Migraine Medications That Are Safe During Pregnancy
- Pain Medications. Also known as analgesics, these are drugs that have the primary purpose of relieving the often excruciating headache associated with a migraine episode.
- Triptans. ...
- Migraine Medications to Avoid During Pregnancy. ...
- A Word From Verywell. ...
Is it safe to take migraine medication during pregnancy?
Nondrug therapies (relaxation, sleep, massage, ice packs, biofeedback) should be tried first to treat migraine in women who are pregnant. For treatment of acute migraine attacks 1000 mg of paracetamol (acetaminophen) preferably as a suppository is …
How to relieve a migraine while pregnant?
Nov 01, 1998 · Nondrug therapies (relaxation, sleep, massage, ice packs, biofeedback) should be tried first to treat migraine in women who are pregnant. For treatment of acute migraine attacks 1000 mg of paracetamol (acetaminophen) preferably as a suppository is considered the first choice drug treatment.
Are migraines normal during pregnancy?
Paracetamol (acetaminophen) is the mainstay for the patient whose typical attacks continue into the first trimester. If paracetamol is insufficient, then partial agonist opioids may be used if typical migraine attacks persist in the second and third trimesters (which is uncommon).
What helps headaches during pregnancy?
Pain Medications Acetaminophen. Considered the safest of pain relief medications for pregnant women and their babies, acetaminophen... NSAIDs. NSAIDs typically are regarded as the second line of defense against migraine pain during pregnancy. Triptans. Medications in this class of prescription drug ...
When do migraines start?
Women typically start to experience migraine attacks during adolescence, which aligns with when menstruation begins. The highest incidence of migraine is between ages 18 and 44, which are also the year many women experience pregnancy. The rate of migraine among women is three times higher than it is for men.
Is it important to stay hydrated while pregnant?
Hydration: Staying hydrated is important for all pregnant women, but especially for those with migraine. “Typically a lot of patients are dehydrated and don’t even realize it,” says Dr. Grossman.
Can migraines be used during pregnancy?
Treatment Options During Pregnancy. Certain medications used for migraine treatment and prevention are contraindicated for pregnancy, due to safety concerns for the developing fetus.
Is acetaminophen safe for pregnancy?
Over-the-counter medications, like acetaminophen, are safe during pregnancy. In combination with non-medication options, it can be effective in preventing and managing migraine symptoms. Non-steroidal anti-inflammatories are another option for relieving migraine.
Can you take triptans while pregnant?
Despite older studies that cited concern for fetal growth restriction and increased blood loss at delivery, new research shows that it’s not necessary to stop using triptans while pregnant. “More recent studies have shown that sumatriptans or triptans are actually very safe in pregnancy and have not been associated with any congenital defects or pregnancy complications,” Dr. Grossman says.
Can you take migraine medication while pregnant?
Many women with migraine who are pregnant or considering pregnancy stop taking their migraine medications and assume they don’t have safe treatment options available— but this is simply not true.
What is the best medication for migraines during pregnancy?
NSAIDs typically are regarded as the second line of defense against migraine pain during pregnancy. These drugs, which work by decreasing the production of hormone-like compounds called prostaglandins that send pain messages to the brain, include: 8 1 Aspirin (the most common brand is Bayer) 2 Advil, Motrin (ibuprofen) 3 Aleve (naproxen)
What is the second line of defense against migraines during pregnancy?
NSAIDs typically are regarded as the second line of defense against migraine pain during pregnancy. These drugs, which work by decreasing the production of hormone-like compounds called prostaglandins that send pain messages to the brain, include: 8
Is it safe to take ibuprofen while pregnant?
Aspirin (the most common brand is Bayer) Advil, Motrin (ibuprofen) Aleve (naproxen) In general, NSAIDs are safe for most pregnant women up until the third trimester, according to the Organization of Teratology Information Specialists (OTIS). 9. During the last three months of pregnancy, there is a risk that ibuprofen might cause a blood vessel ...
Can ibuprofen cause low amniotic fluid?
OTIS also states that ibuprofen used in late pregnancy might lead to low levels of amniotic fluid or stalled labor.
Can NSAIDs cause miscarriage?
