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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Cinchona Officinalis
Brand Name
China 30c
Generic Name
Cinchona Officinalis
Active Ingredient
Cinchona Officinalis BarkCategory
Non-Standardized Food Allergenic Extract [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 30 [hp_C]/mL | LIQUID | ORAL | 44911-0343 |
Detailed information about China 30c
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for China 30c, you must consult a qualified healthcare professional.
Cinchona Officinalis Bark is a botanical extract containing potent alkaloids, primarily used as a non-standardized allergenic extract and nitrogen-binding agent. It is historically significant as the natural source of quinine and quinidine.
Dosage for Cinchona Officinalis Bark is highly variable and depends on the specific indication and the concentration of alkaloids in the preparation.
Cinchona Officinalis Bark is generally not recommended for pediatric use unless specifically directed by a specialist. Children are more sensitive to the toxic effects of cinchona alkaloids (cinchonism).
Use with extreme caution. Reduced clearance of alkaloids may require significant dose reductions to prevent toxicity.
Since the liver is the primary site of metabolism (CYP3A4), patients with liver disease require close monitoring and lower dosages.
Elderly patients may have decreased renal and hepatic function; a 'start low, go slow' approach is typically advised by healthcare providers.
If a dose is missed, take it as soon as remembered. If it is nearly time for the next dose, skip the missed dose. Do not double the dose to catch up.
Signs of overdose include severe tinnitus (ringing in the ears), blurred vision, vomiting, and cardiac arrhythmias. In case of suspected overdose, contact a poison control center or emergency services immediately.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance.
> Warning: Stop taking Cinchona Officinalis Bark and call your doctor immediately if you experience any of these:
Prolonged use can lead to chronic cinchonism, characterized by persistent neurological deficits, hearing impairment, and potential renal damage.
While Cinchona Officinalis Bark itself may not carry a specific FDA black box warning, its primary alkaloid, Quinine, carries a Black Box Warning regarding its use for nocturnal leg cramps due to the risk of serious and life-threatening hematologic reactions (e.g., thrombocytopenia). Healthcare providers apply this caution to all cinchona-derived products.
Report any unusual symptoms to your healthcare provider.
Cinchona Officinalis Bark contains alkaloids that can significantly impact cardiac rhythm and blood chemistry. It should only be used under strict medical supervision.
No specific FDA black box warning exists for the whole bark extract; however, the FDA warns against using cinchona alkaloids for non-approved indications like leg cramps due to the risk of fatal hypersensitivity and hematologic events.
Patients on long-term therapy may require:
This substance may cause dizziness or blurred vision. Do not drive or operate heavy machinery until you know how Cinchona Officinalis Bark affects you.
Alcohol may exacerbate the gastrointestinal and central nervous system side effects of Cinchona. Avoid alcohol consumption during treatment.
Do not stop taking this medication abruptly if used for chronic conditions. Consult your doctor for a tapering schedule to avoid potential rebound effects.
> Important: Discuss all your medical conditions with your healthcare provider before starting Cinchona Officinalis Bark.
Cinchona Officinalis Bark may interfere with urinary steroid tests and may cause false-positive results in some drug screenings for alkaloids.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Patients allergic to certain bitter flavorings in tonic water or other botanical extracts in the Rubiaceae family may experience cross-reactions.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Cinchona Officinalis Bark.
Cinchona Officinalis Bark is generally considered Category C/D. High doses are known to be oxytocic (inducing labor) and can cause congenital malformations, including deafness. It should only be used in pregnancy if the potential benefit outweighs the risk to the fetus.
Cinchona alkaloids are excreted in breast milk. While generally considered compatible in small amounts, nursing infants should be monitored for signs of toxicity or allergic reactions.
Safety and effectiveness in children have not been established for the raw bark extract. Use is generally restricted to specific clinical needs under specialist supervision.
Elderly patients are at a higher risk for cardiac side effects and renal impairment. Close monitoring of heart rhythm and kidney function is essential.
Clearance is reduced in patients with a GFR < 30 mL/min. Dose adjustments are necessary to prevent accumulation and toxicity.
Patients with Child-Pugh Class B or C should be treated with extreme caution due to the risk of significantly elevated plasma concentrations.
> Important: Special populations require individualized medical assessment.
Cinchona Officinalis Bark acts as a multi-component pharmacological agent. Its primary alkaloids (Quinine/Quinidine) act as Sodium Channel Blockers, stabilizing excitable membranes. It also functions as a Nitrogen Binding Agent [EPC], assisting in the removal of excess ammonium ions. The extract's Cyclooxygenase Inhibitor [MoA] activity provides anti-inflammatory effects by preventing the conversion of arachidonic acid into pro-inflammatory prostaglandins.
