Drug & supplement interaction

Lime + Quinine Sulfate

Quinine Sulfate brand names: Quinamm, Quinine Sulfate.

Moderate Interaction
The bottom line Moderate

Quinine Sulfate falls into 2 drug categories that Lime can interact with; the most serious is rated moderate. Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Lime and Quinine Sulfate

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Lime interacts with whole categories of medication. Quinine Sulfate falls into 2 of those categories, so it can interact with Lime in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

PHOTOSENSITIZING DRUGS

1 of 2

Why this applies to Quinine Sulfate

Quinine Sulfate falls under PHOTOSENSITIZING DRUGS — the group Lime interacts with.

Theoretically, concomitant use of lime oil with photosensitizing drugs may increase the risk of phototoxicity.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Here's the gist with quinine and lime. Quinine itself can make your skin more sensitive to sunlight, so you may burn or develop a rash more easily than usual. The concern on file is about lime oil, not the juice in your drink or a squeeze on your food. Concentrated lime oils contain compounds (called furanocoumarins) that can also boost sun sensitivity, especially when they touch your skin and then get exposed to sunlight.

Honestly, this is a theoretical caution based only on lab data, so I wouldn't lose sleep over it. Eating limes or drinking lime water is very unlikely to cause trouble. If you use lime essential oil on your skin while taking quinine, just be smart about sun protection. Any questions, your pharmacist is happy to help.

References
  1. Naganuma M, Hirose S, Nakayama Y, et al. A study of the phototoxicity of lemon oil. Arch Dermatol Res 1985;278:31-6. . PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Quinine Sulfate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Animal research shows that phenolics in lime juice inhibit cytochrome P450 3A4. This has been demonstrated in rats treated with sildenafil, a CYP3A4 substrate, and high doses of lime juice.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Your body relies on a liver enzyme called CYP3A4 to break down quinine and clear it out. The thinking here is that plant compounds in lime juice may slow that enzyme down a bit. If that happens, quinine could linger longer and build up, which can nudge up the risk of its known side effects like ringing in the ears, headache, dizziness, nausea, or in larger excesses, heart rhythm changes. Quinine is not a prodrug, so this works in the direction of more drug effect, not less.

That said, this comes only from animal research using high doses of lime juice, so it's far from proven in people. A squeeze of lime on your food almost certainly won't matter. If you're using concentrated lime products, just run it by your pharmacist or doctor first.

References
  1. Bailey DG, Dresser GK, Bend JR. Bergamottin, lime juice, and red wine as inhibitors of cytochrome P450 3A4 activity: comparison with grapefruit juice. Clin Pharmacol Ther 2003;73:529-37. PubMed
  2. Ademosun AO, Mohammed A, Oboh G, Ajeigbe OF. Influence of lemon (Citrus limon) and lime (Citrus aurantifolia) juices on the erectogenic properties of sildenafil in rats with L-NAME-induced erectile dysfunction. J Food Biochem 2022;46(2):e14074.

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

Lime Also Interacts With Other Medications

Lime has 885 moderate known drug interactions in our database — the Quinine Sulfate one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Lime

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

Everything else you take

See Every Supplement That Interacts With Quinine Sulfate

This page covers Lime 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), Cinchona (major), Foxglove (major), Grapefruit (major) and Lily-of-the-valley (major).

Open the Quinine Sulfate interaction page

One more smart check

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

We hold 322 real supplement products containing Lime, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Lime. Your product may carry other ingredients that interact with Quinine Sulfate too, on top of Lime — 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 Lime 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 Lime
Top 25%

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

29 days ago today
Medication Quinine Sulfate
Steady interest

#2,309 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 Lime

What is Lime?

Lime
  • Source of vitamin C
  • Digestive upset
  • Skin care
  • Mood and aromatherapy
  • Flavoring and food preservation

Lime is a common citrus fruit and a good natural source of vitamin C and plant antioxidants. As a food it is generally safe and enjoyed by most people, but evidence that lime treats any specific health condition is limited. Use the essential oil with care, and check with your pharmacist or doctor before using concentrated lime products for health reasons.

Read the full Lime monograph & all interactions
Keep checking

Other Drugs & Lime

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

0Major
885Moderate
0Minor
1,944No known interaction
Moderate

885 interactions

Showing 60 of 885 moderate interactions — see all 885 on the Lime page.

No interaction 1,944 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 Lime and Quinine Sulfate Together: Common Questions

Can you take Lime with Quinine Sulfate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Lime and Quinine Sulfate?
Quinine Sulfate belongs to more than one drug category, and Lime interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Lime and Quinine Sulfate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

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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.