From the FDA Drug Label
Quinine sulfate capsules are not approved for: Treatment of severe or complicated P. falciparum malaria. Prevention of malaria. Treatment or prevention of nocturnal leg cramps [ see Warnings and Precautions (5.1)]. The risk associated with quinine sulfate capsules use in the absence of evidence of its effectiveness in the treatment or prevention of nocturnal leg cramps outweighs any potential benefit [ see Indications and Usage (1)and Warnings and Precautions (5. 1)].
The treatment of nocturnal leg cramps with quinine is not recommended due to the risk of serious and life-threatening hematologic reactions, including thrombocytopenia and hemolytic uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP), and the lack of evidence of its effectiveness in treating this condition 1.
From the Research
To treat nocturnal leg cramps, quinine sulfate is no longer recommended due to its potential side effects, and instead, stretching the affected muscle, massaging, and applying heat can provide immediate relief, as evidenced by the most recent study 2. When considering treatment options for nocturnal leg cramps, it's essential to prioritize methods that minimize risks and maximize benefits in terms of morbidity, mortality, and quality of life.
Treatment Options
- Stretching the affected muscle: For calf cramps, stand facing a wall, place your hands on it, and extend the cramping leg behind you with the heel on the floor, gently leaning forward until you feel a stretch. Hold for 30 seconds and repeat 2-3 times.
- Massaging the cramped muscle and applying heat can also provide immediate relief.
- Staying hydrated throughout the day and maintaining adequate electrolyte levels, particularly magnesium, potassium, and calcium, may help prevent cramps.
- Over-the-counter medications like acetaminophen or ibuprofen can help with pain after a cramp.
Prevention
- Regular stretching before bed, staying hydrated, and wearing supportive footwear during the day may reduce the frequency of nocturnal leg cramps.
- Avoiding certain medications that can trigger leg cramps, such as diuretics and long-acting beta-agonists, as suggested by 3. If leg cramps are severe, persistent, or associated with other symptoms like weakness or numbness, it's crucial to consult a healthcare provider, as they could indicate an underlying condition like peripheral artery disease or nerve problems, highlighting the importance of a thorough medical evaluation 3, 4.