Unresponsive Intractable Chronic Headache With Sitagliptin

Sitagliptin is an anti-diabetic medication within the dipeptidyl peptidase 4 (DPP4) inhibitor class used as a single agent or in combination therapy. It is a well-studied and well-tolerated medication with commonly reported adverse events of upper respiratory tract infections, nasopharyngitis, headache, and gastrointestinal (GI) upset. Post-marketing reports have also identified associations with acute pancreatitis and joint pain. Here, we report a case of type II diabetes with chronic headache which resolved rapidly after discontinuation of sitagliptin. Our case demonstrates the need for continuous monitoring and post-marketing surveillance for drugs with tolerable side effect profile. Also, increasing patient and physician awareness of long-term side effects of these commonly used medications is essential for adequate patient safety and quality care.