Quinine symptoms and conditions

I had been taking singulair for over two years. I am 70 yrs old and in good health except for light asthma, allergy problems. My doctor took me off it. It did some good in the beginning but the last four mts I was continuing to get wheezing and bronchitis infections. I also had a lot of leg pain and was tested for all kinds of blockage, etc. I experienced very painful leg cramping, toes twitching, etc. The only way I could stop it was to pull my toes forward as the worst happened at night and woke me up. I finally found Leg Cramps with Quinine an all natural homeopathic med. It worked like a charm. I didn't know that this was a side effect of Singulair. Since I am off singulair just two weeks. It was replaced with Flovent an inhaler ( 2 puffs 2 x a day to begin and then later it will be 1 puff as the inflammation gets better. It also comes in granules. I am feeling much better and now I am ready to stop Leg Cramps as I feel the singulair may have been causing the problem. While taking Singulair I also had stomach cramps with diarrhea. I will not go back on Singulair. If the cramping returns, I will definitely go back on Leg Cramps with Quinine (available in any pharmacy over the counter and very inexpensive.

Have taken Avelox for bronchitis and pneumonia in the past. I was well-informed as to possible side effects, and it was suggested that I drink a glass of tonic water daily, that the quinine in it can help offset problems of this class of drugs, the quinolones.
Started myself on it last night for a five-day course, again for bronchial infection (very bad cold turned into bad cough, bringing up discolored mucus, bad taste in mouth). I have asthma and have had bronchial infections many times following a cold.
Had the slightly jumpy reaction, trouble sleeping, and snatches of a song fragment replaying in my head. Finally fell asleep and feel ok this morning--better, actually, as i think i caught the infection at an early stage and it will be gone with a five-day course of this drug.
The reason I have been prescribed this med is that I am allergic to virtually every kind and class of antibiotic. I can successfully take quinolones and sulfa (like Bactrim)--that's it.
However, I've found it to be very effective and the side effects quite minimal. I am drinking that glass of (diet!) tonic water, taking the medication on a full stomach (something carb, like pasta or lots of bread), and being careful not to do any heavy lifting for next couple of weeks to avoid any tendon issues.
This is a very effective drug for those of us who cannot take Zithromax, Penicillin, Erythromycin, etc. My doctor, who runs the pulmonary dept at a hospital, is well-versed in what to use and when.
Will let you all know if there are any problems during or after the 5-day course.

I have been taking the generic for Allegra (180mg), Fexofenadine 180mg, for about 2 years -- ever since I moved to middle-Virginia. I thought I had a cold that would not go away. The doctor put me on Allegra, and it did help, yet didn't stop, the horrible runny nose, watery eyes, etc. Around that same time, I started having horrible leg/feet cramps at night...so bad that my sleep is constantly interrupted with having to jump out of bed multiple times to walk off the cramp. My doctor prescribed Requip and, even on the strongest dose, the cramps would not go away. A pharmacist suggested I try Highlands Leg Cramp pills (w/quinine) and that helped reduce the severity and number of leg/feet cramps for a while. Now the cramping is back, full-strength, and I just began a desperate research of side effects for all the medications I am taking. Lo, and behold, I just read that others who are taking Allegra are experiencing this same symptom. Unfortunately I took my morning dose this a.m., but I will begin tomorrow not taking Allegra and hopefully that is all it takes to end these leg cramps. And, oh yes, I too have regular stomach cramps and diarrhea and have lost 20 lbs. without dieting. I'm now wondering if Allegra is also responsible for all of these unexplained "other things" going on with my body. I hope I won't be bombarded with bad side effects by going off the Allegra "cold turkey." However, anything is better than the leg cramping!

How about MUSCLE SPASMS?? My mom has had right leg and arm muscle spasms for the past 3 weeks, but has been on warfarin since end of March.

i was a healthy 35 year old male but had high cholesterol, so the doctor prescribed lovastatin (mevacor) and tried it for a month but developed muscle weakness. months later, i'm still experiencing severe muscle spasms and my neurologist is stumped -- mri's, spinal tap, emg -- all normal. I just want to feel normal again. can anyone help? please email me!

Singulair, montelukast, contains a chloroquine in it's molecular structure. I am praying that the FDA takes this investigation seriously. Other countries are concerned about the neuro-psychiatric side effects of these categories of drugs for some very good reasons.

"In summary, we have used a combination of electrophysiology, ligand binding, homology modelling and simulated docking to define the mechanisms by which quinine, chloroquine and mefloquine inhibit the 5-HT3 receptor response. Our observations further extend the number of receptors known to be affected by these compounds and the growing diversity of targets may account for the broad spectrum of side effects that have been reported by patients receiving them (Luzzi and Peto, 1993; Palmer et al., 1993; Taylor and White, 2004). Inhibition of the 5-HT3-mediated current could have wide-ranging effects in the nervous system, as 5-HT3 receptors can modulate a variety of neurotransmitter responses such as those to GABA, dopamine and cholecystokinin (Thompson et al., 2006b)."

