Quinine -- popular remedy for leg cramps -- can be deadly

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People who rely on Qualaquin, also known as quinine sulfate, to combat their nighttime leg cramps are putting their lives at risk, warned the Food and Drug Administration. The federal agency issued a warning last week after reviewing reports that spanned from April 2005 to October 2008 in which 38 U.S. patients suffered severe to life-threatening injuries.

Qualaquin was approved by the FDA to treat only malaria, but has remained popular as a leg cramp fix. Of those 38 patients, 25 were prescribed the quinine sulfate drug off-label for leg cramps or for Restless Leg Syndrome. This off-label use has proven to be more harmful than good -- two died, 21 were diagnosed with thrombocytopenia (serious bleeding due to severe lowering of platelets) and were hospitalized, four experienced a condition that could lead to permanent kidney damage, and 10 had adverse effects ranging from hearing loss to an electrolyte imbalance.

"Quinine is an effective treatment for leg cramps but it has potentially deadly side effects," said Dr. Michael Smith, WebMD's chief medical editor, in an e-mail interview with WalletPop. "In fact, the FDA warned against the use of quinine for leg cramps in December of 2006. However, people have continued to use this treatment since there is little else that can help. But due to these serious side effects, and even reports of deaths, the FDA is now warning doctors against the use of quinine for leg cramps."

While quinine is present in tiny amounts in tonic water, Qualaquin is the only prescription strength quinine sulfate available on the market today. The FDA banned the over the counter availability of quinine in 1994 because of its side effects. The agency again moved in 2007 to ban all quinine prescription products except for Qualaquin -- and then only for the treatment of malaria.

With quinine no longer an option, leg cramp sufferers should consult with their physicians to try to find the underlying cause. In some cases, the best treatment may be simply drinking lots of water, as dehydration is one cause.

"Keep hydrated throughout the day and try to drink a glass of water at bedtime," recommended Keri Gans, a registered dietitian and national spokeswoman for the American Dietetic Association.

Leg cramps could also be due to reactions to certain medications or low levels of certain electrolytes, which can be determined by a blood test. If it's a magnesium deficiency, Gans recommends taking a calcium/magnesium supplement before bedtime as well as eating foods rich in that mineral, such as whole grains, nuts and green leafy vegetables.

Sometimes the problem is more serious. "That's why it's important to make sure your doctor has done any necessary testing to identify a potential cause," said Smith. "In many cases, there is no known cause of leg cramps, particularly cramps that occur at night."

One home remedy that has no side effects, and is absolutely free: stretching. "Stretching exercises are a must," urged Smith. That means stretching the calves regularly throughout the day. And right before hitting the sack, adopt an extensive calf stretching routine.
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