Cinchona

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What other names is Cinchona known by?

Bois aux Fièvres, Cinchona calisaya, Cinchona carabayensis, Cinchona ledgeriana, Cinchona officinalis, Cinchona pubescens, Cinchona succirubra, Chinarinde, Cinchonine, Écorce du Pérou, Écorce de Quina, Écorce de Quinquina Rouge, Fieberrinde, Jesuit's Bark, Kina-Kina, Peruvian Bark, Poudre des Jésuites, Quina, Quinine, Quino, Quinquina, Quinquina Gris, Quinquina Rouge, Red Cinchona Bark.

What is Cinchona?

Cinchona is a tree. People use the bark to make medicine.

Cinchona is used for increasing appetite; promoting the release of digestive juices; and treating bloating, fullness, and other stomach problems. It is also used for blood vessel disorders including hemorrhoids, varicose veins, and leg cramps. Some people use cinchona for mild attacks of influenza, swine flu, the common cold, malaria, and fever. Other uses are for cancer, mouth and throat diseases, enlarged spleen, and muscle cramps.

Cinchona is used in eye lotions to numb pain, kill germs, and as an astringent. Cinchona extract is also applied to the skin for hemorrhoids, stimulating hair growth, and managing varicose veins.

Insufficient Evidence to Rate Effectiveness for...

  • Malaria. Cinchona bark contains quinine and related chemicals. While quinine is effective for preventing malaria and controlling its symptoms, people who take cinchona bark are exposed to risky side effects. Some of the chemicals in cinchona can slow the heart, cause constipation, and affect the central nervous system. Medical experts recommend that only purified quinine or other appropriate medications be used to prevent or control malaria. U.S. drug regulations require products containing cinchona to include labeling that states, "Discontinue use if ringing in the ears, deafness, skin rash or visual disturbances occur."
  • Hemorrhoids.
  • Varicose veins.
  • Colds.
  • Leg cramps.
  • Influenza.
  • Malaria.
  • Fever.
  • Cancer.
  • Mouth and throat diseases.
  • Enlarged spleen.
  • Muscle cramps.
  • Loss of appetite.
  • Stomach discomforts, such as bloating and fullness.
  • Other conditions.
More evidence is needed to rate the effectiveness of cinchona for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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How does Cinchona work?

Cinchona bark stimulates saliva and stomach (gastric) juice secretion. It contains quinine, which is a chemical used to treat malaria.

Are there safety concerns?

Cinchona bark seems to be safe for most people when used appropriately. However, in large amounts, cinchona is UNSAFE and can be deadly. Symptoms of overdose include ringing of the ears, headache, nausea, diarrhea, and vision disturbances. Cinchona can also cause bleeding and allergic reactions, including hives and fever.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Don't use cinchona if you are pregnant or breast-feeding. There is some evidence that cinchona is UNSAFE to use during pregnancy. Not much is known about the safety of using cinchona if you are breast-feeding, so it's best to avoid it.

Stomach or intestinal ulcers: Don't use cinchona if you have ulcers. It might increase the risk of bleeding.

Surgery: Cinchona can slow blood clotting, so there is a concern that it might increase the risk of extra bleeding during and after surgery. Stop using cinchona at least 2 weeks before a scheduled surgery.

Are there any interactions with medications?



Quinidine
Interaction Rating: Major Do not take this combination.

Cinchona contains quinidine. Taking quinidine along with cinchona can increase the effects and side effects of quinidine and cause heart problems. Do not take cinchona if you are taking quinidine.



Quinine
Interaction Rating: Major Do not take this combination.

Cinchona contains quinine. Taking quinine along with cinchona can increase the effects and side effects of quinine and cause heart problems. Do not take cinchona if you are taking quinine.



Carbamazepine (Tegretol)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

The body breaks down carbamazepine to get rid of it. Cinchona contains quinine. Quinine can cause the body to break down carbamazepine (Tegretol) too quickly. Taking cinchona along with carbamazepine (Tegretol) can decrease the effectiveness of carbamazepine (Tegretol).



Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Cinchona might slow blood clotting. Taking cinchona along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.



Phenobarbital (Luminal)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Cinchona contains quinine. Quinine might increase how much phenobarbital (Luminal) is in the body. Taking cinchona with phenobarbital might increase the effects and side effects of phenobarbital.



Antacids
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Antacids are used to decrease stomach acid. Cinchona may increase stomach acid. By increasing stomach acid, cinchona might decrease the effectiveness of antacids.

Some antacids include calcium carbonate (Tums, others), dihydroxyaluminum sodium carbonate (Rolaids, others), magaldrate (Riopan), magnesium sulfate (Bilagog), aluminum hydroxide (Amphojel), and others.



Medications that decrease stomach acid (H2-blockers)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Cinchona might increase stomach acid. By increasing stomach acid, cinchona might decrease the effectiveness of some medications that decrease stomach acid, called H2-blockers.

Some medications that decrease stomach acid include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid).



Medications that decrease stomach acid (Proton pump inhibitors)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Cinchona might increase stomach acid. By increasing stomach acid, cinchona might decrease the effectiveness of medications that are used to decrease stomach acid, called proton pump inhibitors.

Some medications that decrease stomach acid include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium).

Dosing considerations for Cinchona.

The appropriate dose of cinchona depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for cinchona. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Reviewed on 3/29/2011 12:35:40 PM

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