Johns Hopkins Health Alert
What Works for Leg Cramps?
A reader of our Health After 50 newsletter asks, "I suffer from frequent leg cramps and I’ve heard that quinine can help. Should I consider taking it?" Here’s what Hopkins recommends.
Muscle cramps are a major problem for people with neurological illnesses such as Parkinson's disease or multiple sclerosis, but muscle cramps also frequently strike otherwise healthy older adults. In fact, it’s estimated that upwards of 50 percent of people older than 65 experience recurring idiopathic (without a known cause) muscle cramps. Quinine is often prescribed off-label for the treatment of muscle cramps.
However, the U.S. Food and Drug Administration (FDA) strongly recommends that people only take quinine for its indicated use -- to treat malaria. Qualaquin, the prescription form of quinine, has been associated with a number of potentially deadly side effects. Between 2005 and 2008, the FDA received 38 reports of quinine-related incidents to its Adverse Event Reporting System.
This may not seem like a lot, but the majority of cases were serious. Many of the people involved developed a condition called thrombocytopenia -- their blood platelets dropped to alarmingly low levels, causing excessive bleeding. Fourteen people had a blood platelet count below 5,000 microliters (normal is between 150,000 and 450,000); five died. A number of other adverse events also were reported, including: GI symptoms, hearing loss, rash, electrolyte imbalance, and drug interactions.
In addition, quinine is only mildly effective at stopping muscle cramps or reducing their severity, according to a recent assessment by the American Academy of Neurology (AAN). Other treatments that also fared poorly in the AAN's analysis include the antiseizure drug gabapentin (Neurontin), magnesium, and basic muscle stretching.
What might work for leg cramps? A host of potential but yet-to-be-proven candidates include muscle relaxers, calcium channel blockers, and even the numbing agent lidocaine. For now, the AAN recommends asking your doctor about B-complex vitamins, diazepam (Valium), or the antiseizure drug naftidrofuryl (Dusodril).
Posted in Healthy Living on October 20, 2010
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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