Quinine Side Effects in Long-Term Use for Arthritis

Quinine side effects?

I am a patient with rheumatoid arthritis, with a history of 35 years.
In recent years, I have been intermittently taking quinine for a long duration, totaling 8 years.
Over the past 2 years, I have noticed darkening of my forehead and chin, hair loss, frequent urination, and urinary incontinence.
Additionally, my skin has become increasingly dark, and my hair has become finer and sparser.
Even after stopping the medication for 2 years, the skin darkening has not improved.
I am unsure if this is related to long-term quinine use, if there is a kidney issue, or if I need to see a doctor for an examination.
I would appreciate your clarification on these concerns.
Thank you very much!

chuchu, 40~49 year old female. Ask Date: 2005/01/25

Dr. Zeng Guosen reply Internal Medicine

Hello, quinine can cause hyperpigmentation, leading to darker skin.
Aside from discontinuing the medication, there are no effective methods to address this issue.
However, it is important to rule out any endocrine, kidney, or liver abnormalities, so please consult a physician for evaluation.
Sincerely, Dr.
Chuan-Sen Tseng, Internal Medicine.

Reply Date: 2005/01/25

More Info

Quinine, a medication traditionally used to treat malaria, has also been employed for managing symptoms of arthritis, particularly in cases of rheumatoid arthritis. However, long-term use of quinine can lead to a variety of side effects, some of which you are experiencing. It is essential to understand these potential side effects and their implications for your health.

Firstly, the symptoms you describe—darkening of the skin, hair loss, frequent urination, and incontinence—are concerning and warrant further investigation. Quinine can cause a condition known as cinchonism, which includes symptoms such as tinnitus, headache, nausea, and visual disturbances. While cinchonism is more commonly associated with acute use, chronic exposure can lead to more severe complications.

The skin darkening you are experiencing could be related to a condition called hyperpigmentation, which has been reported in some patients taking quinine. This side effect may not resolve even after discontinuation of the medication, as you have noted. Hair loss, or alopecia, can also be a side effect of long-term quinine use, although it is less commonly reported. The thinning of hair and changes in hair texture you are experiencing could be linked to the medication, but they could also be influenced by other factors such as hormonal changes, nutritional deficiencies, or other underlying health conditions.

Frequent urination and incontinence are also concerning symptoms. While quinine is not typically associated with these issues, they could indicate a potential problem with your kidneys or urinary tract. Given that quinine can affect renal function, it is crucial to have your kidney health evaluated, especially since you have been using this medication for an extended period.

Given your long history of rheumatoid arthritis and the chronic use of quinine, it is advisable to consult a healthcare professional. A thorough evaluation by a rheumatologist or a nephrologist may be necessary to assess the impact of long-term quinine use on your overall health. They may recommend blood tests to check your kidney function, liver enzymes, and other relevant parameters. Additionally, a dermatologist could provide insights into the skin changes you are experiencing.

In terms of managing your rheumatoid arthritis, it may be worth discussing alternative treatments with your healthcare provider. There are various medications available that may be more suitable for long-term management of arthritis symptoms without the adverse effects associated with quinine. Disease-modifying antirheumatic drugs (DMARDs), biologics, and non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage arthritis and may offer a better side effect profile.

In conclusion, while quinine has been used for arthritis management, its long-term use can lead to significant side effects, as you have experienced. It is crucial to seek medical advice to evaluate your symptoms and consider alternative treatment options for your rheumatoid arthritis. Regular monitoring and open communication with your healthcare provider will be essential in managing your condition effectively and safely.

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