Quinine in tonic water is allowed in quantities of no more than 83 parts per million (ppm) according to the FDA. Although consuming tonic water in moderation is unlikely to cause negative effects, some people may experience side effects if they consume too much or are extremely sensitive to quinine.
Side effects of quinine may include:
- Nausea, vomiting, diarrhea, and stomach cramps
- Ringing in the ears and hearing loss
- Changes in vision
- Weakness
- Confusion
- Nervousness
- Changes in blood sugar
- Behavioral changes
- Serious complications (rare) such as altered mental status, kidney damage, changes in heart rhythm, bleeding problems, seizures, and allergic reactions
What is quinine and what is it used for?
Quinine is taken from the bark of the Cinchona tree and has a bitter flavor. The tree is indigenous to central and south America, Western Africa, and the Caribbean.
Quinine was initially developed as a malaria treatment in the 1800s. It is still occasionally used today, although malaria parasites have developed some resistance to it and other medications have become available.
Comparatively, the amount of quinine in half a liter of tonic water (assumed to contain 83 ppm quinine) is equal to roughly 41.5 mg. However, malaria treatments typically contain about 540 mg or more and are administered 3 times a day.
Quinine has also been used as a remedy for leg cramps. However, this is no longer advised due to concerns about its efficacy and safety. The FDA has prohibited the over-the-counter sale of quinine because it has the potential to be misused, is not always effective, and can have negative side effects.
Who should avoid quinine?
Quinine in tonic water should be avoided if you are taking the following medications because they may interact with each other:
- Blood thinners
- Antidepressants
- Antibiotics
- Antacids, seizure medications
- Neuromuscular-blocking drugs
- Statins
- Seizure medications
If you decide to take quinine as a medication, make sure to carefully follow the dosage instructions and never take it without a prescription.
People with the following conditions should avoid quinine in medications:
- Pregnant or breastfeeding
- Irregular heartbeats
- Liver or kidney dysfunction
- Low blood sugar
For people with these medical conditions, the amount of quinine in tonic water is unlikely to interfere with their prescription or cause problems. However, supplements or medications containing quinine should be avoided.
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Drugs and Supplements Quinine (Oral Route): https://www.mayoclinic.org/drugssupplements/quinine-oral-route/side-effects/drg-20065753?p=1#:~:text=Serious%20skin%20reactions%20can%20occur,hypoglycemia%20(low%20blood%20sugar).
Disseminated Intravascular Coagulation Due to Drinking Tonic Water: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8765093/
Quinine: https://medlineplus.gov/druginfo/meds/a682322.html
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quinine
Quinine is a natural compound (alkaloid) used to treat malaria, a disease with high fevers, shaking chills, and flu-like illness. The most common side effects of quinine are a cluster of symptoms known as cinchonism. Symptoms of mild cinchonism include headache, dilation of blood vessels (vasodilation), sweating, nausea, ringing in the ears (tinnitus), hearing impairment, dizziness, vertigo, blurred vision, double vision (diplopia), visual disturbances, diminished visual fields, and disturbance in color perception. Consult your doctor if pregnant or breastfeeding.quinine sulfate (antimalarial) - oral, Qualaquin