There is some evidence to suggest that use of NSAIDs early in pregnancy (up to eight weeks) could cause bleeding and potential miscarriage, although it is important to note that miscarriage can happen in any pregnancy and often the reason is not specifically known. 10.
Can you take NSAIDs during pregnancy?
Like other NSAIDs, these should not be taken after the second trimester of pregnancy. 11.
Can triptans cause birth defects?
However, research has found triptans to be safe during pregnancy, with no significant increase in birth defects, prematurity, or miscarriage. 14. Triptans for Migraine Relief.
What is the best medication for migraines in lactation?
Acetaminophen, lidocaine SQ, and ibuprofen are preferred first-line treatments for migraine in lactation, and are compatible with breastfeeding. Second-line treatments include diphenhydramine, metoclopramide, ondansetron, and prednisone, while medications that should always be avoided include ergots and opiates.
How many women have migraines?
Migraine in women is most prevalent during reproductive years, with an estimated 21% to 28% of this population experiencing migraine every year. 1 Of these women, up to 80% will continue to have migraines throughout pregnancy, with the highest activity occurring during the first trimester. Migraine with aura tends to present for ...
Is migraine a risk factor for preeclampsia?
Migraine during pregnancy has been associated with a 1.5-fold to 3-fold increased risk of hypertensive disorders, including preeclampsia. 1 Migraine during pregnancy is also associated with a higher risk for. febrile seizure.
Is it safe to have migraines while pregnant?
At this time, monitoring is the only safe known intervention for migraine in pregnancy, as there is no evidence to support any other specific intervention. First-line treatments for migraine during pregnancy are usually nonpharmacological and focus on healthy lifestyle practices, including quality sleep, regular exercise, nutritional meals, ...
Is propranolol safe for pregnancy?
Researchers say that results from observational studies show that when used to treat migraine in early pregnancy, propranolol was associated with a small increase in the risk for intrauterine growth retardation, small placenta, and congenital abnormalities. Safe choices for second-line treatment include cyclobenzaprine and memantine.
Is Valproate safe for breastfeeding?
Results from a 2013 study published in Headache showed that although valproate is considered high-risk during pregnancy, this medication is safer to use while breastfeeding due to low concentrations in breast milk. 2.
When do migraines occur?
Migraines are found more likely to occur in women during menstruation than during any other time. Migraine attacks that occur anywhere from 2 days before menstruation to 3 days after menstruation begins is diagnosed as menstrual migraine. 1 Migraine attacks that occur only during menstruation are diagnosed as pure menstrual migraine, ...
How to know if you have a headache?
Seek care right away if you experience any of these symptoms: 1 Lasting headache 2 More or worse migraines 3 Nausea or vomiting 4 Particularly severe headache pain 5 Shortness of breath 6 Swelling in your legs or feet 7 Upper abdominal pain 8 Vision changes
How often do you get Botox injections?
The goal is to thoroughly block chemicals that transmit nerve pain. Patients typically get ART injections every three months. Watch the procedure now.
Can migraines cause pregnancy complications?
Having high levels of estrogen during pregnancy may be therapeutic. However, migraines may carry a slightly higher risk of pregnancy complications.
Can you get Botox while pregnant?
Yes, this cosmetic injection to reduce the appearance of wrinkles can relieve certain types of migraines. Before or early in pregnancy, tell your Ob/Gyn that you experience migraines.
Can you take ergotamines while pregnant?
Pregnancy-safe options include magnesium oxide, metoprolol, amitriptyline, propranolol (I take this medication daily). Ergotamines are not recommended during pregnancy or while breastfeeding.
Does Botox help with migraines?
Best known for reducing the appearance of fine lines and wrinkles, BOTOX was approved by the U.S. Food and Drug Administration in 2010 for treatment of chronic migraines. A 2018 study showed no increased risk of birth defects in babies whose mothers received BOTOX for migraines during pregnancy.
Can migraines cause nausea during pregnancy?
Cautions about headaches during pregnancy. Most headaches and migraines are not cause for alarm. However, severe migraines sometimes require hospitalization so you can receive fluids, pain medication, or anti-nausea drugs.
What is the first line of treatment for migraines?
After ovulation, first-line treatment is acetaminophen, which is continued if pregnancy occurs.
