Leg-cramp sufferers face quinine quandary
Q. I am devastated that quinine is no longer available. I have taken it safely for decades to reduce leg cramping, especially at night. Since I ran out and cannot get more, I have a terrible time sleeping. I spend most of the night pacing the floor to work out the cramps. Why would the Food and Drug Administration ban quinine when it is the only thing that works?
A. Many people do well with quinine, but for some it is extremely dangerous. One reader wrote: “I took quinine for nighttime leg cramps. I was working for a physician who said quinine might help and wrote me a prescription.
“I took one pill, and within a couple of hours, I was deathly ill, not knowing what was going on. My doctor sent me immediately for blood work. My liver-function results were worse than my husband’s when he died from liver cancer. It took more than two weeks to get my body back on track. I would not recommend quinine to anyone.”
The FDA reasoned that since leg cramps are not life threatening but some reactions to quinine are, the benefit/risk balance did not favor the drug. There are, unfortunately, no other approved medications for leg cramps.
People with nighttime leg cramps may benefit from home remedies. Tonic water, which contains some quinine, is one option. Others include yellow mustard, low-sodium V8 juice or soap under the bottom sheet. More details on these and many other remedies are available in our Guide to Leg Pain. Anyone who would like a copy, please send $2 in check or money order with a long (No. 10), stamped (59 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. RLS-5, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.
Q. I want to warn others about taking too much calcium and vitamin D. Apparently, I took more than my limit and ended up with soft tissue calcifications.
My doctors doubted that this caused my calamity, but I am certain that it contributed. The calcium in my left arm caused a lot of pain. My mammogram also showed calcification. Calcium and vitamin D are very popular these days, but you can overdo.
A. Thanks for the words of caution. Women have been urged to increase their calcium intake to maintain strong bones, but a study from New Zealand also sounded a warning (British Medical Journal, Feb. 2, 2008).
Postmenopausal women were studied for five years. In addition to calcium in their food (roughly 850 mg daily), they took either 1,000 mg calcium or placebo. The women taking extra calcium were more likely to suffer a heart attack during that time. Another study did not confirm this risk, but there is some concern that excess calcium and vitamin D might contribute to calcification.
Q. I was recently diagnosed with shingles and prescribed Valtrex. I had no idea it was used for anything else until I picked up the prescription and read in the flier that it is used for herpes.
I thought this would be comforting for the woman who wrote to you that she was so ashamed about having herpes that she did not want to seek treatment. She was afraid people at the pharmacy would look down on her. These drugs have multiple uses, so who would know?
A. Valtrex (valacyclovir) is indeed used to shorten an attack of shingles as well as to treat genital herpes. You are right that a prescription for Valtrex is no cause for shame.