Pilot study of orphenadrine as a novel treatment for muscle cramps in patients with liver cirrhosis

Background and aims: Muscle cramps markedly affect the quality of life in cirrhotic patients with no available highly effective treatment. The aim of this study was to assess the safety and efficacy of orphenadrine in the treatment of muscle cramps in cirrhotic patients. Methods: The study enrolled 30 liver cirrhosis patients complaining of frequent muscle cramps (>= 3 per week), who were randomized to receive either orphenadrine 100 mg or calcium carbonate 500 mg twice daily as a control for one month. Severity, frequency, and duration of the muscle cramps were assessed before and after treatment as well as recurrence after washout of the drug for two weeks. Side effects were recorded. Results: One month after treatment with orphenadrine; the frequency of muscle cramps decreased significantly to 0.60.74 per week compared to 12.53 +/- 6.01 at baseline (p < 0.001), the duration of muscle cramps decreased from 1 min to 0.1 min after treatment (p < 0.001). The pain score improved significantly from a score of 8/10 to 0/10 (p < 0.001). The side effects were few, such as dry mouth, drowsiness, and nausea, with no significant difference between their occurrences in the two groups. Conclusion: Orphenadrine is safe and effective in treatment of muscle cramps in patients with liver cirrhosis.