tonic water is safe, a glass of gin and tonic with ice and a lime slice, FDA bans quinine, beware tonic water, quinine for leg cramps

In the heat of a summer afternoon, a tall cold glass of tonic water can seem very appealing. It may even have health benefits, such as warding off nighttime leg cramps. But if you get carried away and turn one glass into two or three, is that dangerous? (Mind you, we are talking only about the tonic WITHOUT the gin. Three alcoholic drinks have clear dangers.) How much tonic water is safe for you to drink?

Unexpected Advantages of Drinking Tonic Water:

Q. I am normally a mosquito magnet. By this time of year I would usually have dozens of bites and the itching would be intolerable. I would turn into a bloody mess from constant scratching.

This year I have been drinking tonic water two or three times a day and I haven’t had a mosquito bite in weeks. As an added bonus, I haven’t experienced leg cramps while cycling. In hot weather I used to cramp up after two or three hours of hard riding.

Is there a limit on how much tonic you can drink before overdosing on quinine? I have read in your column that too much could be dangerous, but how much is too much? How much tonic water is safe?

Tonic Water as a Source of Quinine:

A. Doctors used to prescribe quinine pills to prevent leg cramps. The standard dose was between 200 and 300 mg of quinine.

The FDA banned quinine for this purpose but continues to allow it in tonic water. A liter normally has 83 mg of quinine. An eight-ounce glass would therefore have roughly 20 mg, about one-tenth the lowest dose doctors prescribed for leg cramps. Even three glasses daily should be OK as long as you are not sensitive to quinine.

Some susceptible people develop a dangerous blood disorder after even small doses of quinine. For them, no amount of tonic water is safe! Symptoms of quinine toxicity include digestive upset, headache, ringing in the ears, visual disturbances, skin rash and arrhythmias.

It makes sense to pay attention to your reactions, as the threshold for problems such as tinnitus may vary from one person to another.

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  1. Sandy
    NY
    Reply

    To all the people that are raving about the potential health benefits of quinine…

    Why do you think the FDA banned it?

    For that reason alone, I am a fan.

  2. Janice
    CA
    Reply

    I drink about 6 cans of diet tonic water a day. I started drinking it to mix with vodka but soon dropped the vodka. I noticed my leg/feet cramps were better. My Dr sees no harm in drinking it as long as it doesn’t have sugar in it.

  3. Dan
    Sligo, PA
    Reply

    I make tonic water using a machine and tonic concentrate, but I make a dilute solution. I’ve been drinking a liter or two for a long time. I have significant PVCs, enough to put me on the transplant list. I never thought to mention this to my cardiologist, but will now.

    • Madge
      Badger
      Reply

      But most quinine has loads of sugar from high fructose corn syrup. The diet varieties have saccharin.

  4. Joni
    Florida
    Reply

    I came to this site because diet tonic water is the only thing that quenches my thirst and I wanted to see if drinking it was either healthy or unhealthy. I drink about about 48 oz per day. I have no side effects and I’m assuming it’s better than drinking cokes or other diet soft drinks. (I need bubbles to quench my thirst). Hope I’m right.

    • Phyla
      San Antonio
      Reply

      I have been drinking 1 quart in 2 days. Is this safe? I cannot seem to find a definitive answer.

    • Suzanne S.
      IL
      Reply

      Try drinking Pellegrino water. It has no added chemicals or artificial sweetners and is very thirst-quenching.

    • Linda
      California
      Reply

      Hello , I have been drinking 2 liters of diet tonic water a day, thinking that it was better than nothing because it had no sugar. Well, it’s been 10 months, and just one month into drinking it, I ended up in the emergency room with Atrial Fibrillation, and they had to shock my heart back into normal rhythm. Very scary. I was put on three heart pills. Thought that would be it. But things are getting worse. I have been back to the emergency room two more times this month to have my heart shocked. I had never had a heart problem in the 65 years I have been here. I got a phone call today, and the doctor says I was in renal failure. My kidneys are shutting down. What the heck is going on?

