Quinine-containing beverages may cause health problems - Updated BfR Health Assessment No 020/2008, 9 May 2008

When larger amounts of quinine are consumed, it can constitute a health problem for some consumer groups. BfR sees risks in particular for quinine intakes during pregnancy. For instance, a newborn baby, whose mother had drunk more than 1 litre tonic water a day in the weeks up to its birth, suffered health disorders. Based on existing regulations in the medicinal product sector, BfR, therefore, advises pregnant women against drinking quininecontaining beverages on precautionary grounds. People who have been advised against taking quinine, cinchona bark or their preparations by their doctors because of their clinical pictures should not consume any quinine-containing soft drinks either. This applies, for instance, to people who suffer from tinnitus, pre-existing damage to the optic nerve, haemolytic anaemia or who are hypersensitive to quinine or cinchona alkaloids. Patients with cardiac arrhythmia and people who take medicine that interacts with quinine, should only drink quinine-containing soft drinks after consulting their doctors. This applies in particular to medications which inhibit blood coagulation. At higher levels of tonic water consumption, it may be necessary to reduce their therapeutic dose.