12/10/2026
THE HEADACHE THAT MADE HER AFRAID TO TAKE HER BLOOD PRESSURE MEDICINE
I still remember an elderly woman who came to the pharmacy with one major complaint:
“I have a serious headache, and I am tired.”
She explained that she had been taking paracetamol, but the relief was only temporary. After some time, the headache would return, sometimes worse than before.
She had even suspected malaria and taken antimalarial medication, but the headache persisted.
As we continued talking, I checked her blood pressure. It was high.
I then asked whether she was taking any medication for hypertension.
“Yes,” she replied. “I am taking nifedipine.”
I asked who had prescribed it, and she explained that it was her doctor.
Then I asked her an important question:
“Did you experience these headaches before you started taking nifedipine?”
“No,” she replied.
She explained that the headaches began after she started taking the medicine and seemed to become worse after each dose.
The problem was becoming so disturbing that she sometimes hesitated to take her medication because she feared the headache that followed.
As we talked further, I asked whether she also experienced unusual tiredness or sleepiness.
Her response was an emphatic yes!
At that point, I became concerned that she might be experiencing adverse effects from her medication.
Nifedipine is a calcium channel blocker commonly used to treat hypertension. It is an effective medicine, but like all medicines, it can cause side effects.
Headache is a recognised adverse effect of nifedipine. It is often mild and may improve as the body adjusts to treatment. However, some patients experience symptoms that are more troublesome and interfere with their daily lives.
Nifedipine can also cause dizziness and fatigue in some people.
Her symptoms and their timing raised a reasonable suspicion that the medicine could be contributing to her problem. However, because she had a severe, persistent headache and high blood pressure, it was important that other potentially serious causes were not overlooked.
I wrote a note to her doctor explaining my concerns, the relationship between the symptoms and the medication, and a possible alternative treatment for the doctor to consider.
I advised her to take the note to her doctor for assessment and a medication review rather than stopping or changing her treatment on her own.
The following day, she returned to her doctor, who reviewed the concerns, assessed her condition and decided to change her medication.
About a week later, she came back to the pharmacy.
This time, she looked much brighter.
She was happy to tell me that her headaches had stopped and that she was feeling much better on the new medication. She also reported that her blood pressure was now well controlled.
I was glad to hear that she was doing better.
Her experience reminded me of an important lesson in medication safety.
Sometimes, the problem is not that a medicine is ineffective. The problem is that a medicine that works well for many people may not be suitable for a particular patient.
Nifedipine remains an important and effective medicine for hypertension. Its benefits are well established, but individual patients can respond differently to the same treatment.
When an adverse effect becomes troublesome, it can also affect adherence. A patient who associates a prescribed medicine with a distressing headache may begin skipping doses out of fear, potentially leaving their blood pressure inadequately controlled.
This is why it is important to listen carefully when patients describe what they experience after taking their medicines.
Questions such as these can make a difference:
- When did the symptoms begin?
- Did they start after a new medicine was introduced?
- Do they become worse after taking a dose?
- Are there other symptoms that might be related?
- Could another medicine be more suitable?
These questions do not automatically prove that a medicine is responsible, but they can help the healthcare team identify a possible adverse drug reaction and decide what to do next.
This is one of the important purposes of Medication Therapy Management (MTM): identifying, preventing and resolving medication-related problems so that patients receive the intended benefits of treatment with the least possible harm.
And it requires teamwork between patients and healthcare professionals. Patients need to report troubling symptoms, pharmacists can help identify potential medication-related problems, and prescribers can assess the patient and make appropriate treatment decisions.
One important caution: a severe or sudden headache, particularly when accompanied by very high blood pressure, confusion, weakness, vision changes or chest pain, requires urgent medical assessment. Such symptoms should never automatically be attributed to a medication side effect.
If you experience persistent or troublesome symptoms after starting nifedipine or any other medicine, speak to your healthcare provider. Do not stop, change the dose or switch medicines on your own.
Sometimes, the solution is not simply to add another medicine to treat a side effect. It may be necessary to review the medicine causing the problem and determine whether a safer or better-tolerated option is appropriate.
That is why every medication deserves careful review, and every patient's experience deserves to be heard.
The goal is not merely to prescribe medicines. It is to help patients use the right medicines safely, effectively and consistently.
Your Caring Pharmacist.
