Should we treat leg cramps with quinine?

Quinine hasn’t been known for centuries, but it has been used that long. Originally from South America, it comes from the Cinchona plant. Native tribes of South America, specifically Peruvian Indians, used the powdered bark of this tree to treat fever, malaria and indigestion, and in 16th century, Spanish settlers in South America discovered this tree and its medical uses too.

European missionaries brought the bark to Europe in 1630, and it became widely spread treatment for some deadly diseases.

Countess’s and Jesuit’s Powder

Quinine

Cinchona calisaya

In Europe, it was first known as “Countess’s Powder”, after the wife of Peruvian viceroy, Countess of Chinchon, who was cured of a malaria type of fever and who, says the legend, also named the plant Cinchona. After its arrival in Spain, it was used by the Jesuits, and due to their influence, the new name for the powder of Cinchona tree bark became – “Jesuit’s powder”.

In 1820 quinine was isolated from the bark, and the British began the cultivation of the plant, because it was in danger of extinction. The extract, quinine, was primarily used for treatment and prevention of malaria worldwide – building the Panama Canal would be impossible without it, but it was also used as a flavoring for its bitter taste, and to treat hemorrhoids, to manage varicose veins and to stimulate hair growth.

Gin and tonic and Tonic water

Since quinine is almost insoluble in water, but readily soluble in ethanol, the British soldiers were taking their daily doses of quinine dissolved in gin, with lemon or lime which masked the bitter taste of the quinine. Schweppes and other Indian tonic waters that contain quinine came on the scene later, in the late 19th century, and today people around the world are enjoying these beverages.

Quinine for leg cramps treatment

After malaria treatment, second most common use of quinine is for the treatment of leg cramps. Several clinical studies have confirmed its effectiveness in the prevention of nocturnal leg cramps, and many people swear it has helped them, but there are other studies that say quinine has not been shown to be effective for this purpose, and since it is not approved by the FDA, we are inclined to advise not to use it for the treatment of leg cramps, nor for any other off-label use.

Leg cramps quinine

Quinine

The use of quinine in prevention of nocturnal leg cramps is considered to be off-label, since FDA has approved only one drug, Qualaquin, mostly to treat malaria. However, you can still find a multitude of quinine preparations available, advertising for leg cramps, by a simple search of the Internet.

Why is it considered dangerous when used to treat other problems and conditions, but not for the treatment of malaria?

Using quinine can have some serious side effects, and several cases of death have been reported during the years. The risks include: heart attack, stroke, quinine cardiac arrhythmia’s, thrombocytopenia, liver damage or liver failure, kidney damage or kidney failure, hearing loss and other. These risks are real, but since malaria is life-threatening disease, the risks that are associated with quinine use are considered acceptable. Leg cramps, although uncomfortable and painful, aren’t life-threatening condition, and therefore the quinine use isn’t an acceptable risk, and could be especially dangerous if used without medical supervision.

The only way to use quinine for leg cramps that could potentially be safe is in tonic water or in bitter lemon. These beverages, also called quinine water, are available in any supermarket, and the amount of quinine in them is not large enough to be dangerous, if you don’t take more than one glass as a quick remedy.

Should we treat leg cramps with quinine?
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