Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Dec;398(12):16401-16414.
doi: 10.1007/s00210-025-04422-2. Epub 2025 Jun 28.

Efficacy and safety of calcium channel blockers in migraine management; a systematic review

Hamed Ghiami  1 , Mohammadsalman Parsapour  1 , Sahba Khalilzadeh  1 , Hanieh Rahmani  1 , Navid Omidkhoda  2 , Omid Arasteh  3
Affiliations

Efficacy and safety of calcium channel blockers in migraine management; a systematic review

Hamed Ghiami et al. Naunyn Schmiedebergs Arch Pharmacol. 2025 Dec.

Abstract

Purpose: Numerous innovative treatment approaches have been developed to treat migraine, one of the most upsetting disorders. However, the optimal strategy for managing migraines remains unclear. The calcium channel blockers have demonstrated some positive effects on migraine attacks. In this systematic review, we tried to gather data on the efficacy and safety of these drugs to reach a more precise conclusion.

Method: The databases of PubMed, Scopus and Web of Science were searched systematically up to 1 August 2024. The risk of bias was assessed for clinical trials through the Cochrane Collaboration's tool.

Results: Out of 1903 studies, we included 40 clinical trials. Among 27 studies on flunarizine (FLU), most of them showed significantly superior effects in comparison with placebo or other agents. Sedation and weight gain were the most prevalent side effects experienced by FLU. Although three studies demonstrated positive effects of nimodipine (NIM) in migraine management, the seven remaining studies revealed controversial results. Three and one articles evaluating the efficacy and safety of nifedipine (NIF) and verapamil (VER) to other drugs, respectively, reported no special effects.

Conclusion: According to reviewed research, FLU appears to have the greatest impact on migraine episodes, whereas NIM outperforms B blockers in terms of migraine prevention. Further study is necessary to get more precise data on NIF and VER.

Keywords: CCBs; Calcium Channel Blockers; Flunarizine; Migraine; Nimodipine.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical approval: Not applicable. Competing interests: The authors declare no competing interests. Human Ethics and Consent to Participate declarations: Not applicable. Clinical trial number: Not applicable.

References

    1. Ailani J, Burch RC, Robbins MS (2021) The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache 61(7):1021–1039. https://doi.org/10.1111/head.14153 - DOI - PubMed
    1. al Deeb, S. M., Biary, N., Bahou, Y., al Jaberi, M., & Khoja, W. (1992). Flunarizine in migraine: a double-blind placebo-controlled study (in a Saudi population). Headache, 32(9):461–462. https://doi.org/10.1111/j.1526-4610.1992.hed3209461.x
    1. Albers GW, Simon LT, Hamik A, Peroutka SJ (1989) Nifedipine versus propranolol for the initial prophylaxis of migraine. Headache 29(4):215–218. https://doi.org/10.1111/j.1526-4610.1989.hed22904215.x - DOI - PubMed
    1. Ambrosio C, Stefanini E (1991) Interaction of flunarizine with dopamine D2 and D1 receptors. Eur J Pharmacol 197(2–3):221–223. https://doi.org/10.1016/0014-2999(91)90526-v - DOI - PubMed
    1. Amery WK (1983) Flunarizine, a calcium channel blocker: a new prophylactic drug in migraine. Headache 23(2):70–74. https://doi.org/10.1111/j.1526-4610.1983.hed2302070.x - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources