Night Leg Pain

Quinine for Night Cramps

The Spanish have been using quinine to prevent and treat malaria since the 18th century. But in 1936, Dr. Alexander Wolf from New-York showed that it was also effective for muscle disease. Once that discovery was made, it was only a matter of time before doctors started using quinine to treat night cramps as well. But, there is one very important note to make! Quinine can prevent night cramps. But it is not appropriate to treat them once they started.

quinine
The molecular structure of quinine. It is derived from the bark of the Cinchona tree

How does it Work?

The bottom line is that quinine makes it harder for nerves to get muscle fibers to contract. So even if the nerves are over-reactive, they will not get the muscles to cramp, if the medication is on board.

Prescription Quinine for Night Cramps

In theory, your doctor can prescribe quinine sulfate to help prevent night cramps. However, the United States Food and Drug Administration (FDA) issues an important statement. In this statement they wrote that while quinine was only approved for the treatment of malaria, they were aware that doctors were using it to treat muscle cramps. However, they were concerned about this practice. They pointed out the many side effects of quinine. Even though there has been a marked decline in the use of this medication, the FDA was still concerned about using it for cramps.

Quinine in Tonic Water

Despite the FDA’s concern about therapeutic quinine doses, you can still find it in tonic water sold in most supermarkets. It is what gives tonic water to give it the characteristic bitter taste. So how is it that soft-drink manufacturers can just put it in the water? It has to do with the dose. In most pills, you will find 500 mg of quinine per pill. But, in tonic water you will find only up to 83 mg per liter (this amount is also regulated by the FDA). Chances are you will not drink anywhere near a liter, and even if you did, 83 mg is still a far cry from even one pill.

Tonic water contains quinine for night cramps
Tonic water

But, is a bit of tonic water at bedtime going to help prevent night cramps? Well, according to some estimates, you need about 325 mg of the drug. That would mean that you will need to drink just shy of 4 liters of tonic water. Obviously, that is not realistic. Older people may need a bit less, but still… However, there are anecdotal reports that support drinking tonic water to prevent night cramps. Many people don’t mind giving it a try, if it will help prevent night leg pain.

Side Effects

You cannot read an article about quinine without reading about the many important side effects it has. Some of the side effects are reversible. But others are not. Some, like heart rhythm abnormalities can be fatal. An overdose will result in a condition called cinchonism, named after the Cinchona tree. But there are many other side effects. For instance thrombocytopenia, which mans a reduced platelet count. The FDA took these side effects into consideration when they issued the warning not to use this medication to treat night cramps.

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