The Aword

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Nifedipine is a calcium channel blocker usually used to relieve angina pain and to reduce mild to moderate hypertension (raised blood pressure).

However, it has also been found to be helpful in neuropathic pain such as that in CRPS (Complex Regional Pain Syndrome, also known as RSD Reflex Sympathetic Dystrophy).

Periera et al ([i]) found that sublingual nifedipine enhanced analgesia from epidural morphine used post-operatively.

Ohta et al ([ii]) reported that a case of RSD responded favourably to sublingual nifedipine. A testing dose of 10mg gave relief of pain in 10 minutes, lasting 6 hours.

Regular dose of 30-60mg daily was successful in reducing symptoms, which had markedly improved within 4 weeks.

At 3 months, there was complete resolution of pain and although it has recurred from time to time, nifedipine has successfully reduced it again each time.

Prough et al ([iii]) also described this use of nifedipine. It has also been used to reduce symptoms in Raynaud's syndrome.([iv])

[i] Pereira IT, Prado WA, Dos Reis MP  Pain 1993 Jun;53(3):341-5 Enhancement of the epidural morphine-induced analgesia by systemic nifedipine.


[ii] Ohta S, Tanahashi T, Iida H, Asano T, Ueda N, Tani T, Suzuki A, Uematsu H, Yamamoto M

Masui 1989 May;38(5):679-83[A case report of reflex sympathetic dystrophy treated with nifedipine].


[iii] Prough DS, McLeskey CH, Borshy GG et al Anesthesiology 1985;62:796-799 Efficacy of oral nifedipine in the treatment of reflex sympathetic dystrophy.

[iv] Landry GJ, Edwards JM, Porter JM Adv Surg 1996;30:333-47 Current management of Raynaud's syndrome.