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Sorry, I can't just walk away.

When you find patents or patent applications for certain purposes, then you know that your ideas are well founded. There are several patents for using an anti-malaria drug for asthma. I would bet that somebody had that idea all the way back to the 1960's. So it is very possibly no coincidence at all that a chloroquinoline or other quinoline ring would be part of montelukast's chemical structure.

Here is one of the patents.

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It is well known that quinoline rings can be toxic to some people even very rapidly. As in this very extreme example.
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PEDIATRICS Vol. 27 No. 1 January 1961, pp. 95-102 This Article

FATAL ACUTE CHLOROQUINE POISONING IN CHILDREN
Howard M. Cann M.D.1 and Henry L. Verhulst M.S.1

1 National Clearinghouse for Poison Control Centers, Accident Prevention Program, Public Health Service, U. S. Department of Health, Education, and Welfare
Four cases of acute chloroquine poisoning in children are presented. In three instances death occurred within 2 hours of ingestion of larger than therapeutic amounts of the drug. The rapid occurrence of death in acute chloroquine poisoning is probably explained by complete and rapid absorption of the drug from the gastrointestinal tract resulting in high blood concentrations which depress vasomotor function and respiration. Cardiac arrest follows and may be caused by the direct myocardial action of chloroquine, to anoxia, or to both. The similarity of the manifestations of acute chloroquine poisoning and those of acute quinine and quinidine poisoning suggests that acute toxicity may be attributed to the quinoline ring portion of these drugs.

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I don't think that we are seeing extreme examples. But we may be seeing less extreme immediate reactions or reactions where the toxicity builds up over time.

Quinoline rings are know to cause neurotoxicity. There are theories about how that happens. One of the theories is about blocking connexins which are gap junction proteins in the brains.

I don't know how montelukast could be breaking up so that it causes toxicity. Or if the problem is the how rapidly the liver enzymes can metabolize it. But there is plenty, plenty, plenty of clinical evidence that there is a quinoline ring culprit somewhere in the picture. Or some by-product of that causing problems.

Somehow it was decided that montelukast did not have the safety issues that the other drugs in the same category have. See this.

"The starting point in the development of montelukast appears to be a quinoline-containing structure, likely identified as a weak random screening lead (Figure 3). The Merck group hypothesized that this molecule was mimicking the olefin backbone of cysLTs, and that the addition of mimics for the acid and peptide regions of LTD4, might improve its potency. As a first step, the dithioacetal linkage first seen in some SmithKline compounds was incorporated; this led to a compound with greatly increased in vitro potency but poor oral bioavailability. When one of the carboxylic acids was replaced by an amide, forming MK-571, the new antagonist had even greater potency and good efficacy following oral administration. The enantiomers were resolved to yield MK-679 (verlukast), a compound with better clinical effects than MK-571, but whose clinical development was stopped for safety reasons. Further structure-activity relationship studies led to the development of montelukast (16), an antagonist that appears free of the safety concerns plaguing earlier members of this series."

If we can find out why the earlier versions were not safe and how they thought fixed it, then maybe we can find out what is going on with the quinoline ring in some people.

I would be very surprised if the FDA will address our concerns. Why does it always seem like they wait for enough people to die like in Vioxx? Wasn't Vioxx responsible for thousands of deaths?

I spent the weekend reading about the development of Singulair. The early studies recognized that the first phase of the acute asthma response bronco-constriction was probably not caused by leukotrienes. They identified histamines and prostaglandins as the probable sources. I don't think that changed because the Singulair literature states that it should not be considered as a treatment for that. Leukotrienes were a source of inflammation caused by eosinophils and mast cells present in greater numbers (than normal) in airway tissue. So, it was beneficial to find a way to decrease that.

The cysLT1 receptor was identified as source of the signals that tell the cells to produce leukotriene. The receptor, a gene, consist of 337 (they think) amino acids. They modified a compound that would bind to that receptor thus blocking the cells ability to produce leukotrienes. This compound is very specific. It was formulated to bind to the "model" receptor. This compound will not even bind to cysLT receptor sub-types. (That is the good thing.) There is an enormous amount of research that discusses the genetic variability of the chemical reactions that occur in the leukotriene (calling it this for simplicity) pathway. We are also seeing that a number of researchers would like to use gene profiles to predict whether patients will respond favorably to different asthma/allergy drugs. ALL PATIENTS HAVE A RIGHT TO KNOW IF IT IS INHERENT THAT SOME PEOPLE WILL NOT RESPOND TO SINGULAIR OR RESPOND ADVERSELY.

