Nifedipine is not feasible for biliary pain in patients with gallbladder stones

Objective: Biliary pain is generally treated with NSAIDs and spasmolytics, but some patients do not tolerate them. Nifedipine has been suggested to ha ve some analgesic effect and it has been used succesfully in many painful s mooth muscle disorders. Our aim was to evaluate the effect of nifedipine fo r biliary colics and gallbladder volume. Patients and methods: Twenty-seven patients suffering from uncomplicated symptomatic gallbladder stones were prospectively randomized to receive either oral nifedipine (10 mg 3 times d aily) or placebo in a double-blind manner. Liver chemistry and ultrasonogra phy were examined before and after the 8-week study period. The patients co mpleted each day a diary of their pain, headache, palpitation, burning feel ing in skin, dizziness, and their use of painkillers. Results: Biliary pain seemed to be less intensive and shorter in duration, but without statistic al significance, whereas headache tended to be more common (p = 0.077) in n ifedipine group than that in placebo group. This difference would have reac hed statistical significance with over 155 patients randomized. Overall add itional drug use was similar in both groups, and was increased in nifedipin e group for headache (p = 0.05). The fasting gallbladder volume tended to d ecrease (p = 0.085) during the nifedipine treatment but not with placebo. S erum liver chemistry remained within normal range. Conclusions: This small study shows that nifedipine may decrease slightly biliary pain intensity an d duration, and contrary to previous findings in healthy volunteers, it see ms to decrease resting gallbladder volume in patients with symptomatic unco mplicated gallbladder stones, but did not reduce the need of traditional pa in medication partly because of increased need for headache. Thus it is not a feasible choice for routine use against biliary pain in symptomatic gall bladder stones, which is why the study was not continued to reach statistic al significance in respect to biliary pain.