A painkilling, anti-inflammatory drug may help prevent headaches for Muslims fasting from dawn to dusk for Ramadan, according to a study from Israel — where a “Yom Kippur headache” is also known.
About four in every 10 people who abstain from food and water all day during the month-long Ramadan period get headaches, said the study, published in the journal Headache.
“Religious fasting is associated with headache,” wrote lead researcher Michael Drescher, from Hartford Hospital in Connecticut, referring to Ramadan and Judaism’s Yom Kippur, when people fast for 25 hours.
“This has been documented as the ‘Yom Kippur headache’ and ‘first of Ramadan headache,’” he said.
Doctors are not quite sure what causes them. It could be dehydration, or caffeine withdrawal in people who are used to getting their morning coffee, Drescher said.
“There’s probably more than one thing going on,” he said.
Drescher and his Israel-based colleagues had already shown that Jews who took the drug known as etoricoxib, or Arcoxia, before fasting for 25 hours on Yom Kippur got fewer headaches than those who did not.
Arcoxia, a cousin of the painkiller Vioxx, isn’t approved for use in the US because the Food and Drug Administration decided it was too similar to Vioxx, which Merck pulled from the market in 2004, when it was linked to a higher risk of heart attack. However, Arcoxia is available in Israel, among other countries.
The drug has a longer-lasting effect than some other painkillers, which is important because taking a pill in the middle of the day when a headache sets in would be considered breaking the fast.
“If you take Tylenol [acetaminophen] ... by the time you get around to feeling the effects of the fast, the medicine is long out of your system,” Drescher said.
To see how Arcoxia would work during Ramadan, the researchers assigned 222 adults planning to fast last year to either take the drug or an inactive placebo pill just before the start of fasting each day. All participants recorded how often they had a headache and how severe it was. After a week they switched treatments.
During the first day of fasting, when headaches are thought to be most common, 21 percent of people taking Arcoxia reported having a headache, compared with 46 percent of those who took the placebo pill. The Arcoxia group also reported fewer total headaches during that first week, the researchers wrote. And when they did have headaches, they rated them as less severe than participants taking the placebo.
After a week, there was no longer any difference in symptoms between the groups, partly because even the people taking the placebo reported fewer headaches during fasting as time went on.
The study was funded by Merck and two of the study’s six authors are company employees.