      I finally realized that the only thing that was different was that I had started drinking tonic water 10 months ago every day, and I had no idea that the Quinine was dangerous in large quantities. I just called my Cardiologist and am going in to see her in a couple of hours. I am totally sure that the large amounts of Quinine that I have been consuning every day is killing me. Affecting my heart and my kidneys.

      Please, everyone, find something else to drink. Don’t die because of the Quinine.

    • Linda
      Reply

      Please don’t drink tonic water. The Quinine in it will kill you. I became very ill drinking 3 liters a day of tonic water with Quinine. It was my only beverage. I started getting A-Fib and my heart was not beating normal. I was in the emergency room twice in months to have my heart shocked back to normal. Very scary. You can have heart attacks too. Then all of a sudden just sitting down I had a massive nose bleed that would not stop.

      The massive nosebleeds went on for two weeks and the emergency room docs could not understand why I was in the hospital every day , sometimes twice a day . After that my doctor called and said I was going into kidney failure. No one knew I was literally killing myself with drinking tonic water. The Quinine is very dangerous. I figured it out myself and had to convince 4 doctors.

      They had never heard of it. Now, I’m off of the tonic water and no more heart problems, no more massive nosebleeds too. But I still have the blood disorder called Idiopathic Thrombocytopenic Purpura. That will never go away and it was caused by the large amounts of Quinine. So please don’t drink that awful stuff. It will kill you !

  5. Carola
    Oregon
    Reply

    I make my own tonic water (for leg cramps). I don’t like to use commercial with sugar or artificial sweeteners. I buy cinchona bark and it’s easy to boil it up and bottle it.

    • Mary L
      84046
      Reply

      How much bark do you boil with how much water to make an 8 oz. glass of it? Is this really bitter? Just wondering, thanks.

  6. Chuck
    Florida
    Reply

    I have peripheral neuropathy, with the result that my leg muscles twitch constantly and tend to keep me awake at night. I am trying tonic water. This might or might not be helping – the symptoms seem to be improving, but that could be a placebo effect. I have noticed that I don’t have to get up to go to the bathroom more than once/night, whereas I was getting up at least twice. I didn’t connect this with the tonic water until I started reading these posts, but there might be something to that!

  7. eileen
    AZ
    Reply

    I was just diagnosed with RLS on top of my Sleep Apnea. As I cannot have even decaffeinated beverages in the evening I am now drinking diet tonic water with a splash of OJ. I have found that I very seldom need to use the bathroom during the night so something is working for me. On occasion I do get pretty severe leg cramps before going to bed, but as long I get a good night’s sleep it’s all good.

  8. Victoria
    NY
    Reply

    I have been using diet tonic water, daily (four or five sips at a time, I keep a big bottle in the refrigerator at all times). I take it sometimes in the morning or if I feel the cramps start in the evening, usually, and IT STOPS THE CRAMPS IN SECONDS.

    I have had very bad cramps, my whole life, in my calves and feet, my toes curl up, and it is excruciating pain. I’ve had to step on my foot with my other foot to get the toes to go down. I found the high fructose tonic water made me become addicted, immediately, that’s why I chose the diet with saccharin, though I am concerned about saccharin.

    I haven’t had any side affects from the quinine or saccharin, and I’ve been doing this for many years. I’ve read what some doctors have said, and they said it has no affect. They DO NOT know what they are talking about. It saves me, daily!

  9. mark
    England
    Reply

    I have had a-fib for 4 years, and tonic water definitely triggers an attack every time without fail. Sadly, I loved a G&T but will now have to resort to gin and orange juice instead!

