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Have migraine and bleeding nose. Taking proamitine 10mg for lbp. What is causing this?

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General & Family Physician
Practicing since : 2005
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I have had migraines all my life, recently for the past month or so i am waking up everyday with a headache (it isnt a migraine just like a full pressure feeling) everytime i get it my nose starts to bleed and i get sick to my stomach. I have checked my blood pressure when it happens (i have addisons and orthostatic hypotension) and its always low around 80/50 i take proamitine 10mg 5 times a day to keep my blood pressure up ( the highest reading i get anytime is 98/64) i have a pacemaker for sss, svt, and afib. Is there any reason this might be happening?
Posted Fri, 11 Jan 2013 in Headache and Migraines
Answered by Dr. Prasad 10 hours later

Thanks for the query.

I went through the details submitted and my comments are as follows:

1. Though the pain description of migraine headaches varies individually, a person with chronic and recurring migraine has similar characteristic headaches during each of his migraine attacks. Hence I agree with you; the current symptoms are unlikely to be related to migraine.

2. Proamitine, a vasopressor agent is reported to cause few side effects and headache (pressure feeling in the head) is a one of the common and typical side effect.

3. Nasal bleeding is commonly associated with hypertension. In the absence of high blood pressure, I cannot attribute it to the vasopressor drug. However my theory is that the drug may be causing localised vasoconstriction / squeezing effects on the nasal blood vessels causing it to bleed.

4. Pacemaker has no relation to your current headaches and nasal bleeds. But I would like to know if you are on antiplatelet/anticoagulant drugs (warfarin/dicoumarol drugs). Such anticoagulants which are routinely prescribed to patients with atrial fibrillation can cause bleeding tendency. If you are on such agents, then it could be causing such bleeds.

5. That being said, it is definitely worth consulting an ENT surgeon to rule out local nasal causes.

Hope I have provided with useful information pertaining to your query. Let me know if you have any other enquiries.

Best Regards
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