Does tonic water contain quinine?

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Last updated: April 11, 2025View editorial policy

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From the Guidelines

Yes, tonic water does contain quinine, but in very small amounts, typically around 83 mg per liter, which is considered safe for consumption as a food additive by the FDA 1. The use of quinine in tonic water originated from its historical use as a treatment for malaria, but the concentration in modern commercial tonic water is much lower than what is needed for medicinal purposes. Some key points to consider about quinine in tonic water include:

  • The FDA regulates the amount of quinine allowed in tonic water, ensuring it is safe for consumption.
  • The small amount of quinine in tonic water is what gives it its characteristic bitter flavor, making it a popular mixer for spirits like gin.
  • While most people can consume tonic water without issues, some may experience sensitivity to quinine, including symptoms like ringing in the ears, headache, or nausea, especially if consumed in large quantities. It's also worth noting that quinine is still used today as an antimalarial drug, as seen in the provided evidence discussing its use in combination with other medications for treating malaria 1. However, the context of quinine in tonic water is purely as a flavoring agent and not for any therapeutic purpose.

From the Research

Tonic Water and Quinine Content

  • Tonic water is a beverage that contains quinine, as stated in the study published in 2003 2.
  • The United States Food and Drug Administration has banned the use of quinine for certain medical conditions, but it is still widely available in beverages like tonic water and bitter lemon 2.
  • Quinine is used as an antimalarial agent, and its presence in tonic water is a remnant of its historical use as a prophylactic against malaria 3.

Quinine and Its Effects

  • Quinine can cause neurological complications, including confusion, altered mental status, seizures, and coma, particularly in older women 2.
  • The drug can also cause ototoxicity, leading to hearing loss, as documented in studies published in 1997 4 and 1990 5.
  • However, the hearing loss caused by quinine is often reversible, as shown in the study published in 1997 4.

Quinine in Modern Medicine

  • Despite its potential side effects, quinine remains an important antimalarial drug, especially in resource-limited settings where more efficacious treatments may not be available 3.
  • Quinine is still used to treat malaria, particularly in pregnancy and in cases where other treatments are not available 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Quinine-induced hearing loss.

ORL; journal for oto-rhino-laryngology and its related specialties, 1990

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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