Meta-analysis of efficacy of quinine for treatment of nocturnal leg cramps in elderly people. (2024)

PMCID: PMC2548434

M. Man-Son-Hing and G. Wells

Author information Copyright and License information PMC Disclaimer

See letter "Side effect of quinine for nocturnal cramps." onpage738.

See letter "Treating leg cramp. Naftidrofuryl is a safe and effective alternative." onpage1138.

See letter "Treating leg cramp. Study quoted had flawed design." onpage1138.

Abstract

OBJECTIVE--To assess quantitatively the efficacy of quinine (as quinine sulphate) compared with placebo in the treatment of nocturnal leg cramps. DESIGN--A meta-analysis of six randomised, double blind, crossover trials. SETTING--Randomised trials that were available as of April 1994. SUBJECTS--A total of 107 general ambulatory patients who suffered from regular nocturnal leg cramps from six clinical trials. RESULTS--Data from individual patients were used to calculate point estimates and 95% confidence intervals for each of the outcome measures reported by these studies. Treatment with quinine resulted in a significant reduction in the number of cramps for a four week period compared with placebo (8.83 fewer cramps; 95% confidence interval 4.16 to 13.49). Treatment with quinine reduced the number of nights with cramps by 27.4% (24.0% to 30.8%) compared with placebo. Treatment did not produce a significant change in the severity or duration of individual nocturnal leg cramps. Side effects were uncommon. CONCLUSIONS--The results indicate that quinine can prevent nocturnal leg cramps in general ambulatory populations. Given the possible serious side effects of treatment with quinine, the benefits and risks in patients taking this drug should be closely monitored.

• Daniell HW. Simple cure for nocturnal leg cramps. N Engl J Med. 1979 Jul 26;301(4):216–216. [PubMed] [Google Scholar]
• Ayres S, Jr, Mihan R. Nocturnal leg cramps (systremma): a progress report on response to vitamin E. South Med J. 1974 Nov;67(11):1308–1312. [PubMed] [Google Scholar]
• Maguire RB, Stroncek DF, Campbell AC. Recurrent pancytopenia, coagulopathy, and renal failure associated with multiple quinine-dependent antibodies. Ann Intern Med. 1993 Aug 1;119(3):215–217. [PubMed] [Google Scholar]
• Bateman DN, Blain PG, Woodhouse KW, Rawlins MD, Dyson H, Heyworth R, Prescott LF, Proudfoot AT. Pharmaco*kinetics and clinical toxicity of quinine overdosage: lack of efficacy of techniques intended to enhance elimination. Q J Med. 1985 Feb;54(214):125–131. [PubMed] [Google Scholar]
• Bacon P, Spalton DJ, Smith SE. Blindness from quinine toxicity. Br J Ophthalmol. 1988 Mar;72(3):219–224. [PMC free article] [PubMed] [Google Scholar]
• Baltodano N, Gallo BV, Weidler DJ. Verapamil vs quinine in recumbent nocturnal leg cramps in the elderly. Arch Intern Med. 1988 Sep;148(9):1969–1970. [PubMed] [Google Scholar]
• Görlich HD, von Gablenz E, Steinberg HW. Behandlung rezidivierender nächtlicher Wadenkrämpfe. Eine multizentrische, doppelblinde, Plazebo-kontrollierte Vergleichsuntersuchung zwischen der Kombination von Chinin und Theophyllin-Ethylendiamin gegenüber Chinin. Arzneimittelforschung. 1991 Feb;41(2):167–175. [PubMed] [Google Scholar]
• Kaji DM, Ackad A, Nottage WG, Stein RM. Prevention of muscle cramps in haemodialysis patients by quinine sulphate. Lancet. 1976 Jul 10;2(7976):66–67. [PubMed] [Google Scholar]
• Jones K, Castleden CM. A double-blind comparison of quinine sulphate and placebo in muscle cramps. Age Ageing. 1983 May;12(2):155–158. [PubMed] [Google Scholar]
• Warburton A, Royston JP, O'Neill CJ, Nicholson PW, Jee RD, Denham MJ, Dobbs SM, Dobbs RJ. A quinine a day keeps the leg cramps away? Br J Clin Pharmacol. 1987 Apr;23(4):459–465. [PMC free article] [PubMed] [Google Scholar]
• Fung MC, Holbrook JH. Placebo-controlled trial of quinine therapy for nocturnal leg cramps. West J Med. 1989 Jul;151(1):42–44. [PMC free article] [PubMed] [Google Scholar]
• Connolly PS, Shirley EA, Wasson JH, Nierenberg DW. Treatment of nocturnal leg cramps. A crossover trial of quinine vs vitamin E. Arch Intern Med. 1992 Sep;152(9):1877–1880. [PubMed] [Google Scholar]
• Dunn NR. Effectiveness of quinine for night cramps. Br J Gen Pract. 1993 Mar;43(368):127–128. [PMC free article] [PubMed] [Google Scholar]
• Sidorov J. Quinine sulfate for leg cramps: does it work? J Am Geriatr Soc. 1993 May;41(5):498–500. [PubMed] [Google Scholar]