a glass of tonic water with a slice of lemon

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 in dose.

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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  1. Dee

    I’ve been getting bad leg and foot cramps. It was suggested to take a glass if tonic water. It worked great…for the first 2 nights…now the cramps are back…WORSE….In addition I get weird feelings in my arms and back muscles…also near my breastbone…I’ll just stop the tonic water, continue with the pain and cry a lot…it’s better than dealing with something worse than cramps…

  2. PaulM.

    PICKLE JUICE…….. The coach always had a jar of it at practice (football) ..and when any of us “cramped up” a few swigs of it and a little while later …. Bingo!
    I only used it once but it was effective…….
    What else to do when all the pickles are gone!

  3. ted

    I know the feeling, was taking quinine caps. for my cramps but they stoped making them. So now I take salt in my hand about 3 or 4 good shakes with three good swigs of quinine, bingo, cramps gone…………………………ps quinine in tonic mixer, good luck, ted

  4. Daniel
    Stockton-on-Tees Hya

    Hya, I’ve been using Tonic Water for some time now, but after reading about these side effects, I’m not so sure about taking it now, I had Tinnitus before I Started taking Tonic Water, I’ve actually had it for years, but it has been a bit more noisier lately, and I have been feeling very tired all the time, so I just wonder if there’s any connection, with taking Tonic Water. Surely there must be something they can subscribe without any side effects, can anybody help please?

  5. Rdoe

    I can’t tell you all how many people I have helped rid leg cramps!

    It’s electrolytes!!! Potassium number one! Magnesium to make the potassium work, and sodium.

    Try this, have some potassium pills beside your bed, when the Charlie horse hits, take it. If in less than ten minutes the pain is gone? You know you are on the right track.

    It is very tricky to get your hydration correct, but it’s not just about water. It’s about balance! Your body is trying its damnedest to find a balance, if you take too much sodium, the kidneys say dump, dump ,dump, and when that happens you lose potassium too.

    You must also provide sodium, and lots of water!!! What’s crazy about all of it is that calcium is telling your muscles what to do.

    Anyway this is just what has worked for me, I’m a 60 year old brick mason still keeping up with the young kids!!!

    • Barb

      Magnesium! Magnesium! Magnesium – tablet! Eat a banana or orange for the potassium, if you like. If you don’t get relief from magnesium and a banana or orange, go to the doctor and find out if your potassium is low (blood test), and the doctor will prescribe what you need.
      You don’t want to get too much potassium, either -too much is almost as harmful as too little. If you get too much magnesium you might get diarrhea. My husband always gets relief from muscle cramps with magnesium tablets. He just doesn’t eat the “green-leafies” or the right nuts (cashews, almonds and walnuts) to get enough magnesium.

  6. Bonnie

    I don’t understand the FDA’s position on quinine. Many substances can be devastating to certain people (ex.: sugar, peanuts, etc.) but they are are not banned outright. A quinine sulfate capsule can get a person out of a real jam if this cramping attack occurs in the car and you find yourself in such awful shape that you can’t even move well enough to get out of the car in a reasonable amount of time, let alone continue to drive.
    If this was happening to me all the time, I would hesitate to continue driving; but, for a once or twice a month event, I just can’t see not taking something that’s not affecting me negatively.

  7. Bonnie

    Very interesting post. Certainly the first time I have read that. Could you please tell me where you got that information? Thanks, Bonnie

  8. BLJ

    This is very interesting. I too, suffer from unbarable leg, foot, calf, hamstring, toe, and arch cramps, mostly at night, but often if I’m on my feet, standing all day. It’s interesting too, that so many of us describe the speed at which we have to get up and put weight on it, before it gets too tight to straighten. It’s debilitating and I literally have to sob with the pain if I don’t catch it in time. I’ve also noticed that it can come in waves. It gets so tight I am crying out, then it almost goes away, but no. . . it’s back with a vengence. It’s exhausting and the next day soreness is a sad reminder of a painful, sleepless night.
    I have been taking quinine for this condition for several years, at about 8 to 16 oz/day. It has dramatically improved the cramping problem, with almost no cramping at all, and certainly no crying, sobbing, crippling episodes. Now, I’m torn. I do not want to go back to the cramping, but my blood pressure is higher than we’d like, and I have noticed changes in my vision and hearing. I’m afraid to stop all together, so I think I’ll try to reduce the dosage and see if there’s improvement in the negative symptoms, but no loss in the cramp-free area, either. Thank you for the info and a place to share my experience.

  9. bonnie b

    Quinine is the only substance that will get rid of my leg cramps. I’m talking excruciating pain from the groin down to the feet that can last for hours. If I start to get a cramp, sometimes all it takes are some extra minerals, sometimes a homeopathic, sometimes a glass of tonic water. But, if it takes the “big guns,” I’ve got a prescription for quinine sulfate 324 mg caps. Don’t need to go that far very often, but I’m glad I have a doctor who is reasonable.
    My doctor watched me closely to see that there would be none of the serious complications some people get.
    For the FDA to make broad generalizations like they have is petty and suspicious. And as far as studies are concerned, that’s not going to happen. There’s no big money to be made off equine. And for them to just state rather cavalierly that equine is ineffective, is just a big lie.

