Quinine

Background

• The main indication is for treatment of malaria
• Used off-label as a treatment for nocturnal leg cramps1

Safety

Adverse Effects

• Cinchonism: tinnitus, high-tone hearing loss, photophobia and other visual disturbances, dysphoria, headache, nausea, vomiting, sweating, dizziness and postural hypotension
• Hypoglycemia, from pancreatic β cell stimulation
• Hypotension, usually from IV infusion
• Hearing and visual disturbances, including irreversible loss
• Gastrointestinal symptoms
• Cutaneous effects
• Mild QT prolongation (rare unless plasma levels are elevated) and arrhythmias
• Hemolysis (in patients with G6PD deficiency or with hypersensitivity)