malaria.^9 Ground cinchona bark and quinine
have been reported to cause urticaria, contact
dermatitis, and other hypersensitivity reac-
tions in some individuals (GOODMAN AND
GILMAN;MARTINDALE;USD26th;WICHTL).
Cinchona alkaloids are toxic. Poisoning
(cinchonism) is usually due to overdosage or
hypersensitivity, with symptoms including
blindness, deafness, severe headache, tinnitus,
delirium, vasodilation, abdominal pain, diar-
rhea, convulsions, paralysis, and collapse.
Cinchonism has resulted from as little as a
single dose of 4 g quinine. A single oral dose
of 8 g quinine may be fatal to an adult (GOOD-
MAN AND GILMAN;MARTINDALE;USD26th).^9
USES
Medicinal, Pharmaceutical, and Cosmetic.
In European phytomedicine, the dried bark is
seldom used alone. Extracts are ingredients of
herbal formulas (WICHTL) used to stimulate
saliva and gastric secretions in the treatment
of loss of appetite and dyspeptic discomfort
(BLUMENTHAL1).
The current use of quinine, apart from
treating malaria, is primarily in the form of
the sulfate salt in preparations for treating
cold and flu and nocturnal leg cramps, mostly
as prescription drugs (MARTINDALE). Besides
being used as an antimalarial, quinine has
been used for treating various conditions,
including hemorrhoids and varicose veins
(as hardening agent), and in eye lotions for
its astringent, bactericidal, and anesthetic
effects.
Quinidine is used in prescription prepara-
tions mainly for treating cardiac arrhythmias.
In cosmetics, extracts of cinchona are
primarily used in hair tonics, reportedly for
stimulating hair growth and controlling oili-
ness (DE NAVARRE).
Food. Quinine and extracts of cinchona
(mostly red cinchona) are extensively used as
a bitter in tonic water,^9 alcoholic bitters, li-
queurs, and soft drinks (bitter lemon drinks);
amounts incommercial softdrinks are approx-
imately 61–67 mg/L.^10
Other food products in which red cinchona
extract has been reportedly used include
frozen dairy desserts, candy, baked goods,
and condiments and relishes. Use levels re-
ported are lower than those reported in
beverages.Traditional Medicine. Cinchona is used in
treating malaria, fevers, indigestion, and for
mouth and throat problems, usually in the
form of an infusion; has been used in China
to treat hangovers; also reportedly used in
cancers.^11 An infusion of yellow cinchona
was used by the Cherokee Indians as a tonic
and treatment for impotence (MOERMAN).COMMERCIAL PREPARATIONSAvailable as crude and extracts (fluid extract,
solid extract, etc.). Both red and yellow
cinchonas were formerly official in U.S.P. and
N.F.; quinine sulfate and quinidine sulfate
and gluconate are official in U.S.P.; quinine
hydrochloride and sulfate are also official in
F.C.C.Regulatory Status. Both red and yellow cin-
chona barks have been approved for use in
beverages only, with the limitation that the
total cinchona alkaloids do not exceed 83 ppm
(0.0083%) in the finished beverage (§172.510
and §172.575). Concentration must be de-
clared on the label; in China, quinine is not
permitted for use in beverages.^10 Crude drug
subject of a positive. German therapeutic
monograph (BLUMENTHAL1).REFERENCES
See the General References forBLUMENTHAL1;FEMA;GOSSELIN;GUPTA;JIANGSU;LUST;MCGUFFIN1&2;
MERCK;NANJING;TERRELL;UPHOF;YOUNGKEN.
Cinchona (red and yellow) 195