# Is there something in quinine that may affect a pilot enough that there is a regulation against **URL:** \ **Category:** Factual Questions\ **Created:** [September 14, 2015, 5:00am UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180 "2015-09-14T05:00:09Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [September 14, 2015, 5:00am UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/1 "2015-09-14T05:00:09Z")
drinking it before flights? ---
**Author:** ![Jragon](https://avatars.discourse-cdn.com/v4/letter/j/e19b73/32.png) [@Jragon](https://boards.straightdope.com/u/Jragon)\ **Post date:** [September 14, 2015, 5:20am UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/2 "2015-09-14T05:20:20Z")
I think it can cause heart fibrillation, but it’s really rare. ---
**Author:** ![Richard\_Pearse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/richard_pearse/32/13144_2.png) [@Richard\_Pearse](https://boards.straightdope.com/u/Richard_Pearse)\ **Post date:** [September 14, 2015, 7:04am UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/3 "2015-09-14T07:04:59Z")
I could be wrong but I thought ex-pat pilots in PNG took quinine to combat malaria. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [September 14, 2015, 7:08am UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/4 "2015-09-14T07:08:54Z")
[List of possible side-effects of quinine](http://www.drugs.com/sfx/quinine-side-effects.html). Note in particular the neurological side-effects. ---
**Author:** ![Princhester](https://avatars.discourse-cdn.com/v4/letter/p/3e96dc/32.png) [@Princhester](https://boards.straightdope.com/u/Princhester)\ **Post date:** [September 14, 2015, 7:42am UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/5 "2015-09-14T07:42:09Z")
The amount of quinine in modern tonic is tiny compared to that which might be found in a therapeutic dose however. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [September 14, 2015, 9:06am UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/6 "2015-09-14T09:06:47Z")
I once heard that a ‘passed quietly from mother to daughter’ method to induce miscarriage involved quinine consumed in a particular manner. Never even tried to confirm it (I’m male - Mommy taught me basic sewing, cooking, and even laundry, but we never mentioned unwanted pregnancy). ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [September 14, 2015, 9:09am UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/7 "2015-09-14T09:09:42Z")
FAA, pilots, and drinking: It has changed recently (as has the general perception of "drinking and driving’), but 10 years ago or so, the the FAA rule was ‘8 hours from bottle to throttle’ - it is not like them to be overly concerned about quinine. ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [September 14, 2015, 1:52pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/8 "2015-09-14T13:52:13Z")
Years ago there was some concern that chronic long term consumption of beverages containing quinine would eventually do damage to the balance mechanism of the inner ear. Which would obviously be adverse to a pilot’s long term career prospects. But AFAIK there was never a prohibition by USAF or FAA against individual consumption of such beverages. There certainly is no such prohibition now. Switching gears away from beverages … There are many medications that FAA says can’t be taken while flying. In most cases the issue isn’t the medication itself, but rather the fact that if you’re taking medicine X then you have disease Y and they don’t want folks with an active case of Y flying. ---
**Author:** ![Bill\_Door](https://avatars.discourse-cdn.com/v4/letter/b/50afbb/32.png) [@Bill\_Door](https://boards.straightdope.com/u/Bill_Door)\ **Post date:** [September 14, 2015, 1:58pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/9 "2015-09-14T13:58:53Z")
> [@LSLGuy](#): > > (snip)There are many medications that FAA says can’t be taken while flying. In most cases the issue isn’t the medication itself, but rather the fact that if you’re taking medicine X then you have disease Y and they don’t want folks with an active case of Y flying. And yet they think it’s OK for people who have disease Y to fly as long as it’s untreated. I guess I don’t understand how these things work. ---
**Author:** ![Richard\_Pearse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/richard_pearse/32/13144_2.png) [@Richard\_Pearse](https://boards.straightdope.com/u/Richard_Pearse)\ **Post date:** [September 14, 2015, 2:09pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/10 "2015-09-14T14:09:00Z")
> [@usedtobe](#): > > FAA, pilots, and drinking: > It has changed recently (as has the general perception of "drinking and driving’), but 10 years ago or so, the the FAA rule was ‘8 hours from bottle to throttle’ - it is not like them to be overly concerned about quinine. I thought it was 8 meters, have I been doing it wrong all these years? _hic_ ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [September 14, 2015, 2:25pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/11 "2015-09-14T14:25:27Z")
> [@Bill\_Door](#): > > And yet they think it’s OK for people who have disease Y to fly as long as it’s untreated. I guess I don’t understand how these things work. You’re right; you don’t understand how these things work. Pilots are required to report any and all health concerns to the FAA and also report all encounters with the medical industry, including routine checkups. It is a violation of regulations to fly while knowing, or reasonably suspecting, that you have a chronic untreated condition. What we don’t have today is intrusive Big Brother enforcement of this wherein all e-med records everywhere are sent to FAA and all pilots receive a comprehensive stem-to-stern all-possible-diseases workup by some hostile government doctor every 6 months. Plus a session or two with a hostile government shrink. Yet. ---
**Author:** ![dasmoocher](https://avatars.discourse-cdn.com/v4/letter/d/dbc845/32.png) [@dasmoocher](https://boards.straightdope.com/u/dasmoocher)\ **Post date:** [September 14, 2015, 3:31pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/12 "2015-09-14T15:31:07Z")
Not directly related to the OP, but I mention it because of a local story (to me) of a woman who committed suicide after taking [mefloquine](https://en.wikipedia.org/wiki/Mefloquine), which her family blames as the cause. > [@](#): > > Mefloquine (brand names: Lariam, Mephaquin or Mefliam) is an orally administered medication used in the prevention and treatment of malaria. > > Mefloquine was developed in the 1970s at the United States Department of Defense’s Walter Reed Army Institute of Research as a **synthetic analogue of quinine**. The brand name drug, Lariam, is manufactured by the Swiss company Hoffmann–La Roche. In August 2009, Roche stopped marketing Lariam in the United States. Generic mefloquine from other manufacturers is still widely available. It is on the World Health Organization’s List of Essential Medicines, the most important medications needed in a basic health system.[1] > > Rare but serious neuropsychiatric problems have been associated with the use of mefloquine.[2] > … > Adverse effects > > Mefloquine is contraindicated in those with a previous history of seizures or a recent history of psychiatric disorders.[2] Severe side effects requiring hospitalization are rare.[3] Compared to other malaria prophylaxis regimens, mefloqinone may produce more side effects in non-pregnant travelers. In pregnant travelers, it appears to pose minimal risk to the fetus. [10][11] > Neurologic and psychiatric > > In 2013 the United States Food and Drug Administration added a boxed warning to the U.S. label of mefloquine regarding the potential for neuropsychiatric side effects that may persist even after discontinuing administration of the drug.[12][13] Psychiatric effects include anxiety, hallucinations, depression, unusual behavior, and suicidal ideations, among others. Neurologic effects include dizziness, loss of balance, and tinnitus. The label warns that mild symptoms may presage more serious ones, and that the drug should be discontinued at the first sign of symptoms. Mefloquine should not be used in people with a history of psychiatric problems. > > Central nervous system events requiring hospitalization occur in about one in 10,000 people taking mefloquine for malaria prevention, with milder events (e.g., dizziness, headache, insomnia, and vivid dreams) in up to 25%.[14] When some measure of subjective severity is applied to the rating of adverse events, about 11-17% of travelers are incapacitated to some degree.[6] > Cardiac > > Mefloquine may cause abnormalities with heart rhythms that are visible on electrocardiograms. Combining mefloquine with other drugs that cause similar effects, such as quinine or quinidine, can increase these effects. Combining mefloquine with halofantrine can cause significant increases in QTc intervals.[8]:10 [My bold] Not exactly quinine, and as mentioned above, medicinal doses would be much higher than in a serving of tonic. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [September 14, 2015, 6:08pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/13 "2015-09-14T18:08:09Z")
> [@LSLGuy](#): > > You’re right; you don’t understand how these things work. > > Pilots are required to report any and all health concerns to the FAA and also report all encounters with the medical industry, including routine checkups. It is a violation of regulations to fly while knowing, or reasonably suspecting, that you have a chronic untreated condition. > > What we don’t have today is intrusive Big Brother enforcement of this wherein all e-med records everywhere are sent to FAA and all pilots receive a comprehensive stem-to-stern all-possible-diseases workup by some hostile government doctor every 6 months. Plus a session or two with a hostile government shrink. > > Yet. The shrink thing was brought to the fore, at least publicly for a wide audience, with the GermanAir suicide/mass murder. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [September 14, 2015, 6:11pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/14 "2015-09-14T18:11:47Z")
> [@Princhester](#): > > The amount of quinine in modern tonic is tiny compared to that which might be found in a therapeutic dose however. Medicinal tonic water originally contained only carbonated water and a large amount of quinine. However, most tonic water today contains a less significant amount of quinine, and is thus used mostly for its flavor. As a consequence, it is less bitter, and is also usually sweetened, often with high fructose corn syrup or sugar. Some manufacturers also produce diet (or slimline) tonic water, which may contain artificial sweeteners such as aspartame. Traditional-style tonic water with little more than quinine and carbonated water is less common, but may be preferred by those who desire the bitter flavour. In the United States, the US Food and Drug Administration (FDA) limits the quinine content in tonic water to 83 ppm[3] (83 mg per liter if calculated by mass), while the daily therapeutic dose of quinine is in the range of 500–1000 mg,[4] and 10 mg/kg every eight hours for effective malaria prevention (2100 mg daily for a 70 kg adult).[5] Still, it is often recommended as a relief for leg cramps, but medical research suggests some care is needed in monitoring doses.[6] Because of quinine’s risks, the FDA cautions consumers against using “off-label” quinine drugs to treat leg cramps.[7] > **[Tonic water](https://en.m.wikipedia.org/wiki/Tonic_water#Quinine_content)** > > Tonic water is a carbonated soft drink in which quinine is dissolved. Originally used as a prophylactic against malaria, modern tonic water typically has a significantly lower quinine content and is often more sweetened than the original medicinal form. It is consumed for its distinctive bitter flavor. > As early as the 17th century the Spanish used quinine from the bark of Cinchona trees to treat malaria after being shown the remedy from the Indigenous peoples of Peru, Bolivia, and Ecuador. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [September 14, 2015, 9:15pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/15 "2015-09-14T21:15:18Z")
