Musculoskelatal: Nocturnal leg cramps

Question 1

Quinine salts are effective in reducing the frequency of nocturnal leg cramps by about what %?

Answer 1

25%

Question 2

Why is quinine not recommended for routine treatment?

Answer 2

Quinine salts , such as quinine sulfate are effective in reducing the frequency of nocturnal leg cramps by about 25% in ambulatory patients; however, because of potential toxicity, quinine is not recommended for routine treatment and should not be used unless cramps cause regular disruption to sleep.

Question 3

Quinine should only be used when?

Answer 3

Quinine should only be considered when cramps are very painful or frequent; when other treatable causes of cramp have been excluded; and when non-pharmacological treatments have not worked (e.g. passive stretching exercises)

Question 4

With quinine use, it may take up to how long for improvement to become apparent?

Answer 4

It may take up to 4 weeks for improvement to become apparent; if there is benefit, quinine treatment can be continued.

Question 5

Quinine treatment should be interrupted at intervals of approximately how long?

Answer 5

Treatment should be interrupted at intervals of approximately 3 months to assess the need for further quinine treatment. In patients taking quinine long term, a trial discontinuation may be considered. Quinine is toxic in overdosage and accidental fatalities have occurred.