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Verapamil induced gingival enlargement in cluster headache
  1. M S Matharu1,
  2. J A van Vliet2,
  3. M D Ferrari2,
  4. P J Goadsby1
  1. 1Headache Group, Institute of Neurology, Queen Square, London, UK
  2. 2Department of Neurology, Leiden University Medical Centre, the Netherlands
  1. Correspondence to:
 Professor P J Goadsby
 Institute of Neurology, Queen Square, London WC1N 3BG, UK;


Verapamil is an effective prophylactic treatment for cluster headaches and, therefore, is widely used. This report describes four patients with cluster headache who developed gingival enlargement after initiating treatment with verapamil. In two patients, it was possible to control this side effect adequately by optimising oral hygiene and dental plaque control. In the other two patients, lowering of the verapamil dose, in addition to optimal oral hygiene and dental plaque control, was necessary; in one patient verapamil had to be stopped completely to reverse the gingival enlargement. Doctors treating cluster headache with verapamil need to be aware of this side effect, especially as it may be preventable with good dental hygiene and dental plaque control, is reversible with reduction or cessation of verapamil, and can lead to dental loss.

  • headache
  • cluster headache
  • verapamil

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  • Competing interests: none declared

  • PJG is a Wellcome Trust Senior Research Fellow.