a glass of tonic water with a slice of lemon

Q. Since quinine sulfate is no longer available for leg cramps, I wonder if there is any danger in drinking “tonic water” just for the flavor. Quinine is an ingredient, I believe.

A. Although the FDA has banned the use of prescription quinine pills to treat leg cramps, the agency has not proposed eliminating tonic water from the market. If it did, a lot of people who enjoy gin and tonic might revolt.

Readers aware of the quinine in tonic water have put it to use:

“I have been drinking tonic water with quinine for about two months now, and my leg and foot cramps have disappeared completely.”

FDA banned quinine from use against leg cramps because sensitive people may develop a potentially deadly blood disorder in reaction to quinine. Although this complication is rare, it is extremely serious. One reader reported being hospitalized after drinking a 5-ounce glass of tonic water. She developed a terrible skin reaction and her blood platelets plummeted. She was told that in her case even a drop could be lethal.

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  1. Deb
    Woodstock Ga

    My father had malaria in Vietnam and was treated with Quinine pills. He has been fighting peripheral neuropathy for many many years and is not a diabetic. He foot will jump due to the pain they feel it is the neuropathy. But when he drinks the tonic water WITH Quinine it goes away. Doc can’t explain it. But for whatever reason it works. He’s been drinking the tonic with Quinine for 20 yrs at least .

  2. Sally
    Worcs UK

    I had sensory peripheral neuropathy, confirmed with lower and upper limb nerve conduction studies two years ago. I started drinking a glass of tonic water each day and gradually the craps subsided, the neuropathic discomfort disappeared, my sensation is returning and my latest nerve conduction studies wer all completely normal. I’ve taken no other medication. Amazing!

  3. Patricia

    I had back surgery in May of this year. I cannot sleep in my own bed because I am in such excruciating pain when I get up. There are tears in my eyes. I have to sleep in a zero gravity chair and still have back pain, although not as bad. I had surgery between L-4 and L-5 because I had sciatica down my right leg. However this pain that I now have is 10 times as bad. Does anyone know if tonic water would help back pain from the surgery?

    • The People's Pharmacy

      We’ve never heard that tonic water would be helpful in such a situation.

  4. John
    Fort Frances, ON

    I would like to hear if severe stomach spasms can be helped by drinking quinine?

  5. Robert

    I noticed one day my calf had tighten so hard it took my breathe away and tears came to eyes calling to god to take it away it last about 10 minutes before it went away, but i started taking Canada dry tonic water and it takes them away they don’t come back i now make it a case to take it everyday so it does not come back and all you know when you get one it is bad keep drinking tonic water and lots of water so you don’t get dehydrated it helps.

  6. Dave
    homestead fl.

    I have MS and suffer with major pain all year long. I’ve just started tying the club soda to see if there is any difference. I also take my routine meds but they don’t seem to help. Hoping this does.

    • Bob

      Club soda and tonic water are not the same. Tonic water has quinine, which is the ingredient that stops cramps.

  7. Lee Bullard
    florence S.c.

    Is quinine sulfate and hydclorie the same?

  8. t bradley

    Had triple heart by-pass surgery about 5 years ago due to Congestive Heart Failure- afterwards was put on several prescriptions one of them being Lasix- due to the increase in urinating my potassium levels were being lowered even after taking potassium pills. While sleeping I would be awakened by chest, rib cage, abdomen ,leg cramps- pain like I have never experienced. The chest & abdomen cramps were so bad I literally stood up in the bed thinking I was having a heart attack. The cramps continued nightly for a couple of weeks even after my doctor prescribed increased potassium.

    One day while on the computer I did some internet searching and came across Tonic Water with Quinine as a possible remedy. Bought a 6-pack of Tonic Water w/quinine in 10 ounce sized bottles. That very night I was awakened to some of the worst leg cramps I had experienced to date- finally made it to the kitchen and grabbed a bottle of the Tonic Water, after 4 to 5 sips the cramps just went away, I couldn’t believe how quickly the Tonic Water acted. Now I keep a bottle on my nightstand beside my bed, a bottle in my truck, along with the remainder of the 6-pack in the kitchen. The cramps haven’t bothered me in about 2 years now other than a leg cramp ever few months but just a few sips (4-5) of the Tonic Water and cramps are gone almost immediately afterwards.

