Cinchona

Botanical

What is it

Cinchona is a genus of trees native to South America whose bark is the source of quinine and related alkaloids. Quinine was the original antimalarial medication and is also responsible for the bitter flavor of tonic water.

Evidence for 1 use

AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.

Antimalarial activity (medical)

Strong Evidence

Quinine, derived from cinchona, has established antimalarial activity supported by decades of clinical use. This applies to medical prescription use, not consumer supplements.

How it works

Cinchona bark contains quinine, quinidine, cinchonine, and cinchonidine. Quinine has antimalarial activity against Plasmodium parasites. Quinidine has antiarrhythmic activity on cardiac muscle. Low doses found in tonic water and traditional bitters provide a bitter taste but minimal pharmacologic effect. Higher doses (medical use) carry significant cardiac, vision, and hearing risks.

Dosage

Tonic water contains very low quinine (about 50-85 mg/L). Medical antimalarial dosing is much higher and prescription-only. There is no general supplement dose.

When and how to take it

Medical use is prescription-only and follows specific clinician guidance. Cinchona-based supplements (bitters) are typically used in small amounts before meals.

1 commercial form

Compare the main delivery options and what they’re best suited for.

Cinchona bark extract (low-dose, bitters)

Small amounts in traditional bitters and tonic.

Quinine and related alkaloids

Safety

Quinine has serious side effects at therapeutic doses: cinchonism (headache, tinnitus, vision changes), thrombocytopenia, cardiac arrhythmias, and severe hypersensitivity reactions. FDA prohibits over-the-counter use of quinine for leg cramps due to safety concerns.

Who should be cautious

Avoid in pregnancy (limited data, theoretical risk), in people with cardiac arrhythmias, glucose-6-phosphate dehydrogenase deficiency, and in those on multiple medications. Tonic water amounts are generally safe but not entirely risk-free in sensitive individuals.

Interactions

Multiple drug interactions with anticoagulants, certain antibiotics, and other QT-prolonging drugs. Quinidine has well-known interactions with digoxin and other cardiac drugs.

Frequently asked questions

Is tonic water medicinal?⌄

Modern tonic water contains too little quinine for medical effect; it is a beverage, not a treatment.

Can I use cinchona for leg cramps?⌄

No. FDA has banned over-the-counter quinine for leg cramps due to serious safety concerns including potentially fatal blood disorders.

References

Cinchona on Wikidata — Wikidata link

Cinchona on NIH DSLD (US supplement label database) — NIH Dietary Supplement Label Database link

Research on Cinchona (PubMed search) — PubMed link

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Evidence-based·How we grade evidence

Disclaimer: These statements have not been evaluated by the FDA. This page is educational, not a substitute for personalized medical advice. Evidence grades are AI-assisted assessments — talk to your doctor before starting any new supplement, especially if you’re pregnant, breastfeeding, on medications, or managing a chronic condition.