What are the other Names for this Condition? (Also known as/Synonyms)

• PDE Inhibitor-Induced Headache

What is Phosphodiesterase Inhibitor-Induced Headache? (Definition/Background Information)

• Phosphodiesterase (PDE) Inhibitor-Induced Headache is described as a form of headache that occurs secondary to the use of phosphodiesterase inhibitor medications. The onset of the headache is typically within 5 hours of medication intake, and a spontaneous resolution is noted within 3 days
• Phosphodiesterase inhibitors are a group of medications that are used in treating a wide variety of diseases and conditions, including erectile dysfunction, pulmonary hypertension, rheumatoid arthritis, and heart attack, among others
• Some of the PDE inhibitor drugs include sildenafil, tadalafil, roflumilast, milrinone, theophylline, and aminophylline. In most individuals (who do not have a history of migraine), these drugs cause headaches that are similar to tension-type headaches
• PDE Inhibitor-Induced Headaches may be mild-to-moderate in intensity, involve both sides of the head, and present a pulsating quality. In some individuals, physical activity or exercise may worsen the condition

The criteria for diagnosis of Phosphodiesterase (PDE) Inhibitor-Induced Headache as outlined by the International Headache Society (IHS) is given below:

• A phosphodiesterase (PDE) inhibitor has been taken
• Headache fulfilling all the criterion below

Evidence of causation demonstrated by all of the following:

• Headache has developed within 5 hours of intake of the PDE inhibitor
• Headache has resolved within 72 hours of onset
• Headache has at least one of the following four characteristics:
  • Bilateral
  • Mild to moderate intensity
  • Pulsating quality
  • Aggravated by physical activity
• Not better accounted for by another ICHD-3 diagnosis

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)