  10. Al
    Reading
    Reply

    I am partially to the occasional gin and tonic made in a bigger tumbler with lots of ice, filled up with lots of slimline tonic with a nice big slice of Lime. I had one the other evening and sipped it throughout the evening with none of my usual decaf tea and found that I only had to visit the bathroom in the night once! This is a huge deal for me and I will definitely partake of this drink (not with the gin) on a daily basis. Glad I found this site as two other people have commented on the same effects. Thanks

  11. Darren
    Hartlepool
    Reply

    I drink 1l of low calorie Indian tonic water per day. I absolutely love the taste, it’s very thirst quenching. I hope I’m not harming myself :-O

  12. Grahame
    UK
    Reply

    I have started drinking tonic water, suggested as a remedy for leg cramps. After two months the cramps have eased and become less frequent. I buy the supermarket own brand. Have read many articles about the pros and cons and as far as I can tell, like everything, there is always a negative side. I think the medical profession dislike anything that does them out of giving a prescription so tend to populate and exaggerate the downside.

  13. Muriel
    Darlington
    Reply

    I drink tonic water most of the day when I am thirsty but I feel so ill I can hardly put one foot in front of the other I also have lots of pain in my legs during the night .i am going to stop drinking it and see what happens . What have this space

  14. Andrea S
    South Carolina
    Reply

    I started tonic water to reduce leg cramps at night. It didn’t help much for the leg cramps but to my surprise it greatly helped my problem with urinary incontinence!

    • J. Angele
      Pennsylvania
      Reply

      Last night I only urinated once, as compared to 3 times a night, usually. May have been due to the tonic water I drank during the day.

  15. Jerry
    South Carolina
    Reply

    My Doctor told me to start drinking Tonic Water for cramps. I had them in my sides, my legs, feet and hands. Since I have been drinking diet tonic water, I have not had a cramp. I drink two bottles one in the morning and one before bed. Each bottle contains 8.5 fl. oz. (250ml.) I hope this is o.k because I am a firm believer in Diet Tonic Water.

    • Dee
      VA
      Reply

      Hey Jerry, I discovered the same thing! Am getting up much less during the night (for the bathroom) than I used to. Didn’t associate it with the tonic water. Thanks!

    • Dee G.
      VA
      Reply

      Hey Jerry, I had the same experience by drinking tonic water in the evening. Much less need to use the bathroom throughout the night!

  16. LVT
    UK
    Reply

    I suffered really badly from night cramps and started drinking tonic water. I take a large glass up to bed with me. I drink some before sleeping and some during the night if I wake. I drink diet tonic as I am trying to avoid sugary drinks. It has certainly stopped the cramps in legs and feet. I don’t seem to get any side effects, even when I drink it during the evening.

  17. Tom
    New Jersey
    Reply

    I am 82, reasonably good health. I sip diet water about ten time a day, as a thirst quencher. [when I’m home] total about 1 pint.

    I don’t believe it is causing any problems. but I still get lower leg cramps during the night when in bed. tho I tend to blame that on poor circulation typical for my age.

  18. Lori
    Indiana
    Reply

    When really stressed i’ve had muscle twitches of my eyelids. My eye doctor told me to drink 8 ounces of Tonic Water once daily. It works.

    • Yolanda
      Horsham, UK
      Reply

      I was suffering with severe muscle twitching in my left eyelid for many weeks. Not knowing who to go to I visited my optician, Dr and also tried a relaxing Indian Head massage therapy. My eyesight was fine, my Dr could find no reason for the twitching, and the massage did not work. I was then sent an article about the benefits of drinking Tonic Water to alleviate the symptoms and it worked almost immediately, certainly within hours! Definitely works!

  19. Dale
    Florida
    Reply

    I have drank tonic on a regular basis for many years, and as I get older, I’m having issues with the high fructose corn syrup, so I started looking for natural tonic, which is hard to find and is expensive.

    I did find a product at Fresh Market that was reasonable. There are natural tonics out there on the internet. I don’t drink diet tonic either. As far as leg cramps go, I have had issues with that but I take a supplement, which has magnesium, potassium, calcium. I also use a homeopathic leg cream, which works great.

