Throbbing headache associated with enoxaparin administration: a case report, a review of pharmacovigilance databases for similar cases and possible mechanisms

J Clin Pharm Ther. 2015 Jun;40(3):342-4. doi: 10.1111/jcpt.12257. Epub 2015 Mar 2.

Abstract

What is known and objectives: To date, no case of headache has been reported with enoxaparin. We present the case of a 60-years-old man, who developed enoxaparin-induced throbbing headache and discuss the possible pharmacological mechanisms. We provide an analysis of enoxaparin-induced headache in three international databases.

Case summary: A few hours after the subcutaneous administration of this drug at therapeutic dose, the patient experienced throbbing headache. Rechallenge on two other separate occasions separated by several days produced the same effect although with reduced intensity when the dose was lowered. The Naranjo Algorithm indicated a 'certain' relationship.

What is new and conclusion: We report a case of throbbing headache associated with the use of enoxaparin; with the increasing use of enoxaparin, physicians who prescribe this drug should be aware of this potential ADR. We suggest that it is a heparin class-effect, and therefore, a more general caution is also appropriate.

Keywords: adverse drug reaction; enoxaparin; headache; pharmacovigilance.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Databases, Factual
  • Dose-Response Relationship, Drug
  • Enoxaparin / administration & dosage
  • Enoxaparin / adverse effects*
  • Headache / chemically induced*
  • Humans
  • Male
  • Middle Aged
  • Pharmacovigilance

Substances

  • Anticoagulants
  • Enoxaparin