Many types of medication used for both preventive and acute treatment cannot be used during pregnancy and breastfeeding, either because they are harmful to the fetus or child, or because they are relatively new types of medication and we therefore do not yet know if they are actually harmful.
During pregnancy, about 70% will experience a significant improvement in their migraines in the 2nd and 3rd trimesters. This primarily applies to migraine without aura and likely occurs because estrogen levels stabilize during pregnancy.
You can follow the advice below during pregnancy and breastfeeding.
Try using non-medicinal methods such as rest, lying down, ice packs, and the like. If you have severe attacks, Paracetamol or Sumatriptan can be used, but consumption should be limited as much as possible.
Other triptans, NSAIDs (e.g., ibuprofen, diclofenac, naproxen, tolfenamic acid), and preparations containing acetylsalicylic acid (Kodimagnyl, Treo, and Triplo) should not be used. Codeine (e.g., Kodimagnyl) and Ergotamine must not be used.
If you are severely troubled by nausea and vomiting in connection with your migraine attacks, Ondansetron and Metoclopramide can be used if necessary.
Preventive treatment should not be used during pregnancy. Some experts believe that propranolol, metoprolol, and magnesium can be used, but there is no full consensus on this. Remember that migraines usually improve during the last ⅔ of pregnancy.
Just as during pregnancy, medication intake should be limited. Therefore, prefer non-medicinal methods such as rest, lying down, ice packs, and the like.
If acute treatment is still necessary, Paracetamol can be used as a first choice. It is also possible to use ibuprofen if necessary. Of the triptans, Sumatriptan and Eletriptan can be used if necessary. If other types of triptans are used, breastfeeding is not recommended for 24 hours afterwards.
Avoid using preparations containing acetylsalicylic acid (Kodimagnyl, Treo, and Triplo), benzodiazepines (e.g., Stesolid), and ergotamine.
For nausea, metoclopramide, ondansetron, and domperidone can be used if necessary.
If it can be avoided, preventive medication should not be used. If it becomes necessary, however, you may consider using propranolol, metoprolol, or amitriptyline.
While you are actively trying to conceive, the recommendation is to follow the same guidelines as if you were already pregnant.
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