  20. J. David Auner
    Springfield, MO, USA
    Reply

    Hemolytic anemia is a rare problem with quinine and quinidine – but could happen with even small exposures.

    • Aida
      Reply

      Fever-Tree elderflower tonic water made with natural quinine, no artificial sweetners, flavorings or preservatives. A little more expensive then other brands, but…..I’ll have a vodka tonic once in awhile with 5 ounces tonic water.

      • Wendy
        Pennsylvania
        Reply

        Thanks so much for the recommendation. I was wondering if there was one without fructose or artificial sweeteners, and I just found it at a big mega-grocery chain.

    • Mary
      Lakeland, FL
      Reply

      If you have Publix (FL) grocery stores, they have their own brand regular or diet. It works great. I use an over the counter lidocaine(4%) / menthol (1%) potion rubbed on over areas of severe cramping along with it for faster and longer relief. I am finally getting more that a couple hours sleep.

    • Ellen
      CA
      Reply

      David,
      This is creepy to find your comment because just an hour ago I was searching around the web for explanations for my round-the-clock red eyes and swelling of the ankles and stomach. I landed on hemolytic anemia, and then separately I started to wonder if I had been drinking too much tonic water (probably a liter a day of diet tonic). I lost my taste for for it for a few weeks and wondered if my body was telling me something? What else can you tell me about the link between quinine and hemolytic anemia?
      Ellen

  21. Marilyn
    Indiana
    Reply

    Why not take magnesuium for leg cramps? I take 250 mg but most people can safely take 500 mg per day without problems. Many people are magnesium defficent and don’t know it anyway.

    • Robert
      Hyattsville, MD
      Reply

      I use magnesium for leg cramps, constipation and to reduce arthritic inflammation. I take 1,200 gr daily, 400 gr per pill. No side effects.

  22. Virginia
    Reply

    What has happened to paregoric for stomach cramps? Even my pharmacist isn’t familiar with this drug that was once OTC – then by prescription, then not available at all. There has never been an OTC product as effective for relieving pain.

    • Steve
      Reply

      Paregoric is an opiate that historically was widely abused by addicts. It’s most common usage was to treat diarrhea but was pretty much sidetracked in favor of Imodium. As part of the general crackdown on drugs which can be abused, it’s been heavily discouraged, and is available only by prescription.

  23. Katharine
    Reply

    On quinine and tonic water: some people (including myself) find that this is a trigger for atrial fibrillation. I would experience an a fib attack about an hour after entering a restaurant, which was about 50 minutes after imbibing my customary gin and tonic. After reading that quinine can be an a fib trigger, I stopped the drink and have not had an attack since then.

    • Cindy
      Seattle, WA
      Reply

      This is a reply to Katharine, who warns that tonic water is a trigger for A-Fib (at least for her) and says people should be aware of this. Well, I had A-Fib for about 2 years (now resolved with the help of surgery), and I sure don’t want it to return.

      Since I like tonic water a lot, I IMMEDIATELY did a Google search for “Tonic water and A-Fib.” I must say, I found no references at all for tonic water being a trigger, but FOUR references that said it was used in the TREATMENT of A-Fib, i.e., that it would help RESOLVE it.

      I thought this was so interesting that I dug this PP email out of the trash and did this comment. Anyway, I now feel better about the quinine water. Cheers!

      • Linda
        Reply

        Tonic water with Quinine can certainly put your heart into A-Fib. All of a sudden, I have a major heart problem.

  24. Amy
    Reply

    A friend who has Parkinson’s drinks tonic water to reduce leg cramps. When I tore the vitreous in my left eye and developed muscle spasms in my eye, she suggested thatI start drinking tonic water to reduce the muscle spasms. It worked for me! Initially, I had to drink 2-3 glasses per day but was able to reduce to 1-2 glasses. It has taken most of the past year for the tear to heal. I’m not drinking tonic water every day, but I keep it around for days I feel more pressure in my eye.
    I worried a little about the quantity I drank initially, but the pain was so intense and unbearable.

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