> [@dasmoocher](#): > > Not directly related to the OP, but I mention it because of a local story (to me) of a woman who committed suicide after taking [mefloquine](https://en.wikipedia.org/wiki/Mefloquine), which her family blames as the cause. This is probably what I what trying to think of when I wrote [my post above](http://boards.straightdope.com/sdmb/showthread.php?p=18683818#post18683818) about neurological side-effects of quinine. Mefloquine has been controversial because of the reports of [serious and _long-term_ neuro-psychiatric adverse effects](http://www.biosciencetechnology.com/news/2013/09/brain-damaging-side-effects-force-army-pull-mefloquine): > [@](#): > > The top doctor for Green Berets and other elite Army commandos has told troops to immediately stop taking mefloquine, an anti-malaria drug found to cause permanent brain damage in rare cases. > > \< . . . snip . . . \> > > The new prohibition among special operations forces follows a July 29 [2013] safety announcement by the Food and Drug Administration that it had strengthened warnings about neurologic side effects associated with the drug. The FDA added a boxed warning to the drug label, the most serious kind of warning, saying neurologic side effects like dizziness, loss of balance and ringing in the ears may become permanent. > > The drug’s other side effects include anxiety, depression and hallucinations — conditions that some military families over the years believe prompted psychotic behavior in their loved ones, including killings and suicides. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [September 14, 2015, 9:25pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/16 "2015-09-14T21:25:26Z")
> [@LSLGuy](#): > > You’re right; you don’t understand how these things work. > > Pilots are required to report any and all health concerns to the FAA and also report all encounters with the medical industry, including routine checkups. It is a violation of regulations to fly while knowing, or reasonably suspecting, that you have a chronic untreated condition. > > What we don’t have today is intrusive Big Brother enforcement of this wherein all e-med records everywhere are sent to FAA and all pilots receive a comprehensive stem-to-stern all-possible-diseases workup by some hostile government doctor every 6 months. Plus a session or two with a hostile government shrink. > > Yet. There are 150 people who died in the Alps a few months ago because a pilot did not do this. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [September 14, 2015, 9:26pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/17 "2015-09-14T21:26:49Z")
More mefloquine horror stories. [Crazy Pills](http://www.nytimes.com/2013/08/08/opinion/crazy-pills.html?_r=0), David Stuart MacLean, New York Times, Aug. 7, 2013. [Another nightmare account of Lariam adverse effects](http://homecomingvets.com/2011/07/24/another-nightmare-account-of-lariam-adverse-effects/), Homecoming Vets web site (a re-post of an earlier article from somewhere else). ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [September 14, 2015, 9:28pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/18 "2015-09-14T21:28:07Z")
> [@LSLGuy](#): > > Pilots are required to report any and all health concerns to the FAA and also report all encounters with the medical industry, including routine checkups. It is a violation of regulations to fly while knowing, or reasonably suspecting, that you have a chronic untreated condition. All pilots, or just (or mainly) commercial pilots? What about private non-commercial pilots? ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [September 14, 2015, 9:28pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/19 "2015-09-14T21:28:48Z")
> [@Senegoid](#): > > This is probably what I what trying to think of when I wrote [my post above](http://boards.straightdope.com/sdmb/showthread.php?p=18683818#post18683818) about neurological side-effects of quinine. Mefloquine has been controversial because of the reports of [serious and _long-term_ neuro-psychiatric adverse effects](http://www.biosciencetechnology.com/news/2013/09/brain-damaging-side-effects-force-army-pull-mefloquine): I’ve never had occasion to take mefloquine (Lariam) but I’ve dispensed it many times, and have also heard many times that people often prefer having malaria to taking that dreadful stuff. Fansidar, a combination product, is less unpleasant, but more expensive and has to be taken every day, vs. weekly for Lariam. Now back to our regularly scheduled programming. ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [September 14, 2015, 9:33pm UTC](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180/20 "2015-09-14T21:33:49Z")
> [@Senegoid](#): > > All pilots, or just (or mainly) commercial pilots? What about private non-commercial pilots? The regs don’t distinguish. As a practical matter (ref other posts) we see a lot more public concern with these issues with commercial pilots as opposed to hobbyist pilots. [Next page](https://boards.straightdope.com/t/is-there-something-in-quinine-that-may-affect-a-pilot-enough-that-there-is-a-regulation-against/731180.md?page=2)