There are many studies from the 1998 era that conclude that montelukast is not effective for everyone. Those researchers stated that it can be predicted that those people who are going to respond favorably will do that within the first 14 days or so. That conclusion would be consistent with a genetic component for efficacy and safety of Singulair. Those doctors concluded that those who did not respond within that time frame should not take Singulair for fear of harming them. That makes good sense.

The Italian researchers wanted to know if there was more going on than blocking leukotrienes in the action of montelukast. They set up a "test tube" study regarding montelukast, the cysLT1 receptor, and some t-cells that they selected. Why? Researchers always have something on their minds. They observed the death of these particular t-cells.

Montelukast is a quinoline. We basically know of quinilines and quinolones as compounds that were invented as broad spectrum antibiotics. They work because they interference with bacterial DNA so they cannot replicate themselves. Montelukast is a quinoline modified to bind with the cysLT1 receptor (a gene) and prevent that gene from activating. That's consistent with what a quinoline/quinolone does.

So what does montelukast do in blood plasma if it does not bind to the receptor because of genetic mis-match? (If montelukast does bind, then a chemical reaction has occurred and the liver will break down the by-products. Montelukast metabolized in 10-12 hours.) What happens if it doesn't bind? How long before it breaks down? Does it produce toxic by-products?

I want to know what happens to lymphocytes such as t-cells just because montelukast is a quinoline. Maybe nothing but what's up with the Italians researchers? I want to know if montelukast has the capability to interfere with lymphocytes who can clone themselves. That could be a good thing under circumstances when these lymphocytes are causing inflammation. But it could be a bad thing in the case of normal individuals with no problems.

I want to know if the bad side effects are due to the fact that the body has to break down and metabolize a quinoline that did not bind to the receptor for which it was created. The side effects of Singulair are strangely similar to what is observed in the quinolones such as levaquin. I have not as yet been able to compare montelukast as a quinoline to levaquin as a quinolone. I am hoping to find something on these categories. There may be no reason to worry that they cause similar damage. But frankly, I think that there is. There is some terrible chit happening to some people. The scariest is the neurological damage.

All of these questions would be in the everybody pharma knows to ask category. I don't know where the answers are. I haven't found them as of yet. Maybe there are no answers. We have to remember that Singulair and Vioxx were released in the same year. They have continued to be drugs under the current executive management of Merck. If the Vioxx marketing promoters had their ghost writers, why not the Singulair marketing promoters. The genetic component appears to be widely accepted but we haven't heard one thing about even that.

I think that it is sad that maybe the marketing of Singulair as one stop shopping for asthma/allergies may have destroyed the original concept. I really think from reading the original work that they knew that they couldn't engineer a drug for one size fits all. Everybody gets harmed when information is withheld.

Shame on the allergist who yelled at the mother who wanted to discuss issues. Does he know exactly who is allergic to Singulair and who isn't? Get him a dunce hat. Just because Singulair is marketed for allergies does not mean that you cannot be allergic to it. See the power of Madison Avenue? The ad agencies focus group these drugs to death. The ad agencies cleverly craft the product information. A good piece of legislation would be to prohibit consumer drugs ads.

I have had Mirena in since may 2007, 8 weeks after my second child. It was not painful to insert. I spot for about 1 month. I have been feeling tired, my nerves been bothering me, some back pain and feeling "spaced out / hard to focus". But I don't just blame it just on Mirena. All hormone birth control will have this affect.(what women have to deal with, it is a shame) Sad to say birth control is just not natural and is not good for us women. Birth control causes Candida (yeast to grow rapid). This causes all the problems we see in birth control. The problem is there is a natural solution to birth control, but the medical industry would not make money off of us. This natural form of birth control is available in India. They use Neem Oil in a cream form.Vaginal creams and suppositories made with Neem oil are quickly becoming the birth control method of choice in India.They are non-irritating and easy to use while almost 100 percent effective. It's important to note, however, that even toxic spermicides are not 100 percent effective.Neem has a proven ability to prevent pregnancy.Years of study in India by some of the world's leading scientists resulted in the development of a Neem-based polyherbal vaginal cream that has both spermicidal and anti-microbial action. The cream combines 25 per cent Neem seed extract with extracts from the soap nut and quinine hydrochloride. Based on the success of these experiments, a Neem-based contraceptive cream was developed by a pharmaceutical company in India. Tests of its effectiveness showed that it compared favorably with the chemical-based foams and gels. It was safer and easier to use, caused no irritation or discomfort, was nearly 100% effective, and was therefore used more frequently than the foam or gel spermicides.The effect does not appear to be hormonal and is considered a safe and effective alternative to other methods that use hormones.

I do know that when effective natural birth control becomes available (besides not having sex LOL not going to happen) I will be the first to run and get it. We need to advocate for natural non-hormone birth control. It is affecting the race of women. I encourage you to respond.

