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Randomized-controlled trial of methocarbamol as a novel treatment for muscle cramps in cirrhotic patients

Abd-Elsalam, Sheriefa; Arafa, Monaa; Elkadeem, Mahmouda; Elfert, Asema; Soliman, Shaimaab; Elkhalawany, Walaaa; Badawi, Rehaba

European Journal of Gastroenterology & Hepatology: April 2019 - Volume 31 - Issue 4 - p 499–502
doi: 10.1097/MEG.0000000000001310
Original Articles: Hepatology

Background Muscle cramps occur in 29–88% of patients with liver cirrhosis. They adversely affect quality of life. This study aimed to evaluate the efficacy and safety of methocarbamol as a novel therapy in controlling muscle cramps in cirrhotic patients.

Patients and methods This study was carried on 100 patients with liver cirrhosis in addition to chronic hepatitis C who presented with frequent muscle cramps (≥three cramps per week). Half of these patients received methocarbamol and the other half received placebo. This was done through equal randomization. Questionnaires on muscle cramp were answered. Patients were evaluated before, after 1 month of treatment, and 2 weeks after washout of treatment in terms of severity, duration, and frequency of cramps. Liver, renal functions, and electrolytes were analyzed. Also, any side effect was detected.

Results Patients who were treated with methocarbamol showed a significant decrease in the frequency and duration of cramps. Also, the pain score improved significantly. However, no significant changes were observed in the placebo group. Few side effects of methocarbamol were recorded, including dry mouth and drowsiness.

Conclusion Methocarbamol seems to be a promising safe and well-tolerated medication, and plays a role in the treatment of muscle cramps in patients with liver cirrhosis.

aDepartment of Tropical Medicine, Tanta University, Tanta

bDepartment of Public Health and Community Medicine, Menofia University, Shebeen El-Kom, Egypt

Correspondence to Sherief Abd-Elsalam, MD, PhD, Tropical Medicine Department, Tanta University, Tanta 35127, Egypt Tel: +20 109 515 9522; e-mail:

Received August 24, 2018

Accepted October 20, 2018

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