    • ML

      Lasix works very well to get rid of the extra fluid but it works on the part of the kidney tubules that also makes us lose a lot of potassium (K+) and sodium (Na++). We also lose other electrolytes as well. You will be losing magnesium (Mg++) and calcium (Ca++) as well. Although I “prescribe” tonic water for my patients to help with leg cramps, you WILL need to check with your primary care provider as you likely are needing Mg++ and Ca++ supplementation as well. These are important for helping the K+ and Na++ to work with the electrical activity of our nerves and muscles. They also are more difficult for our body to absorb from the gut as we age and take many other medicines. Our body will rob our bones in order to maintain a blood level so you may show “normal” blood levels of these and still be needing/lacking these minerals. Please talk with your primary care provider.

  9. Kimberly

    I’m confused. My leg cramp pills have quinine in them.

    • Nan

      I have found the same effect with Tonic Water – absolutely wonderful and only takes a few sips – every day I think of the person who suggested this with gratitude x

  10. JB

    500mg Magnesium does wonders for my screaming episodes of leg cramps-I keep Magnesium in my purse, car, and on the headboard of my bed. It is very fast acting to take care of all my cramps.

  11. ca banks

    My husband’s doctor recommended tonic water for his leg cramps, which can be quite severe at times leaving him bruised and tender for several days afterward. Picked some up from Walmart although I wasn’t too happy with the HCF (our son has a potentially life threatening allergy to HCF – meaning no glucose IV for him, saline only). I was seeking info on tonic water and how/why it works. Now I have a concern and hope someone might have some answers. Quinine “sulfate” is the quinine referred to in most of the above posts; the tonic water I purchased listed the ingredient as quinine “hydrochloride.” Is there a difference? If the tonic water works for my husband, then I would have considered trying it myself (I have fibromyalgia and take flexeril for night leg cramps but it just takes the edge off). However, I am allergic to sulfer and have to read meds carefully to be sure I’m not taking a sulfate – for example my doctor has told me that I cannot take the glucosamine/chondroitin supplements because of the sulfate. But can I drink tonic water with quinine “hydrochloride” and would the benefits be the same? Thanks for any help and thanks for all the posts provided on this site – they have been most informative and helpful.

  12. Lydia C

    I’ve had leg cramps for the last two or three years, on and off. When getting out of bed in the morning, or when stretching my legs or body before getting up. The pains were severe, even though I am not a whimper or screamer… I’d groan for almost half an hour. Sometimes I would walk to the bathroom, with the pain, simply running hot water through my hands. I could feel the pain going away slowly. This way, after 1/2 hour, the pain
    would leave me. Now, I wear a pair of cotton short socks, and a pair of knee wrap going to bed to sleep. So far, I’ve not had scrimps for more than a few weeks. Another thing I do is DOING TAI-CHI for 15 minutes before going to bed. I don’t know whether this helps , or in some way it helps, the cramps have stopped showing up.
    When I did have the cramps, it would exhaust me so much that I felt fatigued whole day the following day. I do not try any kind of quinine, because I suffered from malaria as a child, and had taken quinine, I remember, so I don’t want any more of that stuff in my body.
    But thanks to all the above mentioned writers, I learned a lot from you, because I’ve never had these cramps before until probably a couple of years ago.

    • Phyllis
      Chino Hills, CA

      Check with a pharmacist

  13. Mrs B

    I now take potassium tablets, one in water each evening and I drink a large amount of low calorie tonic. My muscle spasms, cramps etc have now gone completely.

  14. Gary

    I get cramps in my feet, legs, hands, chest, and back, so I started drinking tonic water, my question is how much tonic water should I drink per day to relieve these cramps?

