Origin
Quinine is a natural alkaloid compound that originates from the bark of the cinchona tree (Cinchona genus), which is native to the Andean regions of South America, particularly in Peru and Bolivia. The indigenous people of these areas had long used cinchona bark to treat fevers and other illnesses.
The discovery of quinine's medicinal properties by Europeans is often attributed to Jesuit missionaries in the early 17th century. They learned about the native use of cinchona bark and introduced it to Europe. Quinine quickly gained recognition for its effectiveness in treating malaria, a mosquito-borne disease that was a significant health threat in many parts of the world.
Quinine's introduction to Europe led to its cultivation in various tropical regions, such as Java (Indonesia) and India, to meet the growing demand for this valuable antimalarial compound. The isolation and chemical characterisation of quinine happened in the early 19th century, which further advanced its use in medicine.
Common uses
Treating Malaria: One of the most well-known uses of quinine is in the treatment of malaria. The bark contains quinine, which effectively combats the Plasmodium falciparum parasite responsible for this devastating disease. Medical professionals worldwide prescribe quinine for its ability to target and destroy these parasites, helping to save lives in affected parts of the world.
Nighttime Leg Cramps: Beyond its anti-malarial properties, quinine sulfate derived from cinchona bark has shown remarkable efficacy in alleviating nighttime leg cramps. Many individuals suffer from these painful cramps, and quinine sulfate can provide much-needed relief. However, it's important to note that the FDA advises caution in using quinine for this purpose due to potential adverse effects.
Adverse Effects and Allergic Reactions: While quinine sulfate can be highly effective, it's not without potential side effects, which may include heart rhythm disturbances, ringing in the ears, and fluctuations in blood sugar levels. Some individuals may also experience allergic reactions. Therefore, it's imperative to use quinine sulfate under medical supervision to mitigate any potential risks.
Regulation and approvals
TGA Australia regulation (Department of Health and Aged Care - Therapeutic Goods Administration): In Australia, the use of quinine and its salts, including quinine sulfate, is subject to specific regulations. According to the Therapeutic Goods Administration (TGA), quinine is not restricted to human therapeutic use when the maximum recommended daily dose is 50 mg or less. This means that for doses within this limit, individuals in Australia can access quinine-containing products without the same strict regulations that apply to higher doses.
The TGA's approach to quinine reflects its commitment to ensuring the safe use of therapeutic substances while accommodating the needs of individuals seeking lower doses for various purposes. It's important to note that exceeding the recommended daily dose or using quinine for extended periods can still carry risks and should be done under the guidance of healthcare professionals.
FDA United States Approval and Usage: The FDA has approved quinine sulfate for the treatment of malaria due to its ability to kill the malaria parasite within red blood cells. It's crucial to follow FDA guidelines when using quinine sulfate to treat any condition. Only healthcare professionals should prescribe quinine, and its use should be closely monitored due to the potential for adverse effects.
Regulation Australia vs USA
Interestingly, the FDA limits the quinine content in tonic water to 83 ppm (83 mg per litre), which is 43 mg per litre higher than in Australia, where quinine or tonic water is exempt from Schedule 3 entry if less than 40 mg/L quinine is present (before therapeutic regulation kicks in).