Can intranasal corticosteroids cause migraine-like headache?
J Pokladnikova
Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University in Prague, Hradec Kralove, The Czech Republic,
Search for more papers by this authorRHB Meyboom
WHO Collaborating Centre for International Drug Monitoring, Uppsala Monitoring Centre, Uppsala, Sweden, and
Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht University, Utrecht, the Netherlands
Search for more papers by this authorJ Vlcek
Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University in Prague, Hradec Kralove, The Czech Republic,
Search for more papers by this authorRI Edwards
WHO Collaborating Centre for International Drug Monitoring, Uppsala Monitoring Centre, Uppsala, Sweden, and
Search for more papers by this authorJ Pokladnikova
Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University in Prague, Hradec Kralove, The Czech Republic,
Search for more papers by this authorRHB Meyboom
WHO Collaborating Centre for International Drug Monitoring, Uppsala Monitoring Centre, Uppsala, Sweden, and
Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht University, Utrecht, the Netherlands
Search for more papers by this authorJ Vlcek
Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University in Prague, Hradec Kralove, The Czech Republic,
Search for more papers by this authorRI Edwards
WHO Collaborating Centre for International Drug Monitoring, Uppsala Monitoring Centre, Uppsala, Sweden, and
Search for more papers by this authorAbstract
Intranasal corticosteroids (INCs) act predominantly locally and are considered to exert minimal systemic effects. On reviewing the international data collected in the World Health Organization's global pharmacovigilance programme an unexpected cluster was found of 38 case reports of migraine in suspected connection with INCs. These reports came from five countries (May 2007) and concerned six different drugs. In all reports the INC was the sole suspect drug. In nine cases re-exposure to the drug had taken place, leading to the recurrence of the event in eight of these patients. However, INCs are mainly used for rhinitis, and there is a known connection between rhinitis and migraine. Although representing only 0.6% of the total of case reports, international pharmacovigilance data suggest that the use of INCs may cause or trigger migraine or migraine-like headache. Further study is needed to determine if the reported association is true or not and, if so, what the possible mechanism is.
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