Quinine alert still stands for night cramps
9 August 2002
People who have had quinine-induced thrombocytopenia have been warned to avoid all products containing quinine, including drinks such as tonic water and bitter lemon.
Thrombocytopenia is a disorder where there is a lack of platelets, which are a type of blood cell involved in clotting.
The Adverse Drug Reactions Advisory Committee (ADRAC) has issued the warning as it is still receiving reports of thrombocytopenia in people who had taken quinine for night cramps, despite safety warnings in the late 1980s and early 1990s.
The committee had received 20 reports since 2000, it wrote in its August bulletin.
Analysis of medical trials had shown that quinine prevented on average one or 2 cramps a week compared with placebo, without reducing cramp duration or severity, ADRAC said.
Since 1972, the committee has received 571 reports of suspected adverse reactions to quinine sulphate or bisulphate — including 198 reports of thrombocytopenia, 4 of which had a fatal outcome.
The US Food and Drug Administration had withdrawn the nocturnal cramp indication from quinine products in 1995, because of a lack of evidence of efficacy.
The Australian Medicines Handbook also recommended against the use of quinine for this indication.
Last Reviewed: 12 August 2002
- 1. Medical Observer Weekly 9/8/02
