title: Reversible cerebral vasoconstriction syndrome possibly induced by etoricoxib.
abstract: Etoricoxib is a newer cyclooxygenase (COX)-2 inhibitor anti-inflammatory drug with a favorable safety profile. However, several randomized trials have provided evidence of an increased risk for acute myocardial infarction associated with the use of COX-2 inhibitors. Fewer data are available concerning the risk for ischemic stroke associated with COX-2 inhibitors. Although sporadic classes of drug-induced reversible cerebral vasoconstriction syndrome (RCVS) have been reported, this was not the case for etoricoxib. We report a patient who developed thunderclap headache, reversible cerebral arterial vasoconstriction, high blood pressure, and ischemic stroke (ie, RCVS) with recent exposure to etoricoxib. Although the association is hypothetical, the authors suggest consideration of RCVS in hypertensive patients presenting with headache, focal deficits, and evidence of cerebral ischemia during COX-2 inhibitors use.
authors.affiliation: *Division of Neurology, and †Department of Radiology, Ospedale Civile, Voghera, Pavia, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Dallocchio
authors.forename: Carla
authors.initials: C
authors.lastname: Arbasino
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Borutti
authors.forename: Giada
authors.initials: G
authors.lastname: Gola
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Egitto
mesh_terms: D000328:Adult; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects; D000077613:Etoricoxib; D005260:Female; D051270:Headache Disorders, Primary / Q000139:chemically induced*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D011725:Pyridines / Q000009:adverse effects*; D020521:Stroke / Q000139:chemically induced*; D013450:Sulfones / Q000009:adverse effects*; D013577:Syndrome; D020301:Vasospasm, Intracranial / Q000139:chemically induced*
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D011725:Pyridines; D013450:Sulfones; D000077613:Etoricoxib