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Letters

Quinine and leg cramps

David B. Hogan
CMAJ July 14, 2015 187 (10) 757; DOI: https://doi.org/10.1503/cmaj.1150040
David B. Hogan
University of Calgary, Calgary, Alta.
MD
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I thank Katzberg and Breiner for their letter.1 I do not believe that the use of quinine for muscle cramps should be banned, and I concur with the conclusion of the systematic review that Katzberg coauthored: “quinine derivatives for the treatment of muscle cramps should be avoided for routine treatment.” Quinine derivatives should only be prescribed to patients who have been informed of the potentially serious adverse effects and “when cramps are very disabling, no other agents relieve symptoms, and there is careful monitoring of side effects.”2

Our intent was to voice caution about the indiscriminate use of quinine for idiopathic muscle cramps in older patients, not to limit its use for patients with conditions such as amyotrophic lateral sclerosis, who were excluded from the study by Garrison and colleagues.3

References

  1. ↵
    1. Katzberg HD,
    2. Breiner A
    . Quinine and leg cramps [letter]. CMAJ 2015;186:757.
    OpenUrl
  2. ↵
    1. Katzberg HD,
    2. Khan AH,
    3. So YT
    . Assessment: symptomatic treatment for muscle cramps (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2010; 74:691–96.
    OpenUrlCrossRefPubMed
  3. ↵
    1. Garrison SR,
    2. Dormuth CR,
    3. Morrow RL,
    4. et al
    . Seasonal effects on the occurrence of nocturnal leg cramps: a prospective cohort study. CMAJ 2015; 187:248–53.
    OpenUrlAbstract/FREE Full Text
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Canadian Medical Association Journal: 187 (10)
CMAJ
Vol. 187, Issue 10
14 Jul 2015
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Quinine and leg cramps
David B. Hogan
CMAJ Jul 2015, 187 (10) 757; DOI: 10.1503/cmaj.1150040

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Quinine and leg cramps
David B. Hogan
CMAJ Jul 2015, 187 (10) 757; DOI: 10.1503/cmaj.1150040
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