see if they had anything I could take. I purchased Hyland P.M. for restless legs I took the required dose and do not remember anything after that. Woke my grandaughter up around midnight putting pans of water on the stove saying I was going to work. What happened was I wrecked my car and got arrested for a DUII and I don’t drink. I don’t not remember anything that happened. My doctor said it was possible a reaction. When I can to my senses I took every ingredient in that product and check all the side effects. There were many that mimics being drunk I am just thankful that I did not kill anyone. I will never take an over the counter product without fully researching it. If anyone knows or has had issues with this product please let me know. Thanks

  28. NorthAlta

    Quinine is the only thing that works for my leg cramps! It has improved my quality of life 100% and I have not ever had any side effects.

    • Benjamin
      New Hampshire, USA

      I agree that quinine is the best treatment for me, but have great difficulties obtaining the drug. My physicians are reluctant to write a prescription fearing reprisals and possible loss of license. Is it possible to visit Canada and become a paying patient of a Canadian doctor and buy quinine on his prescription? I’d be interested to hear of other means of access to this drug. USA is one of the only countries to ban quinine.,

    • Sandy L.

      How much of the quinine water do you take in a day. I have been taking up to as much as 16 ounces per day and I am having severe intergestion and I wonder if it is the quinine water that is causing it. Any helpful information would be greatly appreciated. Thank you.

      Sandy L.

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