To prevent drug-induced headache (medication-induced headache), attention must be paid to reducing individual risk factors. Behavioral risk factors
- Drug use
- Heroin
- Overweight (BMI ≥ 25, obesity).
Medication
- Acetylcholinesterase inhibitors (donezepil, galantamine, rivastigmine).
- Alpha-adrenoreceptor antagonists or alpha-blockers (alfuzosin, tamsulosin).
- Analgesics [analgesic-induced MOH is preceded by an average duration of use of 4.8 years]
- Non-opioid analgesics (flupirtine).
- Nonacid analgesics (NSAIDs) (acetylsalicylic acid (ASA), coxibe, diclofenac, ibuprofen, indometacin, meloxicam, naproxen, acetaminophen/paracetamol)
- Opioids (alfentanil, buprenorphine, dextropoxyphene, diamorphine (heroin) fentanyl, hydromorphone, levomethadone, meptazinol, morphine, nalbuphine, oxycodone, pentazocine, pethidine, piritramide, remifentanil, sufentanil, tilidine, tramadol).
- Other analgesics
- Antiarrhythmics
- Adenosine, Ia antiarrhythmics (ajmaline).
- Ic antiarrhythmics (flecainide, propafenone).
- Class II antiarrhythmics (esmolol, metoprolol).
- Class IV antiarrhythmic drugs (diltiazem, verapamil).
- Anthelmintics (albendazole, diethylcarbamazine).
- Antibiotics
- Aminoglycoside antibiotic (paromomycin).
- Quinolones (ciprofloxacin)
- Derivative of rifamycin (rifaximin).
- Epoxide antibiotics (fosfomycin trometamol).
- Macrolides (azithromycin, clarithromycin, erythromycin).
- Nitroimidazoles (metronidazole).
- Oxazolidinones (linezolid)
- Rifampicin
- Sulfone (dapsone)
- Anticholinergics (ipratropium bromide).
- Antidepressants
- Serotonin antagonists (dolasetron, granisetron, ondansetron, tropisetron).
- Selective dopamine and norepinephrine reuptake inhibitor (NDRI) – bupropion.
- Selective serotonin reuptake inhibitors (SSRI = Selective Serotonin Reuptake Inhibitor) – citalopram, dapoxetine, escitalopram, fluvoxamine, paroxetine, sertraline.
- Antiepileptic drugs
- Carboxamide derivatives (eslicarbazepine acetate).
- Functionalized amino acids (lacosamide).
- Classical antiepileptic drugs (gabapentin, topiramate).
- Antihistamines (cetirizine, clemastine, dimetindene, ketotifen).
- Antimalarials (artemether, atovaquone, quinine, chloroquine, dihydroartemisinin, lumefantrine, primaquine, proguanil).
- Antimony preparations (pentavalent antimony).
- Antifungals, systemic
- Azoles (griseofulvin)
- Triazole derivatives (ketoconazole)
- Antipsychotics (neuroleptics) – melperone, risperidone.
- Antirheumatic drugs, non-steroidal – acetylsalicylic acid (ASA), diclofenac, ibuprofen.
- Antisympathotonic (clonidine, urapidil).
- Antitussive
- Non-opioid antitussives (levodropropizine, noscapine, pentoxyverine).
- Antivertiginosa (betahistine).
- Anxiolytics (hydroxyzine)
- Α2-agonists (apraclonidine, brimonidine, clonidine).
- Barbiturates (pentobarbital, phenobarbital, primidone, thiopental).
- Benzodiazepine-like substances (buspirone).
- Beta-blockers
- Nonselective beta-blockers (e.g., carvedilol, pindolol, propranolol, soltalol).
- Selective beta blockers (e.g., atenolol, acebutolol, betaxolol, bisoprolol, celiprolol, nebivolol, metoprolol).
- Beta-blockers, eye drops – betaxolol, timolol.
- Betamimetics (synonyms: β2-sympathomimetics, also β2-adrenoceptor agonists) – fenoterol, formoterol, hexoprenaline, indaceterol, olodaterol, ritodrine, salbutamol, salmeterol, terbutaline.
- Biologicals (secukinumab).
- Calcium antagonists (amlodipine, diltiazem, felodipine, fendiline, gallopamil, lacidipine, lercanidipine, nitrendipine, nifedipine, nimodipine, nicardipine, isradipine, nisoldipine, nilvadipine, manidipine, verapamil)
- Calcium channel blockers
- Benzothiazepines (diltiazem)
- Dihydropyridines (amlodipine, felodipine, isradipine, lercandipine, nicardipine, nilvadipine, nisoldipine, nitrendipine)
- Phenylalkylamine (verapamil)
- Calcium sensitizer (levosimendan).
- Chelating agents (deferoxamine, deferasirox, deferiprone).
- Chloride channel activator (lubiprostone).
- Cholinergics (carbachol, physostigmine, pilocarpine).
- Direct factor Xa inhibitor – rivaroxaban.
- Dipeptidyl peptidase 4 inhibitors (DPP-4 inhibitors; gliptins) – saxagliptin, sitagliptin, vildagliptin
- Dopamine agonists (cabergoline, bromocriptine).
- Endothelin receptor antagonists (endothelin receptor antagonists) – ambrisentan, bosentan.
- Ergotamine (ergot alkaloids).
- Glutamate modulator (acamprosate)
- Cardiac glycosides (digoxin, digitoxin, ß-acetyldigoxin, ß-methyldigoxin).
- Hormones
- ADH analogues – desmopressin
- Anti-androgens (cyproterone acetate, flutamide).
- Aromatase inhibitors (anastrozole, testolactone).
- Progestins (dyhrogesterone)
- Gonadotropins (FSH. LH)
- GNRH analogues (buserelin, buderelin acetate, goserelin, goserelin acetate, leuprorelin, leuporelin acetate, nafarelin acetate, triptorelin, triptorelin acetate).
- GnRH antagonists (abarelix, cetrorelix, degarelix).
- Contraceptives (estrogen-progestin combination).
- LHRH agonists (goserelin)
- LHRH analogues
- Estrogens
- Parathyroid hormone analogue (teriparatide)
- Progesterone receptor antagonist (mifepristone).
- Prolactin inhibitors (bromocriptine, cabergoline, lisuride, metergoline, quinagolide).
- Prostaglandin analogues (alprostadil/prostaglandin E).
- Prostanoids (prostacyclins) – epoprostenol, iloprost, treprostinil.
- Somatotropic hormone (STH) – growth hormones (somatotropin; growth hormone (GH)).
- Immunosuppressants (azathioprine, ciclosporin (cyclosporin A), methotrexate (MTX))
- Immunotherapeutics (fingolimod, mitoxantrone, natalizumab).
- Intestinal anti-inflammatory (sulfasalcin).
- Local carbonic anhydrase inhibitors (brinzolamide, dorzolamide).
- Lipid-lowering agents
- Cholesterol absorption inhibitor – ezetimibe
- HMG-CoA reductase inhibitors (statins) – atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin
- MAO inhibitors (tranylcypromine).
- Monoclonal antibodies – pertuzumab, trastuzumab.
- MTOR inhibitors (everolimus, temsirolimus).
- Multi-tyrosine kinase inhibitor (vandetanib).
- Mucolytics (acetylcysteine (ACC), N-acetylcysteine (NAC); N-acetyl-L-cysteine).
- Muscle relaxants (baclofen, tizanidine).
- Ergot alkaloids (ergotamines)
- Neurokinin antagonists (aprepitant, fosaprepitant).
- Nicotinic antagonist (varenicline).
- N-methyl-D-aspartate recptor antagonist (Memantine).
- Nitrates (glycerol nitrate, glycerol trinitrate, isosorbide dinitrate (ISDN), isosorbide 5-mononitrate, molsidomine, nitroglycerin, nitroprusside sodium).
- Opioid antagonists (loperamide, nalmefene, naltrexone).
- Parasympathomimetics
- Indirect parasympathomimetics (cholinesterase inhibitors): alkylphosphates, distigmine, donepezil, galantamine, neostigmine, physostigmine, pyridostigmine, rivastigmine, tacrine
- Phosphodiesterase-4 inhibitor/PDE4 inhibitor (apremilast).
- Phosphodiesterase-5 inhibitors/PDE5 inhibitors (sildenafil, tadalafil, vardenafil).
- Proton pump inhibitors (proton pump inhibitors, PPI) – esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole.
- Psychotropic substances such as modafinil.
- Retinoids (acitretin, alitretinoin)
- Rheologics (pentoxifylline)
- Selective α1-adrenoceptor antagonists (selective alpha-1-adrenoceptor antagonists; α1-blockers) – alfuzosin, doxazosin, tamsulosin, terazosin.
- Sinus node inhibitor (ivabradine).
- Spasmolytics (tolterodine, trospium chloride).
- Stronitum salt (strontium ranelate).
- Sympathomimetics
- Tranquilizers
- Triptans (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan) [triptan-related MOH is preceded by an average duration of use of 1.7 years].
- Tyrosine kinase inhibitors (vandetanib).
- Uricosurics (benzbromarone, probenecid).
- Vasoactive substances – alprostadil (prostaglandin E), dihydralazine, vasopressin, diazoxide.
- Antivirals
- Nucleos(t)idic polymerase (NS5B) inhibitors (sofosbuvir).
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs) – didanosine, efavirenz, nevirapine, rilpivirine.
- NS5A inhibitors (daclatasvir, ledipasvir,
- Nucleoside analogs (abacavir, aciclovir, brivudine, famciclovir, foscarnet, ganciclovir, ribavirin, telbivudine, valaciclovir
- Nucleotide analogues (adefovir, tenofovir).
- Nucleoside reverse transcriptase inhibitors (NRTI) – entecavir, lamivudine, stavudine, zidovudine.
- Protease inhibitors (PI; protease inhibitors) – atazanavir, fosamprenavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir.
- Bismuth (bismuth nitrate, bismuth subcitrate, bismuth subsalicylate).
- Cytokines (glatiramer acetate, interferon ß-1a, interferon ß-1b).
- Cytoreductive drugs (anagrelide).
- Cytostatic drugs (methotrexate (MTX))
Primary prevention
- Educate patients about the relationship between pain medications and pain medication overuse headache.
- Patients at risk for drug-induced headache should be seen by their general practitioner or neurologist at regular intervals (every 3-6 months).
