Drug & supplement interaction

Cinchona + Quinine Sulfate

Quinine Sulfate brand names: Quinamm, Quinine Sulfate.

Major Interaction
The bottom line Major

Cinchona has a major interaction with Quinine Sulfate. Theoretically, taking cinchona might increase plasma levels and adverse effects of quinine.

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cinchona and Quinine Sulfate

Here is the interaction we found between these two, with the evidence behind it.

Major

QUININE

Theoretically, taking cinchona might increase plasma levels and adverse effects of quinine.
Cinchona contains quinine.
Severity Major Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: cinchona bark naturally contains quinine, the very same active ingredient in your Quinine Sulfate prescription. So taking both at once is basically doubling up on the same drug. That can push your quinine levels higher than intended and make side effects more likely.

With too much quinine, people can get what's called cinchonism: ringing in the ears, headache, nausea, dizziness, and blurred vision. At higher levels it can affect heart rhythm and blood cells, which is why this combo is rated as a serious concern. This warning is based on pharmacology rather than lots of human studies, but the logic is solid since you'd be stacking the same compound. Please don't change anything on your own. Just check with your pharmacist or doctor before combining these.

References
  1. Hardman JG, Limbird LL, Molinoff PB, eds. Goodman and Gillman's The Pharmacological Basis of Therapeutics, 9th ed. New York, NY: McGraw-Hill, 1996.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Cinchona Also Interacts With Other Medications

Cinchona has 2 major, 473 moderate, 16 minor known drug interactions in our database — the Quinine Sulfate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Cinchona

Covers the 2,830 medications we’ve checked against Cinchona. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Quinine Sulfate

This page covers Cinchona only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Quinine Sulfate page lists 175 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Foxglove (major), Grapefruit (major), Lily-of-the-valley (major) and Oleander (major).

Open the Quinine Sulfate interaction page

One more smart check

Taking Cinchona as Part of a Dietary Supplement Product? Check It for Interactions

We hold 12 real supplement products containing Cinchona, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cinchona. Your product may carry other ingredients that interact with Quinine Sulfate too, on top of Cinchona — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Cinchona and Quinine Sulfate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Cinchona
Steady interest

#882 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Quinine Sulfate
Steady interest

#2,259 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Cinchona

What is Cinchona?

Cinchona
  • Malaria (historical/traditional)
  • Fever
  • Leg cramps and restless legs
  • Digestive upset and loss of appetite
  • Bitter tonic

Cinchona bark is the natural source of quinine and has been used for centuries to treat malaria and fever, but the bark itself is not standardized and can be unpredictable and risky. Modern medicine uses purified, dose-controlled quinine instead, and the supplement form carries real dangers, including serious heart and blood problems. Talk to a pharmacist or doctor before using it, and avoid it during pregnancy.

Read the full Cinchona monograph & all interactions
Keep checking

Other Drugs & Cinchona

Browse every other medication we’ve checked against Cinchona — both the ones with a known interaction and the ones without. Select any drug for the full detail.

2Major
473Moderate
16Minor
2,338No known interaction
Major

2 interactions

Moderate

473 interactions

Showing 60 of 473 moderate interactions — see all 473 on the Cinchona page.

Minor

16 interactions

No interaction 2,338 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Cinchona and Quinine Sulfate Together: Common Questions

Can you take Cinchona with Quinine Sulfate?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Cinchona and Quinine Sulfate interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Quinine Sulfate and Cinchona?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.