Sildenafil can induce the onset of a cluster headache bout


  • Guan-Yu Lin
  • Jiunn-Tay Lee
  • Giia-Sheun Peng
  • Fu-Chi Yang



Cluster headache, erectile dysfunction, phosphodiesterase type 5 inhibitors, sildenafil


About 25% of patients who are prescribed sildenafil, the phosphodiesterase type 5 (PDE-5) inhibitor, for erectile dysfunction (ED) experience headaches. These migraine effects are well-described, including cluster headaches. We report the case of a man who experienced a cluster headache attack following each of 2 sildenafil doses. His symptoms were resolved by adding naproxen to his treatment regimen and changing his ED treatment from 50 mg of sildenafil to 5 mg of vardenafil. To our knowledge, no study has reported cluster headaches triggered by the less commonly used PDE-5 inhibitors, namely vardenafil and tadalafil. Urologists should be cautious in prescribing sildenafil to patients with ED and with a history of cluster headaches. In these patients, they should consider prescribing low-dose vardenafil or tadalafil instead. Failure to recognize sildenafil risks could result in unnecessary headache bouts in patients with a history of cluster headaches.


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How to Cite

Lin, G.-Y., Lee, J.-T., Peng, G.-S., & Yang, F.-C. (2014). Sildenafil can induce the onset of a cluster headache bout. Canadian Urological Association Journal, 8(5-6), e378–80.



Case Report