Quinine

[Bazile]

Her indoors received a letter from her GP stating that they are going to stop the repeat prescription for Quinine - which she was prescribed, for serious leg cramps .

It stated due to possible side effects and potential life threatening bleeding due to it affecting platelets in the blood . ( apparently it should only be taken for 4 weeks )

Has anyone taking this medication , being advised similarly ?

[Mamyalynne]

There have been rumblings on this one for some time, the FDA (USA) clamped down on Quinine some time back.

Has the GP come up with an alternative at all?

[slaney]

These are the latest guidelines I can find...
http://www.evidence.nhs.uk/formulary/bnf/current/10-musculoskeletal-and-joint-diseases/102-drugs-used-in-neuromuscular-disorders/1022-skeletal-muscle-relaxants/nocturnal-leg-cramps

Quinine induced thrombocytopenia (low platelets ) is pretty rare - I must have seen 3 cases in 30 years.

[TheChair]

This is what it says on the NHS site:

Thrombocytopenia is a rarer but more serious complication of quinine. It occurs when the number of platelets in your blood falls to a dangerously low level. Platelets help the blood to clot which means people with thrombocytopenia are at increased risk of excessive bleeding.


It is recommended that quinine is only prescribed when:
you have tried the exercise techniques discussed above and they haven't helped prevent your leg cramps
you have frequent leg cramps which affect your quality of life

In these circumstances, you may be prescribed a four-week course of quinine.

After this time, if you have not gained any benefit, the treatment will be withdrawn.

[slaney]

And Mamyalynne is right - the Americans have been discouraging its use for cramps over 10 years now.

[jno]

also not good if you have tinnitus, I'm told

[jno]

what do they suggest for cramps, then?

[Bazile]

The GP letter does not offer any alternatives

[jno]

Crampex used to be good but has vanished from the shops. I eat of bananas and some potassium+magnesium pills. Not a complete solution but I do wake up yelling and accidentally booting my OH out of bed much less than I used to.

[slaney]

I have to go out now, but have had a quick look at the Cochrane database to look at magnesium supplements and leg stretching exercises for nocturnal cramps - there is limited evidence that either of them work.