  15. Savita

    For cramps, high doses of magnesium can help, as well as monitoring electrolyte levels.
    Tonic water has an immediate effect but watch out for those quinine tablets. I took them regularly for a while and ended up hallucinating.
    I suspect side effects were the reasons they took them off the market. But the small amount in tonic water doesn’t seem to do any harm and can relieve the night cramps.
    People’s Pharmacy response: Keep in mind, before taking “high doses” of magnesium that overdoing it will result in diarrhea.

  16. lola

    I suffer from severe excruciating calf and inner thigh spasms. The thigh pain is worse than child birth in my opinion because with that you had a breather in between – the thigh pain does not stop until its good and ready. I get the thigh spasm when getting up off couch and the calf at night. They are wearing me out at nite especially.
    Drs can’t help. I also am afraid of knee replacement due to this spasm issue. when they hit you cannot just lie there. I jump up out of bed nearing killing myself in process but at least the calf will ease up in short time. stretching does not help me. As for the thigh one – that is the killer and makes me cry and ask god for relief. If I have knee surgery – I don’t think the surgeon will care about the spasms afterwards. Not his arena! I need the knee replacement badly too. Good luck to you – you are not alone.

    • Mary

      Hi Lola. I had my knee replacement 2 years ago now in Sydney NSW. I am 74years old and also suffer from terrible cramps in my legs hands and feet, especially after I have been shopping wheeling a trolley, then in the evening I get the cramps. to which they make me cry.

      One day I was shopping with my daughter, and my feet started cramping, then my legs my thighs too, I hurried to the ladies and sat on the toilet and just massaged my legs. I was afraid of not to be able to walk and having to be sent to hospital.

      When i do have them, lying down is no good. Now I’m starting to get a bit worried about my knee, is it because of those cramps? have I stretched my leg too far that it is now tight and feels tender. I don’t know, I did take tonic water one day last week and I felt good. but then I thought, quinine? I’m taking antidepressant, and now the doctor has put me on Celebrex for my leg. I’m not a pill taker as such, but I am worried.

      The other day I had an x-ray to my knee and blood test, which I haven’t received the reports yet.

      Lola, the knee operation was good under a spinal block. I recovered quickly and the surgeon was so pleased even my own GP. I am due for a 2year check up now. I will be able to tell him all about the problems I’m having with these cramps and will it effect my knee. It’s been great walking without pain so go for it.
      When you go for a pre op tell them about your cramps.

  17. lola

    You are not alone jewel – I get these inner thigh spasms when getting up off couch. And you are right! They are excruciating. Mine bring me to tears. Nothing seems to stop it once it starts – I just hobble off to kitchen and hang onto counter with leg up and trying all sorts of positions until it passes. But it is truly a terrible pain that cannot cannot cannot be ignored. I talked to my doctor about it and the only thing she said was she thought it might be coming from my lower back problems. Not sure abt that. Strangely enough – my late sister had them so it perhaps runs in my family. These pains are worse than child birth as far as I’m concerned.

  18. TES

    Have the Dr check your potassium and electrolyte levels my potassium runs low and take medication. Certain meds you take will alter your levels too. I still struggle from time to time with these horrible thigh and calf cramps I hope this helps.

    • Lindsay

      I get severe inner thigh cramps, I find that if I heat a grain bag (you can buy at a drug store) and apply to the area this usually gives me instant relief.

  19. AA

    I have been suffering with severe leg cramps and weak, painful muscles for over a year.
    Two months ago, I decided to switch from drinking wine to drinking gin & tonic. After two weeks, I noticed a great improvement in my muscle pain, so I switched from drinking water during the day to slimline tonic water. Now, I never get the slightest cramp and my muscles have improved beyond belief. Plus, when I add a spot of gin in the evening, I have cut the calories by 90%.

