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Quinine and Cinchona Bark
Quinine adverse effects:
Quinine or cinchona bark toxicity includes nausea, vomiting, confusion, blurred vision, dizziness, hearing loss, headache, arrythmia, hemolysis, rash, and renal failure.
Quinine and risk of bleeding:
Quinine can increase bleeding risk by potentiating warfarin (Coumadin) and patients need to stop taking these supplements with blood thinning agents (2).
Assessment and Plan: Quinine and Cinchona Bark
Quinine has been prescibed by physicians for leg cramps off-label without any strong evidence of effectiveness, and the FDA has warned for many years that harm outweighs benefit of this agent for this condition (1).
Quinine is present in cinchona bark available as an herbal supplement which has an unknown quinine content, and is not standardized or regulated by the FDA.
Quinine or cinchona bark toxicity includes nausea, vomiting, confusion, blurred vision, dizziness, hearing loss, headache, arrythmia, hemolysis, rash, and renal failure.
Quinine can increase bleeding risk by potentiating warfarin (Coumadin) and patients need to stop taking these supplements with blood thinning agents (2).
