Leung's Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics

CINCHONA (RED AND

YELLOW)

Source: Red cinchona:Cinchona officinalis
L.,C.pubescensM.Vahl.(syn.C.succirubra
Pavo ́n ex Klotzsch) and its hybrids;Yellow
cinchona:Cinchona calisayaWeddell,C.
ledgerianaMoens ex Trimen, and their hy-
brids with otherCinchonaspecies (Family
Rubiaceae).

Common/vernacular names:Red bark, red
Peruvian bark, cinchona rubra (C. pubescens);
yellow bark, calisaya bark, ledger bark, brown
bark, cinchona flava (C. calisayaandC. led-
geriana); Jesuit’s bark, Peruvian bark, China
bark, cortex chinae, and fever tree.

GENERAL DESCRIPTION

Evergreen shrubs or trees, up to about 30 m
high; C. calisaya being the tallest, while
C. pubescens reaching about 24 m and
C. ledgerianaonly up to 6 m; native to moun-
tains of tropical America (Bolivia, Costa Rica,
Ecuador, Guatemala, Peru, etc.) between alti-
tudes of about 900 and 3400 m; extensively
cultivated in Central and South America,
Southeast Asia (India, Java, Sumatra, China,
etc.), and Africa. Part used is the dried bark.

CHEMICAL COMPOSITION

Contains up to about 16% (average 6–10%)
total quinoline alkaloids that consist mainly of
quinine, quinidine, cinchonine, and cinchoni-
dine, with quinine usually in major concen-
tration. Other alkaloids in minor amounts
include quinamine, epiquinamine, epiquinine,
hydroquinine, hydroquinidine, and many
others, totaling over three dozen. Contents of
the total alkaloids vary, depending on the
sources, withC. ledgerianagenerally contain-
ing a higher amount thanC. pubescens. Other
constituents present include norsolorinic acid
(an anthraquinine), quinovic acid, quinovin A,
B, and C (bitter glycosides), quinic acid,
b-sitosterol, tannins, starch, resin, wax, and
others (JIANGSU;LIST AND HO ̈RHAMMER;MORTON
3;NANJING;STAHL;USD26th).1–4

PHARMACOLOGY AND BIOLOGICAL

ACTIVITIES

Cinchona has astringent and bitter tonic prop-

erties; also reportedly has analgesic and local

anesthetic properties, among others (GOODMAN

AND GILMAN;JIANGSU;NANJING).

Quinine, quinidine, cinchonine, cinchoni-

dine, and cinchonicinol have shownin vitro

inhibitory activity against the cytotoxicity of

polyorphonuclear leucocytes.^5 Potent mono-

amine oxidase inhibiting activityin vitrowas

found from quinine, cinchonicinol, and cinch-

onaminone derived fromC. succirubra.^6

The alkaloids of cinchona have antimalari-

al and antipyretic activities, with quinine be-

ing the most potent. Certain strains of malarial

parasites, particularly those of Vietnamese

origin that have become resistant to synthetic

antimalarials, are still susceptible to quinine

treatment.^7

A double-blind, placebo-controlled trial of

quinine in the treatment of nocturnal cramps

found significant reductions in the pain, inten-

sity, and frequency of cramps.^8

TOXICOLOGY

Use of the bark is contraindicated in pregnan-

cy and ulcers, intestinal or gastric, and if

taken concomitantly with anticoagulants can

increase their effects (WICHTL). For some in-

dividuals, even low doses of quinine, such as

those found in tonic and gin drinks, can elicit

thrombocytopenia with purpura (‘‘cocktail

purpura’’); usually a self-limited and benign

syndrome provided immediate cessation of

quinine.^8 Quinidine and quinine have cardi-

ac-depressant properties, with quinidine being

twice as active as quinine (GOODMAN AND

GILMAN;MARTINDALE;USD26th). High plasma

levels of quinine (16 mg/L) are strongly asso-

ciated with cardiac arrhythmias.^9

Quinine has been reported to cause a hyper-

sensitivity reaction known as ‘‘black water

fever,’’ which consists of hemolysis, hemo-

globinuria, and hemoglobinemia and can ad-

vance to renal failure. The syndrome is more

commonly reported in patients with G6PD

deficiency, pregnant women, and those with

194 Cinchona (red and yellow)