A Guide to Headache Management
Dipyridamole (DP), as formulated in Aggrenox®/Asasantin®, may induce headache in a significant number of patients who are prescribed the medication. Dipyridamole-induced headache is generally short-lived during continued treatment, approximately 3-5 days, and there is good evidence that it wanes in severity and frequency and disappears in the majority of patients over that time. The headache is thought to be due to cerebral vasodilatation induced by the drug and may be akin to the headache reported with nitrates used in patients with angina. Patients who have had a prior stroke, when starting treatment containing dipyridamole may be alarmed by the headache and therefore complain to the doctor. Examples of inappropriate advice, such as "leave it off for a day or two and then try again" have ended up with the patient declining to take the medication. The headache induced by initial treatment with dipyridamole is harmless and generally disappears within 3-5 days. It is important that patients understand this and persevere with their medication in order to prevent recurrent stroke. This guideline suggests what can be done to assist patient compliance.
Headache Management Advise
The most obvious conclusion is that dipyridamole-induced headache is something that the patient needs to be prepared for by the prescriber and it is therefore recommended that the policy of information be routinely adopted. At the moment in the Patient Information Leaflet (PIL) headache is simply one of a list of events that the patients may have happen to them, rather than something which would be not unexpected. More constructive advice could be given to both doctor and patient by the Company so that the prescriber informs the patient directly and by means of the PIL.
Headache Studies
