Background. Several calcium channel blockers have been evaluated in controlled clinical studies and some holdconsiderable promise for future. Efficacy in migraine prophylaxis has been claimed for drugs belonging to all threeclasses of calcium channel blockers (nifedipine-like, verapamil-like, and flunarizine-like), but the extent and quality of theevidence varies, and a comparison of efficacy between different calcium channel blockers has not been reported.Objective.The objective of the study is to assess the comparison of efficacy and safety of flunarizine and nifedipinein migraine prophylaxis.Patients and methods.The study was conducted in a prospective, double-blind, randomized controlled trial, parallelgroup design. 78 patients were studied for a 1-month period during which all patients received placebo followed by a3-month experimental period. Headache response to medication was measured monthly by compilation ofmigraine-scores derived from quantitative data recorded by patients in a daily diary.1 Student's t-test was used tocompare results from the flunarizine (10 mg) and nifedipine (20 mg) group for each month.Results.Both groups showed a significant reduction in the migraine-scores after 3-months. No significantdifferences were detected between groups, but there was a clinical significantly different reduction of migraine-scoresbetween the groups in the first month after the run-in period (58% vs 38%). It shows that the beneficial effect offlunarizine was more rapidly manifest than that of flunarizine. Tachycardia more frequently occurred in the nifedipinegroup than in the flunarizine treatment group.Conclusion.It concluded that flunarizine is a potentially more useful agent in the prophylaxis of migraine headache.