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I've been on Prednisone after and allergic reaction to penicillin (Amoxicillin) (bullous pemphigold - large blister on my arms and legs, some on the back and very little on the stomach) I've been on the medication for three days (40mg/day) I cannot standup or move my hands, my entire leg hurts and the foot is swollen (it could be from the penicillin). I'm hoping it will go away after I come off prednisone but has anyone experienced long term pain from this drug?

I'm pretty sure my pain is from the allergic reaction. Has anyone had long term pain from any type of bullous reaction?

I think I maybe just figured out the answer to these symptoms you guys are describing, with mood changes and nightmares?

From Merck Frosst website:
The team finally chose quinolein as the basis for their compound, because it has affinities with the LTD4 (leukotriene) region.

Quinolein - elsewhere it has been listed as a seratonin inhibitor...

Also, is Quinolein related to Quinine (a malarial treatment that causes nightmares and psychotic symptoms?)

What do you all think?

I don't remember when I started taking Zocor - I think it was late 1990's. Recently I've been having pins and needles in my legs, arms and other parts of my body. Doctor did an EMG and it came back normal. Blood tests were also normal. He's now sending me to a neurologist. I researched Zocor and found that it can cause nerve damage which is what my doctor said I probably have. The research said that it starts in the feet then travels to the rest of the body. In 1999 I went to the doctor with pins and needles in the feet and he diagnosed it as arthritis and gave me quinine. I was in a car accident in 2001 and have been on pain medicine since then which was covering up the pain. The pain sometimes has me using a cane.

Last resort, sent to new pain clinic where for chronic sever low back and leg pain began rec'ing epidural steriod injections. Results were good, but side effects of severe, ex-cruiating charley horse cramps to feet and calves of both legs I felt like cutting them off. Brought it up to doc and he say oh yeah, and prescribed quinine which is helping. But its another pill to take! Its awful to feel like your feet bones are crossing over each other and calf cramps that are so tight your legs feel like splitting open. The pain and soreness lingers for a week or more. Never has steriods of other kinds affected me like this. Its the first time rec'ing kenalog.

I took Lipitor 40 mg q.d. for a few years. Then I started having unbearable leg cramps upon awakening in the mornings. They were practically debilitating! I also started having another kind of leg pain, the kind which is very hard to describe. My leg or legs would feel kind of dead, not crampy, but pain inside the leg near the bone you might say. That was worse than the leg cramps, because I could usually get up and walk around and eventually the leg cramps would go away for the rest of the day. This dead but extremely painful feeling in my legs would go all the way up into the thigh area and I would just have to lie there until it went away. Thank God it did always eventually go away, but not before my vowing to have my legs amputated if the pain continued. My doctor had no idea what could be causing this, and I got the impression that he thought the symptoms were psychosomatic. As a last resort, I stopped taking Lipitor and within 24 hours the leg pain (both kinds) stopped. After one year of blessed relief and no Lipitor the doctor tested my cholesterol and it was very high again. So I tried going back on Lipitor, only I cut the dose in half. The doctor also gave me 300 mg of gabapentin and 325 mg of quinine to take at night about three hours before bedtime. To date, my cholesterol is down to below normal levels and I have not had any more of either kind of leg pain. But if I forget the quinine or gabapentin even one night, the pain comes back. I hope this helps someone else who is suffering as I did.

I take 10 mg of Zocor. My cholesterol was 240. It dropped to 110. I have been on it 2 years. I use to run and and never experienced leg cramps. Now I wake up with leg cramps about every 2 hours. They are severe enough to force me to get up and stretch my calf, Hamstring, Quad or foot which ever is cramping. The Dr. put me on Quinine for cramps, no help. I forgot to take my pill for 2 days now, purely accident and no more cramps. My hip has also been a problem where as it was not before. I am going to try not taking it for a couple days and see. If no more cramps ...NO MORE Zocore.

I also had Hepatitis A 30 years ago, told my Dr. and he said no problem. Now I read about liver problems and ZOCOR should not be combined. Who can we believe anymore.

What most people don't read, is that if you are taking Levaquin or any of the quinine based antibiotics you are NOT supposed to ingest caffeine. No tea, no coffee, no chocolate. I was getting major rushes off of it. It was kinda neat :) But not when the heart started racing like crazy. It also contributed to a lot of other icky symptoms. Stopped the caffeine as opposed to the antibiotics and the infection is getting better. Now I just have to kill the caffeine deficiency headache :) Oh, and if you go off caffeine, you're going to sleep like the dead for a couple days.

I have an MRSA (antibiotic resistant staph infection) did a round of Zithro, a round of Cipro and now on a round of Clindamycin. Infection is finally being held at bay from getting worse. Now I have to convince it to die and go away.

What fun

Kat