Pretreatment With Sumatriptan Can Reduce Cilostazol-Induced Headaches

Investigators assess whether pretreatment with sumatriptan prevents headaches induced by cilostazole in healthy volunteers.

Headaches induced by cilostazol can be mitigated through pretreatment with sumatriptan, according to a study published in The Journal of Headache and Pain.

This randomized, double-blind crossover study included 30 healthy participants who were administered cilostazol 200 mg during 2 separate visits. Each participant received either oral sumatriptan (50 mg) or placebo before cilostazol and an additional dose of sumatriptan or placebo along with cilostazol. All but 3 individuals developed headaches that ranged from mild to moderate on the Numerical Rating Scale due to cilostazol. Headache score did not differ significantly 2 hours (P=.67) or 4 hours (P=.1) post-treatment between the 2 treatment days. The headache score’s median peak was 1.5 out of 5 with sumatriptan and 2 out of 7 with placebo (P=.26). There was not sufficient headache development among the placebo group to contribute results of statistical significance.

No significant difference in headache score were observed between the 2 days at 2 hours after treatment (P=.52).   In addition, no significant different was observed 4 hours after treatment (P=.06).

To assess headache symptoms and response, participants completed self-reported questionnaires. Participants included healthy individuals aged 18 to 60 who weighed between 45 and 90 kg. Only participants with less than 1 episodic tension-type headache per week were included in the study. Other exclusion criteria included pregnancy, daily medication intake (with the exception of oral contraceptives), or acute psychiatric or somatic disorders. All participants were given warnings that cilostazol could cause headaches or migraines.

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The study researchers conclude that “[pretreatment] with sumatriptan prevents cilostazol induced headache from developing. However, the placebo group did not develop enough headache to get statistically significant results. We also show by comparison to previous studies that the placebo effect on experimental headache is considerable and should be taken into consideration in future power calculations.”


Falkenberg K, Olesen J. Pre-treatment with sumatriptan for cilostazol induced headache in healthy volunteers. J Headache Pain. 2018;19(1):71.