Losing sleep over FDA's quinine ban

Q: I am devastated that quinine is no longer available. I have taken it safely for decades to reduce leg cramping, especially at night. Since I ran out, I have a terrible time sleeping. Why would the Food and Drug Administration ban quinine when it is the only thing that works?

A: Many people do well with quinine, but for some it is extremely dangerous. One reader wrote: "I took one pill, and within a couple of hours, I was deathly ill, not knowing what was going on. My doctor sent me immediately for blood work. My liver-function results were worse than my husband's when he died from liver cancer. It took more than two weeks to get my body back on track."

The FDA reasoned that since leg cramps are not life threatening but some reactions to quinine are, the benefit/risk balance did not favor the drug. There are, unfortunately, no other approved medications for leg cramps.

People with nighttime leg cramps may benefit from home remedies. Tonic water, which contains some quinine, is one option. Others include yellow mustard or low-sodium V8 juice.

Q: I want to warn others about taking too much calcium and vitamin D. Apparently, I took more than my limit and ended up with soft tissue calcifications.

My doctors doubted this caused my calamity, but I am certain that it contributed. The calcium in my arm caused a lot of pain. My mammogram also showed calcification. Calcium and vitamin D are popular these days, but you can overdo.

A: Thanks for the words of caution. Women have been urged to increase their calcium intake to maintain strong bones, but a study from New Zealand also sounded a warning (British Medical Journal, Feb. 2, 2008). Postmenopausal women were studied for five years. In addition to calcium in their food (roughly 850 mg daily), they took either 1,000 mg calcium or placebo. The women taking extra calcium were more likely to suffer a heart attack during that time. Another study did not confirm this risk, but there is some concern that excess calcium and vitamin D might contribute to calcification.

Q: I was recently prescribed Valtrex for shingles. I had no idea it was used for anything else until I read that it is used for herpes.

I thought this would be comforting for the woman who wrote to you that she was so ashamed about having herpes that she did not want to seek treatment. She was afraid people at the pharmacy would look down on her. These drugs have multiple uses, so who would know?

A: Valtrex (valacyclovir) is indeed used to shorten an attack of shingles as well as to treat genital herpes. You are right that a prescription for Valtrex is no cause for shame.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or via their Web site: www.peoplespharmacy.org