Medication Headaches
Many drugs can induce acute headache, including nitroglycerin,
antihypertensive agents (beta blockers, calcium channel blockers,
angiotensin-converting enzyme ACE inhibitors, and methyldopa), dipyridamole,
hydralazine, sildenafil, histamine receptor antagonists (e.g., cimetidine and
ranitidine), NSAIDs (especially indomethacin), cyclosporine, and antibiotics
(especially amphotericin, griseofulvin, tetracycline, and sulfonamides).
Drug-induced aseptic meningitis, a rare occurrence, has numerous possible
causes, including NSAIDs, antibiotics (e.g., trimethoprim-sulfamethoxazole,
sulfasalazine, cephalosporins, , isoniazid, and penicillin),
intrathecal drugs and diagnostics (e.g., antineoplastic agents such as
methotrexate and cytarabine; gentamicin; corticosteroids; spinal anesthesia;
baclofen; repeated iophendylate for myelography; and radiolabeled albumin);
chemotherapy; intravenous immunoglobulin; vaccines (polio;
measles, mumps, and rubella; and hepatitis B); and some other drugs, such as
, muromonab-CD3, and ranitidine.43
The clinical presentation of drug-induced aseptic meningitis is the same as
that of viral meningitis. Cerebrospinal fluid findings are the same as those in
viral meningitis, except for a neutrophil predominance; however, in cases
induced by intravenous immunoglobulin, eosinophils are present.