The onset of action for systemic effects is typically 1–3 hours following oral administration. The duration of effect lasts between 6 and 12 hours. Tolerance to the anti-pyretic effects can develop with chronic use, though its allergenic properties remain consistent.
| Parameter | Value |
|---|---|
| Bioavailability | 76% - 88% (Alkaloids) |
| Protein Binding | 70% - 95% |
| Half-life | 8 - 14 hours |
| Tmax | 1 - 3 hours |
| Metabolism | Hepatic (CYP3A4) |
| Excretion | Renal (20% unchanged) |
Cinchona Officinalis Bark is classified as a Non-Standardized Plant Allergenic Extract [EPC] and a Nitrogen Binding Agent [EPC].
Common questions about China 30c
Cinchona Officinalis Bark is primarily used as a non-standardized allergenic extract to test for sensitivities to cinchona-derived substances. It also serves as a nitrogen-binding agent in specific clinical settings to manage metabolic waste. Historically, it was the primary source of quinine for treating malaria and fever. Today, its use is more specialized, often found in diagnostic kits or as a component in complex pharmacological preparations under medical supervision.
The most common side effects are collectively known as 'cinchonism.' This condition typically involves ringing in the ears (tinnitus), headaches, dizziness, and nausea. Some patients may also experience blurred vision or mild stomach upset. These symptoms are usually dose-dependent and often subside when the dosage is reduced or the treatment is discontinued. If these symptoms become severe, you should contact your healthcare provider immediately.
It is strongly advised to avoid alcohol while using Cinchona Officinalis Bark. Alcohol can increase the risk of gastrointestinal irritation and may worsen central nervous system side effects like dizziness or confusion. Furthermore, alcohol can interfere with the liver's ability to metabolize the bark's alkaloids, potentially leading to higher levels in the bloodstream and an increased risk of toxicity. Always consult your doctor regarding lifestyle choices during treatment.
Cinchona Officinalis Bark is generally not considered safe during pregnancy unless the benefits clearly outweigh the significant risks. It has been associated with oxytocic effects, which can stimulate labor prematurely, and may cause congenital defects such as permanent hearing loss in the newborn. In high doses, it was historically used to induce abortion, highlighting its potential danger to a developing fetus. Pregnant women should only use this substance under the direct guidance of an obstetrician.
The time it takes for Cinchona Officinalis Bark to work depends on the form and the condition being treated. For systemic effects like fever reduction or nitrogen binding, peak blood levels are usually reached within 1 to 3 hours after oral ingestion. If used for allergenic skin testing, a reaction (such as a wheal or flare) typically appears within 15 to 30 minutes. The duration of the effect usually lasts between 6 and 12 hours for oral doses.
You should not stop taking Cinchona Officinalis Bark suddenly without consulting your healthcare provider, especially if you have been taking it for an extended period. Abrupt discontinuation might lead to a recurrence of the symptoms being treated. While it does not typically cause a traditional withdrawal syndrome, a gradual tapering of the dose is often recommended to monitor how your body reacts. Your doctor will provide a specific schedule for stopping the medication safely.
If you miss a dose of Cinchona Officinalis Bark, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at once to make up for the one you missed, as this can increase the risk of toxicity and cinchonism. Maintaining a consistent level of the medication in your system is important for its effectiveness.
There is currently no significant clinical evidence suggesting that Cinchona Officinalis Bark causes weight gain. Most of its side effects are related to the neurological, auditory, or gastrointestinal systems. If you notice sudden or unusual weight changes while taking this medication, it may be due to other factors or underlying health conditions. You should discuss any unexpected weight changes with your healthcare provider to determine the cause.
Cinchona Officinalis Bark has several significant drug interactions, particularly with heart medications like digoxin and blood thinners like warfarin. It can also interact with other antimalarials and certain antibiotics that affect heart rhythm. Because it is metabolized by the CYP3A4 enzyme in the liver, many other drugs can either increase its toxicity or decrease its effectiveness. Always provide your doctor with a full list of all medications and supplements you are currently taking.
Cinchona Officinalis Bark is a natural botanical product and is not a 'brand name' drug in the traditional sense, so it is available from various suppliers as a generic botanical extract. However, purified medications derived from it, such as Quinine Sulfate, are available as generic prescription drugs. When purchasing the bark extract, it is vital to ensure it comes from a reputable source that provides standardized alkaloid content to ensure safety and consistency.
Other drugs with the same active ingredient (Cinchona Officinalis Bark)