Quinine Phenprocoumon

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Isolated reports describe increased anticoagulant effects in two women taking warfarin and a man taking phenprocoumon, which were attributed to the quinine content of tonic water. Limited evidence suggests that quinine does not alter the half-life of phenprocoumon. 

In the preliminary report of a study in 5 healthy subjects, quinine 100 mg daily started 7 days after a single 12-mg dose of phenprocoumon did not ehange the elimination half-life of phenprocoumon in the following 7 days. ... 

However, a patient on long-term phenprocoumon treatment repeatedly developed extensive haematuria within 24 hours of drinking 1 litre of Indian tonie water eontaining 30 mg of quinine. ... 

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