Harvard Men's Health Watch

On call: Leg cramps and quinine

On call

Leg cramps and quinine

Q. I have the same problem with leg cramps as the man who wrote to you in the fall. I asked my doctor about quinine, and she gave me a prescription. But my pharmacist said it's not available anymore, even by prescription. What happened?

A. I've written many prescriptions for quinine over the years, and I've taken it myself. But I haven't had occasion to prescribe it since the FDA restricted it to the treatment of certain types of malaria in 2007. It's part of a broad FDA crackdown on "legacy drugs," older medications that have been produced in the United States for years but never went through the current drug approval process. Like your doctor, I failed to note this new situation. To my knowledge, only one prescription brand of quinine (Qualaquin) is still on the market in the United States. Because of potentially serious side effects, it is approved by the FDA only for life-threatening malaria, but doctors can prescribe medications for off-label uses. It is much more expensive than the generic formulations that were previously available.

I regret my error, and I apologize for the inconvenience it caused you. Unfortunately, I don't know of any other effective or less expensive medications for nighttime leg cramps. Still, the time-honored remedy of doing calf-stretching exercises helps prevent these painfully pesky cramps.

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