How long before trying to conceive can you have migraines?
This plan weighs the efficacy and urgency of treatment for migraine with possible adverse fetal effects. Any conception plans are addressed during the new patient visit and counseling is given to make a specific follow-up at least 6 months before trying to conceive.
Why is risk stratification important?
Risk stratification of pharmacologic intervention is important, because 70% of pregnant women report taking at least 1 prescription medicine. 9 In 2015, the Food and Drug Administration (FDA) implemented the Pregnancy and Lactation Labeling Rule, removing previously used letter codes for pregnancy risk stratification in exchange for a narrative summary. This summary includes any human, animal, and pharmacologic risk data available. The new system eliminates what some considered an overly simplistic pregnancy risk system that did not detail current data available on each pharmacologic agent. With the new labeling system, clinicians cannot rely on a predetermined risk category, but need to review the current data and make an informed decision on a case-by-case basis. The lack of a standardized risk assessment is both a strength and weakness of this update, requiring individual review of each medication for a specific individual. 10
Can you take magnesium while pregnant?
Supplements and vitamins for migraine prevention may be an option for women who want an alternative to pharmacologic agents while pregnant. Intravenous magnesium, however, now has a warning against use in pregnancy because of concern that prolonged high doses of intravenous magnesium sulfate can cause fetal low calcium and bone abnormalities. 14 Oral magnesium has not been associated with teratogenic effects and likely can be considered as a preventive option. 15 Riboflavin and coenzyme Q10 (CoQ10) both have some efficacy in migraine prevention with limited studies in pregnancy; neither is known to be associated with adverse pregnancy outcomes. Riboflavin may be beneficial in reducing hematologic risks (eg, anemia during pregnancy), and CoQ10 may reduce risk of preeclampsia. 16,17 Riboflavin and CoQ10 may be effective for migraine prevention in pregnancy.
Is riboflavin good for pregnancy?
Riboflavin may be beneficial in reducing hematologic risks (eg, anemia during pregnancy), and CoQ10 may reduce risk of preeclampsia. 16,17 Riboflavin and CoQ10 may be effective for migraine prevention in pregnancy.
Can MABs be used during pregnancy?
The new calcitonin gene-related peptide (CGRP)-blocking monoclonal antibodies (MAbs) approved for migraine prevention were not tested during pregnancy. Although MAbs are known to cross the placenta, administration of supra-therapeutic doses did not result in adverse fetal outcomes in animal models. 24-26 Expressed in omental arteries of pregnant women, CGRP plays a role in vasculature regulation, 27 and there is concern for pre-eclampsia because systemic levels of CGRP were lower in individuals with pre-eclampsia compared with normotensive individuals. 28 Whether this is cause or effect remains unknown; however, given the role of CGRP and pregnancy vasculature we would avoid use of these agents during pregnancy until further studies are performed. Providers should take into consideration that these medications have a month-long half-life. In our practice, we advise discontinuation at least 5 months before conception.
Is onabotulinumtoxin teratogenic?
Animal studies raised concern for teratogenicity from onabotulinumtoxinA initially. These animal studies occurred at higher doses than those used for migraine prevention, however. 29 It is thought that the 150 kDa onabotulinumtoxin is too large to cross the placenta; investigations of other agents have shown that molecules larger than 500 Da cross the placenta only incompletely. 30,31 In case reports of pregnant women with systemic botulism, respiratory compromise occurred, but pregnancy outcomes were normal. A single woman with botulism developed ventilator-dependent paralysis, but her fetus continued having visible movements and was delivered without evidence of botulism. 32 A retrospective review of 232 women with exposure to onabotulinumtoxinA 3 months before or during pregnancy did not show an increased prevalence of fetal abnormalities. Of the 137 cases with dose information, 45.2% were exposed to 100 units or more. 33 In a report of a woman who received onabotulinumtoxinA for migraines while 18 weeks pregnant, complete resolution of migraines occurred, and her child was born without birth defects and had typical development during 6.5 years of follow up. 34 We recommend practitioners considering use of onabotulinumtoxinA for preventive treatment of chronic migraine during pregnancy discuss the available literature and risk versus benefit with the patient and in consultation with colleagues in maternal-fetal medicine.