  10. DLN

    I will try the tonic, just to see what’s so affecting about the taste, but wanted to add that, in my case, leg-cramping always seems to be a result of not having drunk a glass of milk for a while, and drinking one at the onset invariably relieves it.

  11. R. Patch

    I’ve had episodes of night cramps in my legs since I was in my 20s, not often, but occasionally. I’m 67 now. In the past several months, I started having severe cramps in my calves, that would wake me 2 or 3 times every night. I read that quinine would help – started taking quinine tonic water – a small glass or two, 6 to 12 oz. – before going to bed. Cramps stopped!
    I’ve got severe osteoarthritis in my hip, but that seems completely unaffected by the quinine. I know that quinine in large doses can cause tinnitis – I had a roommate, 35 years ago, who got addicted to Schweppes Bitter Lime soda, was drinking a quart or two (or more) a day, finally got severe tinnitis from that dosage level; it took several months of no quinine for his hearing to normalize. Sticking to a glassful each evening shouldn’t cause a problem, unless you have an acute sensitivity.

  12. EM

    Well now, this is just my luck. I am a devout Coke Zero drinker, and the only reason I bought the bottle of tonic water, was to see if it actually glowed in the dark, as I had read.
    For the heck of it yesterday, I took a swallow of it before throwing it away, because I was sure I was going to hate it, but wanted to see what it tasted like anyway.
    Lo and behold, I loved it! Unfortunately, I’m already being treated for A Fib and reading comments of how it may cause heart arrhythmias, nearly broke my heart! That is one thing I don’t need for sure, is help in that area!
    Now I’m going to miss my new found drink. :(

  13. Joan G

    After an auto accident has left me in severe pain over the last 3+ yrs, I was taking (daily) Oxycodone, Soma, and for acid reflux, an OTC acid reducer, and Crestor for high cholesterol. Suddenly, I began to get SEVERE nighttime leg cramps, which later became cramps in every body part that has a muscle… meaning, I had cramps everywhere.
    When I called my physician, he discontinued the Crestor, and prescribed Livalo, and also advised me to try drinking tonic water. The tonic water worked like a charm.
    Now, suddenly, I’m losing my hair like nothing I’ve ever experienced. I’m a retired hair stylist, so I’m confident in mt ability to recognize my hair loss as unhealthy. My research on the drugs I take, both prescribed and OTC, has shown that some can cause hair loss as a rare, but possible side affect. I then stopped these drugs immediately. I DID NOT stop the tonic water, however.
    My hair loss is not as bad, but, still unhealthy. Tonight, in my never ending quest to get to the bottom of the cause my my hair loss, it dawned upon me that the new addition to my previously benign drug intake, was the tonic water. Is it possible, that the tonic is the culprit?

  14. Jd

    My doctor recommended a small glass before bed for restless leg syndrome. Last night was the first night I tried it. I slept all night for the first time in a long while. Seems to work.

  15. daisy

    I want to know if a child of 13 years can consume tonic water or not? Having it once in a blue moon for a child is ok?

  16. Mary C

    My doctor told me to drink tonic water with quinine for possible low potassium due to restless legs and dizyness. She said to drink it all day. The next morning my blood pressure was 230//99, horrific headache, slurred speech (lasted 1 day), hearing and eyesight diminished. Is any of this reversible? It has been 3 weeks now.

  17. AJP

    I am 60 years old male and 2 years ago I was diagnosed with Arrythmia which was treated by Cardio-Version (sorry if spelled incorrectly). I am now taking 1 Flecanide tablets/day to manage my condition. I have always liked tonic water but have recently started to drink a glass per day (about 3/4 pint).
    I have started to get a strange jittery sensation under my breast bone and wondered if this might have been brought on by tonic water. I have stopped drinking it now and was oblivious to its ill effects. Is it possible that I may have caused my Arrythmia to return and should I go and get checked out to see if my heart rate is irregular?
    Your advice will be greatly appreciated.
    Kind regards AJP

  18. Bharat

    I have had Charley Horse (cramps) in my legs where the calf muscle rides high on the leg and I need to get up and either massage it down with my hands or walk around till it goes back down. This has been going on for years. Just last week, one of the devotees at my temple told me that she takes tonic water with quinine for her leg cramps.
    I tried it and it seems to work. However, after reading all these posts at this site, I hesitate because I have had a heart attack, I have had a kidney removed (so only one kidney at present) and I have diabetes and borderline hypertension (high blood pressure.) I do not know if the quinine will aggravate any of these. Please advise.

  19. KH

    I have had severe leg cramps and no sleep at night and I was told by a coworker to try diet tonic water for the cramps. Believe me, I have tried it all.
    The tonic water works the best and I am now able to sleep at night with no leg cramps. What works for some may not work for others. I also have arthritis and tonic water is the only thing that has helped with the pain.

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