  20. jb

    First, I want to say thank you to all who have shared about their excruciating leg spasms. I thought I was the only one, as no one I know can relate.
    Two years ago, before I had knee replacement surgery, I went to a P.T. for therapy, as I was so worried about possible cramping post surgery. I honestly did not think I could survive the pain of the spasms in addition to the surgical pain.
    The PT used an ultrasound machine on my thighs. She also used hot packs and used a tens machine. I had no problem with the spasms throughout the surgery or after, and have only had two bouts with spasms since then.
    I had tried the tonic water with quinine, and think it helped to shorten the spasms, but it did not get rid of them. The physical therapy was a miracle for me.

  21. tem

    I cannot find anything regarding the use of the quinine in tonic water and a skin reaction. What type of skin reaction? Where is the source of the information? Also, what is the name of the blood disorder that was mentioned as a possible reaction to quinine?

  22. Anita

    I have been taking magnesium tablets every night as the leg cramps is unbearable. It is like have a heart every morning. I am constantly on a diet and would diet tonic help or is there something new on the market that will help me.

  23. Jackie B.

    Quinine water DOES help tremendously for leg cramps. Take one 8 oz. glass a day preferably late afternoon or early evening. Shasta tastes the best (if you can find it) & it is also cheaper than Schwepps or Canadian club. I’ve been taking it for years with NO side effects. I add a tablespoon of Grenadine to add a little sweetness. It has eliminated my leg cramps by probably 90%. That’s huge.

  24. s f

    I have had legs cramps occasionally for years but after I injured my back (herniated disk/pinched nerves) the cramps hits daily several time. Will Tonic Water with Quinine work? Also how much should I start out drinking and are there any side effects?

  25. Kevin

    I have CHF and am on a hefty regimen of diuretics. One of the drawbacks to diuretic use is gout…the other is severe cramping. I would get severe cramps across my ribcage, down my back and in my neck that would often put me on the floor. I have been prescribed potassium and slo-mag but they never seemed to help.
    At bedtime I drink a glass of tonic water with lime and I have not experienced cramping in weeks. Just my personal observation. Tonic water contains sugar and for those of you using diet tonic water there has been no appreciable difference found in weight gain or loss using diet or regular.

  26. Mabel

    I have been drinking two glasses of Schweppes Diet Indian tonic water for cramps for 2 months. I am getting less cramps, but am trying to lose weight. Will the drink make it harder for me to lose weight?
    Would QTonic water be a better option for me? Thank you in anticipation.

  27. Judith

    Does anyone know how to alleviate a heavy burning sensation in the soles of the feet?
    I have peripheral neuropathy, and this tingling/burning happens when the temperature goes above 24Celcius/75Fahreneit and keeps me from sleeping at night. I usually only feel it when my feet are off the cold tiled floor, though walking in a hot climate will also bring it on.
    High doses of calcium pantothenate (pantothenic acid) helped once but it doesn’t work any more.
    I’m 67 and also suffering from rheumatoid arthritis, though the burning feet pre-dates the RA.
    Any suggestions?

    • Barb

      Judith, I have been getting shots in my feet from my Podiatrist. Something called prolotherapy. It’s not FDA approved and my insurance won’t pay for the treatments, but it seemed to have helped the hotness and burning in my feet.

  28. James D.

    I have suffered leg cramp for the last two years and lately I have been drinking a small glass of tonic water before bed time and I no longer have cramps but if I miss a dose the cramps return I suffer from severe unstable angina and so far no side effects hope this helps.

  29. Mayan2012

    This is so true. There are more drugs on the market now that have terrible side effects and nothing is done.
    If they can not patent it… then get rid of it. There is no money to be made. So much progress in many areas but it seems we have gone backwards when it comes to prescription drugs.

  30. Jake M.

    from http://www.health.harvard.edu/family_health_guide/leg-cramps-the
    On rare occasions, quinine can cause thrombocytopenia, a significant reduction in the number of platelets in the blood that may result in easy bleeding. Because of this problem – and doubts about the drug’s effectiveness – the FDA stopped the over-the-counter sale of quinine in the mid-1990s, although you can still buy quinine tablets because of the loophole for dietary supplements. The very small amount of quinine in tonic water (about 15 milligrams per 8 ounces) is low enough not to pose a danger, but probably too low to offer any benefit.

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