Yes, They Still Use Quinine in Tonic Water

October 20, 2025 •

4 min read

The U.S. Food and Drug Administration (FDA) regulates the amount of quinine in tonic water, capping it at a low, safe level of no more than 83 parts per million. Yes, modern tonic water continues to contain this historic ingredient, but its purpose has evolved from medicine to a key flavoring agent.

Quick Summary

Despite its history as an antimalarial drug, commercial tonic water uses very small, regulated amounts of quinine for its distinctive bitter taste. The concentration is far too low for any therapeutic effect, making it safe for most consumers.

Key Points

Still in Use: Yes, quinine remains an active ingredient in most commercial tonic waters today.
Purpose is Flavor: Its primary function is to provide the distinctive bitter flavor, not to serve as a medicine.
Regulated Low Concentration: The amount is strictly regulated by government agencies like the FDA, ensuring it is present in very small, safe concentrations.
No Therapeutic Effect: The low dose of quinine in tonic water is insufficient to treat medical conditions like malaria or leg cramps.
Safety for Most: When consumed in moderation, tonic water is considered safe for the majority of people, though some individuals may have sensitivities.
Quinine-Free Options Exist: For those who prefer or need to avoid quinine, there are several brands offering quinine-free tonic waters using alternative bittering agents.

The Shift from Medicine to Flavoring Agent

Quinine's story with tonic water began in the 17th century, derived from the bark of the cinchona tree and used as a potent antimalarial treatment. During British colonial rule in India, soldiers mixed medicinal quinine powder with sugar, water, and gin to make it more palatable, inadvertently creating the first gin and tonic. Over time, as more effective antimalarial drugs were developed and quinine's side effects at medicinal doses became well known, its use for therapeutic purposes declined. However, the bitter flavor it imparted had become a beloved characteristic, leading manufacturers to continue adding it in much smaller quantities to modern, sweetened tonic water. Today, quinine's role is purely as a flavoring agent to create the beverage's classic, refreshing bitterness.

How Regulatory Bodies Ensure Safety

To protect public health, regulatory bodies like the FDA and the European Food Safety Authority (EFSA) strictly control the amount of quinine permitted in commercial beverages. In the United States, the FDA limits quinine content to no more than 83 parts per million (ppm), or 83 milligrams per liter. By comparison, a therapeutic dose of quinine for malaria is significantly higher, requiring 500 to 1,000 mg of quinine tablets several times a day. This regulatory standard ensures that the quinine in tonic water is far below levels that could cause harm. The FDA also banned the over-the-counter sale of quinine for treating nighttime leg cramps due to safety concerns and its potential to cause severe side effects at medicinal doses. Consumers should never mistake tonic water as a treatment for medical conditions.

A Closer Look at Cinchonism

Cinchonism is the term for the syndrome of symptoms caused by high, medicinal doses of quinine. These symptoms can include ringing in the ears (tinnitus), headache, blurred vision, nausea, and vertigo. The small amount of quinine in commercial tonic water is generally not enough to induce cinchonism in most people. However, individuals with a particular sensitivity to quinine could experience mild adverse effects, and there are documented, albeit rare, cases of more serious reactions from overconsumption or underlying conditions.

Quinine-Based vs. Quinine-Free Tonic Waters


Feature	Traditional Tonic (with Quinine)	Quinine-Free Alternatives
Bittering Agent	Quinine from cinchona bark.	Quassia bark, gentian root, or other botanicals.
Flavor Profile	Classic bitter, often balanced with citrus.	Can be more herbal, floral, or have a less traditional bitter profile.
Allergy Risk	Small risk for individuals sensitive to quinine.	Avoids quinine-related allergies entirely.
Origin	Cinchona tree.	Various botanicals, depending on the brand.
Availability	Very common, most major brands.	Niche and craft brands offer quinine-free options.

Homemade Tonic: The Quinine Dilemma

For those who enjoy DIY projects or want to customize their flavors, homemade tonic syrup is an option. Recipes often call for cinchona bark, but this comes with significant risks. The potency of cinchona bark can vary, making it extremely difficult to properly dose quinine and potentially leading to toxicity. A much safer alternative is to use quinine-free ingredients for bitterness, such as quassia bark or gentian root.

More control over the final flavor profile, creating unique and customized concoctions.
Eliminates the health risks associated with the potential toxicity of improperly dosed cinchona bark.
Safe for those with quinine sensitivities or allergies who still want to enjoy a bitter, bubbly mixer.
Allows for experimentation with various botanicals, like lemongrass, allspice, and cardamom, to develop a complex flavor.

Who Should Be Cautious About Quinine?

While the amount of quinine in tonic water is safe for most, certain individuals should exercise caution or avoid it entirely, particularly when considering medicinal doses.

Pregnant or Breastfeeding Individuals: These groups are often advised to avoid quinine as a precaution.
Those with Heart Conditions: Individuals with certain heart rhythm abnormalities, such as a prolonged QT interval, should consult a doctor as quinine can affect heart rhythm.
Individuals with Liver or Kidney Disease: Those with impaired liver or kidney function may process quinine less efficiently.
Those on Certain Medications: Quinine can interact with some prescription drugs, including blood thinners and certain antidepressants, making medical consultation necessary.

Conclusion

In summary, the use of quinine in tonic water continues today, but its purpose is solely for its distinctive bitter flavor, not as a medication. Regulatory agencies like the FDA ensure that the concentration is kept at a very low, safe level for the general population. The key distinction lies between this minute flavoring agent and the much higher, potentially dangerous medicinal doses used historically or for malaria treatment. For those with sensitivities or who wish to avoid quinine, numerous quinine-free alternatives are widely available, both commercially and for safe homemade preparation using other bittering agents.

For more detailed regulatory information on food additives, consider consulting the U.S. Food and Drug Administration website.

Frequently Asked Questions

In modern tonic water, quinine's main purpose is to provide the distinctive bitter flavor that balances the sweetness and carbonation, not for any medicinal use.

No, the amount of quinine in modern tonic water is far too low to have any therapeutic effect for conditions like malaria or leg cramps.

Yes, the FDA limits quinine content to no more than 83 parts per million (83 mg per liter) in the United States to ensure it is safe for consumption as a food additive.

High, medicinal doses of quinine can cause side effects like ringing in the ears (tinnitus), nausea, vomiting, and, rarely, more serious issues. These are not typically associated with moderate tonic water consumption.

While rare, some individuals with a specific sensitivity or allergy to quinine could experience mild adverse effects, even from the small amounts in tonic water.

Yes, several brands offer quinine-free tonic water, often using alternative bittering agents like quassia or gentian root for flavor.

Homemade tonic with cinchona bark is risky because bark potency varies, making it difficult to control the quinine dosage and increasing the potential for toxicity. It is safer to use quinine-free recipes.