Long-term use of quinine for muscle cramps associated with increased risk of death

May 9, 2017, The JAMA Network Journals

Long-term off-label use of quinine, still prescribed to individuals with muscle cramps despite Food and Drug Administration warnings of adverse events, is associated with an increased risk of death, according to a study published by JAMA.

Laurence Fardet, M.D., Ph.D., of the Universite Paris Est Creteil, France and colleagues used data from a UK primary care database and included adults who received new quinine salt (sulfate, bisulfate, dihydrochloride) prescriptions for idiopathic (unknown cause) muscular cramps or for at least one year from January 1990 to December 2014 at an average dosage of 100 mg/d or more (exposed group).

The study population included 175,195 individuals; median follow-up was 5.7 years. Exposed persons received a median 203 mg/d of quinine. There were 11,598 deaths (4.2 per 100 person-years) among the exposed individuals vs 26,753 (3.2 per 100 person-years) among the unexposed individuals. The increase in the risk of was more pronounced (approximately three times) in those younger than 50 years. A dose-effect was found for exposure to doses 200 mg/d and higher compared with less than 200 mg/d.

Many drinks such as bitter lemon or tonic waters contain quinine. Individuals in this study received more than 100 mg/d of quinine, equivalent to a daily consumption of more than one liter of bitter lemon or tonic waters.

Limitations of the study are noted in the article.

"The benefits of quinine in reducing cramps should be balanced against the risks," the authors write.

Explore further: Nocturnal leg cramps more common in summer

More information: JAMA (2017). jamanetwork.com/journals/jama/ … .1001/jama.2017.2332

Related Stories

Nocturnal leg cramps more common in summer

January 26, 2015
Painful nocturnal leg cramps are about twice as common during summer than in winter, found a new study in CMAJ (Canadian Medical Association Journal).

Bitter taste receptors hold key to treating asthma

April 27, 2017
One in nine Australians, among more than 300 million people worldwide, suffer from asthma. They experience a wide range of debilitating, even life-threatening respiratory symptoms from a disease that can be controlled but ...

Research team finds no adverse risk to use of common antimalarials in first trimester of pregnancy

May 4, 2017
LSTM, University of Washington and international researchers publish the most comprehensive international analysis on artemisinin combination antimalarials safety in pregnancy

Does death of a sibling in childhood increase risk of death in surviving children?

April 24, 2017
Bereavement in childhood due to the death of a sibling was associated with an increased risk for death in both the short and long term, according to a new article published by JAMA Pediatrics.

Recommended for you

Another opioid epidemic downside: more heart infections

April 26, 2018
(HealthDay)—Here's yet another consequence of the U.S. opioid crisis: a rise in serious heart infections in a state hard-hit by the drug epidemic.

Doctors prescribe opioids at high rates to those at increased overdose risk

April 24, 2018
The number of first-time prescriptions for opioid drugs has not risen since about 2010, according to UCLA researchers. However, patients taking a class of drug known to increase the risk for overdoses were likelier to receive ...

Study: Ibuprofen, acetaminophen more effective than opioids in treating dental pain

April 17, 2018
Opioids are not among the most effective—or longest lasting—options available for relief from acute dental pain, a new examination of the results from more than 460 published studies has found.

Text messaging tool may help fight opioid epidemic

April 17, 2018
A new automated text messaging service may curb opioid abuse and reduce the likelihood of relapse while also decreasing treatment costs, according to researchers at Washington University School of Medicine and Epharmix, a ...

Marijuana-based drug gets positive review from US agency

April 17, 2018
A closely watched medicine made from the marijuana plant reduces seizures in children with severe forms of epilepsy and warrants approval in the United States, health officials said Tuesday.

Post-surgical opioids can, paradoxically, lead to chronic pain

April 16, 2018
Giving opioids to animals to quell pain after surgery prolongs pain for more than three weeks and primes specialized immune cells in the spinal cord to be more reactive to pain, according to a new study by the University ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.