Standard headache and neuralgia treatments and SARS-CoV-2: opinion of the Spanish Society of Neurology's Headache Study Group

Neurologia (Engl Ed). 2020 Nov-Dec;35(9):628-632. doi: 10.1016/j.nrl.2020.07.007. Epub 2020 Jul 28.
[Article in English, Spanish]

Abstract
in English, Spanish

Introduction: In recent months, doubts have arisen among patients, general practitioners, and neurologists as to whether some drugs commonly used in patients with headaches and neuralgia may favour or complicate the disease caused by SARS-CoV-2.

Material and methods: We collected information on the opinions of scientific societies and medicines agencies (American, European, and Spanish) to clarify doubts regarding the use of drugs such as lisinopril, candesartan, ibuprofen, corticosteroids, carbamazepine, and monoclonal antibodies targeting the calcitonin gene-related peptide in the context of the COVID-19 pandemic.

Results: We make recommendations about the use of standard headache treatments in the context of the COVID-19 pandemic, based on the current scientific evidence.

Conclusions: At present, there is no robust scientific argument to formally contraindicate any of the standard treatments employed for headaches and neuralgias.

Introducción: En los últimos meses han surgido dudas por parte de pacientes, médicos de familia y neurólogos sobre la posibilidad de que algunos de los fármacos que habitualmente se utilizan en cefaleas y neuralgias puedan facilitar o complicar la infección por el SARS-COV-2.

Material y métodos: Hemos recabado información sobre el posicionamiento de sociedades científicas, así como de las distintas Agencias de Medicamentos (americana, europea y española) para poder esclarecer dudas respecto al uso de fármacos como lisinopril, candesartán, ibuprofeno, corticoides, carbamazepina, anticuerpos monoclonales contra el CGRP durante la pandemia por COVID-19.

Resultados: Planteamos recomendaciones acerca del uso de fármacos habituales en el tratamiento de las cefaleas en el contexto de la pandemia por COVID-19, basándonos en las evidencias de las que disponemos en el momento actual.

Conclusiones: Actualmente, no existe ningún argumento científico robusto para contraindicar formalmente ninguno de los tratamientos que se emplean en cefaleas y neuralgias.

Keywords: COVID-19; Candesartan; Candesartán; Cefalea; Corticoides; Corticosteroids; Headache; Ibuprofen; Ibuprofeno; Lisinopril.

Publication types

  • Practice Guideline

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Analgesics / adverse effects*
  • Analgesics / pharmacology
  • Analgesics / therapeutic use
  • Angiotensin-Converting Enzyme 2
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use
  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use
  • Antiviral Agents / pharmacology
  • Benzimidazoles / adverse effects
  • Benzimidazoles / therapeutic use
  • Betacoronavirus
  • Biphenyl Compounds
  • COVID-19
  • COVID-19 Drug Treatment
  • Calcitonin Gene-Related Peptide Receptor Antagonists / adverse effects
  • Calcitonin Gene-Related Peptide Receptor Antagonists / therapeutic use
  • Carbamazepine / adverse effects
  • Carbamazepine / therapeutic use
  • Coronavirus Infections / complications*
  • Coronavirus Infections / drug therapy
  • Disease Susceptibility / chemically induced
  • Drug Interactions
  • Enzyme Induction / drug effects
  • Headache / complications
  • Headache / drug therapy*
  • Headache / prevention & control
  • Humans
  • Ibuprofen / adverse effects
  • Ibuprofen / pharmacology
  • Ibuprofen / therapeutic use
  • Lisinopril / adverse effects
  • Lisinopril / therapeutic use
  • Neuralgia / complications
  • Neuralgia / drug therapy*
  • Pandemics
  • Peptidyl-Dipeptidase A / biosynthesis
  • Peptidyl-Dipeptidase A / genetics
  • Pneumonia, Viral / complications*
  • Receptors, Virus / biosynthesis
  • Receptors, Virus / genetics
  • Risk Factors
  • SARS-CoV-2
  • Tetrazoles / adverse effects
  • Tetrazoles / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Analgesics
  • Antibodies, Monoclonal
  • Anticonvulsants
  • Antihypertensive Agents
  • Antiviral Agents
  • Benzimidazoles
  • Biphenyl Compounds
  • Calcitonin Gene-Related Peptide Receptor Antagonists
  • Receptors, Virus
  • Tetrazoles
  • Carbamazepine
  • Lisinopril
  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2
  • candesartan
  • Ibuprofen