What is the recommended dose of Nifedipine (a calcium channel blocker) for Cluster headaches?

From the Guidelines

Nifedipine is not recommended for Masonic headaches, and its use should be cautious due to potential side effects such as hypotension, dizziness, and edema 1.

Nifedipine Dosing and Indications

The usual dose of nifedipine for its approved indications, such as hypertension and angina, is between 30 to 90 mg daily orally for immediate release, and 30 to 180 mg orally for slow release 1.

Considerations for Use

However, for conditions like Masonic headaches, which are not a standard medical term and may refer to a specific type of headache, the first-line treatments typically include triptans, NSAIDs, or combination analgesics for acute management, and beta-blockers, certain antiepileptics, or CGRP antagonists for prevention 1.

Alternative Calcium Channel Blockers

If a calcium channel blocker is considered for headache prevention, verapamil (120-360mg daily) might be more appropriate than nifedipine due to its different side effect profile and potential benefits in certain types of headaches 1.

Importance of Medical Consultation

Patients experiencing headaches should consult with a healthcare provider for proper diagnosis and individualized treatment, as headache management often requires a tailored approach based on symptom severity, frequency, and individual response to medications 1.

From the Research

Nifedipine Dose for Masonic Headaches

There are no research papers to assist in answering this question, as the provided studies do not mention "Masonic headaches" or the use of "Nifedipine" for this condition.

Available Information on Cluster Headaches

• The most effective pharmacological treatment options for acute cluster attack include subcutaneous sumatriptan, 100% oxygen, and intranasal zolmitriptan 2.
• Prophylactic therapy is important both for episodic and chronic cluster headache, and the main options are verapamil and lithium 2, 3, 4.
• Verapamil is used mainly in cardiovascular diseases, but high-dose verapamil (360-720 mg) is currently the mainstay in the prophylactic treatment of cluster headache 5.
• The dose of verapamil used for cluster headache is approximately double the dose used in cardiovascular disease, most likely because verapamil is a substrate for the efflux transporter P-glycoprotein in the blood-brain barrier 5.

Verapamil Dosage

• Published papers usually state 240 to 480 mg taken in three divided doses give good results, ranging from 50% to 80% 6.
• Some patients may require higher doses, up to 720 or 1200 mg per day 6.
• The majority of patients needed 200 to 480 mg, but some needed 520 to 960 mg for control 6.