No more Quinine............

[Nan]

We were told in my unit this week that we would no longer be given quinine at the beginning of treatment, (if we asked for it)  because they were no longer going to be carrying it.  They said it does not work.....excuse me.....I am the one CRAMPING!!! One nurse laughed and said....it is all in your head....that it helps cramping! So what does everyone think about this....DOES it help with cramping or 

[jbeany]

I don't know, never tried it.

But if it's all in your head, then it's working on a placebo effect - so ask them why they didn't just start giving you a sugar pill?  Yeesh - I hate nurses with attitudes.

[aharris2]

(We're both here)
Cramping is caused by more one thing. If your cramping is due to electrolyte imbalance or dehydration, it is inappropriate to treat it with quinine and, in fact, our nephrologist would not pursue it. Instead he focused on the causes. Now, we are way beyond that and can manage that ourselves. But another cause has emerged. Apparently the nerves of a dialysis patient can become excitable (comments anyone?) and it can cause cramping as well as other issues. After ruling out the other causes of cramping, the nephrologist consulted with a neurologist and prescribed quinine "as needed". We have only used it once and it was almost immediately effective  

[Panda_9]

If you are cramping on the machine it is probably because of the fluid being taken off too quickly. Try to cut down on intake between treatments and see if that helps. If you are cramping whilst not on the machine, try drinking some tonic water. I always got cramps in bed, extremely bad ones, and I drank about 200ml of tonic water before bed and it helped alot. There is only minimal quinine in tonic water but it helped, who cares if it was a placebo!

Now Im on nocturnal dialysis and getting such excellent blood results, I very very rarely get cramps, or any of the other horrible dialysis problems. It is so worth the sleepless nights.

[billable]

I was told that the reason is that there have been no studies to show that quinine helps with cramping.  Since quinine is dirt cheap, there is no incentive to do the studies to prove or disprove that it works or not.

Quinine is used for treating malaria and any other use is considered off label.

[Sluff]

I am not on dialysis but my neph told me to try quinine for the cramping I get and it did nothing for me.

[boxman55]

I take two before I start treatment and it seems to help me.  Boxman55

[Hawkeye]

We were told in my unit this week that we would no longer be given quinine at the beginning of treatment, (if we asked for it)  because they were no longer going to be carrying it.  They said it does not work.....excuse me.....I am the one CRAMPING!!! One nurse laughed and said....it is all in your head....that it helps cramping! So what does everyone think about this....DOES it help with cramping or 

I'm not sure about if it works or not, but I know the reason we no longer carry it at my clinic is because it is no longer available from our medication supplier to order.  Amerisource-Bergen is the company that we order our medications through and they sent out a message saying they would no longer be distributing it.  If it is something you want/need you can get a script for it from your nephrologist and bring your own to treatment.  That's how we have been forced to handle it here.

[billable]

We were told in my unit this week that we would no longer be given quinine at the beginning of treatment, (if we asked for it)  because they were no longer going to be carrying it.  They said it does not work.....excuse me.....I am the one CRAMPING!!! One nurse laughed and said....it is all in your head....that it helps cramping! So what does everyone think about this....DOES it help with cramping or 

I'm not sure about if it works or not, but I know the reason we no longer carry it at my clinic is because it is no longer available from our medication supplier to order.  Amerisource-Bergen is the company that we order our medications through and they sent out a message saying they would no longer be distributing it.  If it is something you want/need you can get a script for it from your nephrologist and bring your own to treatment.  That's how we have been forced to handle it here.

http://www.chron.com/disp/story.mpl/life/4470505.html

Jan. 15, 2007, 11:22AM
Despite dangers, doctors still prescribe quinine sulfate for restless legs


BY JOE GRAEDON and TERESA GRAEDON
King Features Syndicate

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Quinine is one of the oldest drugs in the pharmacy. Even before the Spanish discovered the New World, native healers in Peru were using the bark of the cinchona tree to treat fever, malaria and indigestion. An Augustinian monk wrote about the uses of the "fever tree" back in 1633.

In Europe, this bark proved useful for treating the fever and chills of malaria. Chemists later determined that the active ingredient in this healing bark was quinine, and it was used around the world wherever mosquitoes carried the disease. The British even incorporated it into their "tonic water."

No one in the United States has worried about malaria for decades. But quinine was popular as a treatment for nighttime leg cramps. For years, people bought this drug in over-the-counter products such as Legatrin, Q-vel and Quinamm to relieve muscle cramps.

In 1994, the Food and Drug Administration banned quinine from over-the-counter sale. The agency decided that quinine was too dangerous for people to take without medical supervision.

Quinine can cause serious side effects, including life-threatening anemia and irregular heartbeats. Other hazards include severe headache, visual disturbances, rash, itching, ringing in the ears, nausea, diarrhea and liver damage. If a pregnant woman took quinine, her baby could be born with a defect.

The FDA maintains that leg cramps are not a serious health problem, while quinine can be lethal. Through the years, more than 90 people have died of quinine complications.

Despite this, nearly 2 million Americans took quinine to relieve their leg cramps. Doctors continued to prescribe quinine sulfate for restless legs as well as leg cramps.

Now, however, the FDA is cracking down. Soon, only one brand of quinine will be allowed on the market. Qualaquin is approved only for treating certain types of malaria, and it costs more than $4 per pill.

The more rigorous ban might pose problems for millions. One reader wrote: "It was refreshing that our doctor prescribed quinine sulfate for my husband's restless leg syndrome. He takes one pill each night before bedtime and gets wonderful results."

Even people who have used quinine successfully for years won't have access to it now. The trouble is that there aren't very many other medications that can relieve leg cramps.

We discuss a number of home remedies and other approaches to this common problem in our Guide to Leg Pain. Anyone who would like a copy, please send $2 in check or money order with a long (No. 10), stamped (63 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. RLS-5, P.O. Box 52027, Durham, NC 27717-2027. It can also be downloaded for $2 from our Web site: www.peoplespharmacy.com.

One reader had good results from an inexpensive remedy: "After suffering with leg cramps for over 30 years, I heard about putting a bar of soap under the bottom sheet of the bed. Nothing kept me from having to get up and massage my feet and legs until I tried the soap. What a relief to be able to finally get a good night's sleep!"

Other approaches to leg cramps include drinking low-sodium V8 juice and consuming extra calcium, magnesium and B vitamins. Some even report that a little yellow mustard can relieve nighttime leg cramps.