Headache calcium antagonists

The side effects or toxic effects that the calcium antagonists have in common are hypotension, facial flushing, headache, di22iness, weakness, sedation, skin rash, edema, constipation, and abdominal discomfort (nausea, vomiting, and epigastric pressure). 

Headache is one of the most frequent complaints which mankind suffers from. Most commonly the headache starts from one of the pain sensitive structures of the skull, but diseases originating outside the skull are also important causes of headache. Diseases of the eye, sinuses, jaw, teeth and neck often cause headache, but also visceral tissue may give rise to headache. The headache may be secondary to many diseases, e.g. anaemia and hypertension. Drug induced headache is not uncommon, either as an adverse reaction, e.g. to calcium antagonists and SSRIs, or as part of more complex problems in chronic headache. 

Peroutko, S. J., Banghart, S. B., Allen, G. S. Relative potency and selectivity of calcium antagonists used in the treatment of migraine, Headache 1984, 24, 55-58. 

Barnidipine is a dihydropyridine with antihypertensive activity and tolerability similar to that of other calcium antagonists of the same class. The most frequent adverse events are edema, headache, and flushing, but barnidipine does not cause reflex tachycardia (1). 

In patients with BPH, the most common adverse effects for ai-adrenergic antagonists are related to vasodilation, including dizziness, orthostatic hypotension, headache, and tachycardia, which occurred during the first 2 weeks of treatment (46). Therefore, a dose titration usually is required, especially in patients older than 60 years. These cardiovascular side effects are attributed to a nonselective blockade of ai-adrenoceptors present in vascular smooth muscle in addition to the required blockade of ai-adrenoceptors in prostate. No first-dose effect and fewer vasodilatory adverse events have been reported with the sustained-release formulations, which occur more frequently with the immediate-release formulation At higher doses, orthostatic hypotension occurs more frequently. The first-dose phenomenon of orthostatic hypotension and syncope has been reported occasionally in elderly patients and in those concurrently receiving calcium antagonists, diuretics, and p-blockers. 

Monitoring for major adverse effects should be undertaken they include headache and dizziness with nitrates fatigue and lassitude with /J-blockers and peripheral edema, constipation, and dizziness with calcium channel antagonists. 

Methysergide, a 5-HT c antagonist, has been used for the prophylactic treatment of migraine and other vascular headache, including Horton s syndrome. Calcium-entry blockers such as flunarizine have been shown to be effective in treating migraine. 

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