Iatrogenic headaches: giving everyone a sore head

An exploratory study evaluating the 30 medications most commonly associated with headaches in the FDA Adverse Event Reporting System

OBJECTIVE

This project seeks to identify the top 30 drugs most commonly associated with headaches in the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS), as well as their respective reporting odds ratios (RORs).

BACKGROUND

Headache secondary to medication use is a well-known entity. However, which medications are most likely to cause headaches on a global scale is unknown.

METHODS

We extracted case identifiers, adverse events, and attributed medications for entries in the FAERS database from July 1, 2018, to March 31, 2020. Entries were split into two datasets based on whether or they contained the word "headache(s)." Non-medication words were then excluded. The medications most commonly associated with headaches were then identified.

RESULTS

We extracted 2,673,081 entries, of which 86,086 contain the word "headache(s)." The 30 most frequently appearing medications were then ranked by ROR values with associated 95% confidence intervals. The three medications with the greatest association with headaches were selexipag (ROR 16.7, 95% CI 15.8-17.7), epoprostenol (ROR 11.7, 95% CI 10.8-12.7), and glecaprevir (ROR 8.7, 95% CI 8.3-9.2). Immunosuppressants, antivirals, as well as pulmonary hypertension medication classes were most commonly associated with headache.

CONCLUSION

Our study offers a potential list of the medication classes commonly associated with iatrogenic headaches.