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Abstract
The combination of aspirin and dipyridamole is more effective in secondary stroke prevention than aspirin monotherapy. Headache is a frequent early adverse event in patients treated with dipyridamole. In the European Stroke Prevention Study 2, 8% of patients terminated treatment with dipyridamole due to headache compared with 2.1% with placebo. Dipyridamole induces headache more frequently in persons suffering from migraine than those without a primary headache. One way to reduce headache burden is to titrate dipyridamole slowly. Acetaminophen, however, is not effective in treating dipyridamole-induced headache. The optimal strategy to avoid early treatment termination and increase compliance is patient information about the occurrence and limited duration of headache and dose titration.
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Conflicts of interest
HC Diener has received honoraria for participation in clinical trials, contribution to advisory boards or oral presentations from Abbott, AstraZeneca, Bayer Vital, Böehringer Ingelheim, D-Pharm, Fresenius, GlaxoSmithKline, Janssen Cilag, MSD, Novartis, Novo-Nordisk, Paion, Parke-Davis, Pfizer, Sanofi-Aventis, Sankyo, Servier, Solvay, Wyeth, Yamaguchi. Financial support for research projects was provided by AstraZeneca, GlaxoSmithKline, Böhringer Ingelheim, Novartis, Janssen-Cilag, Sanofi-Aventis. The Department of Neurology at the University Duisburg-Essen received research grants from the German Research Council (DFG), the German Ministry of Education and Research (BMBF), the European Union, the Bertelsmann Foundation and the Heinz-Nixdorf Foundation. HC Diener has no ownership interests and does not own stocks of any pharmaceutical company. G Davidai is an employee of Böehringer Ingelheim USA.