Table 2: Drugs commonly used for treatment and/or prophylaxis of migraine and their FDA rating and fetomaternal effects.

Drug FDA rating Maternal effects Fetal effects Compatible with breastfeeding Paracetamol B Medication overuse None Yes Opioids B/C Overuse/dependence Constipation ??cleft palate/inguinal hernia Yes Aspirin C Increased risk bleeding Narrowing of ductus arteriosus Yes NSAIDs B/D Inhibition of implantation Premature closure of ductus arteriosus Restriction of renal blood flow NEC and IVH in preterm foetuses Yes Triptans C Limited evidence possible increased miscarriage ?Preterm birth and IUGR ?? Antiemetics B/C None None Yes Caffeine B Overuse/withdrawal headache NoneHigh doses—miscarriage, IUGR Yes Ergot alkaloids X Uterine hypercontractility Reduced placental perfusion Miscarriage Fetal compromise Intestinal atresia No Beta blockers B/C None ?IUGR, fetal bradycardia Yes Antiepileptics C/D None Malformations Yes Antidepressants B/C None High doses—neonatal depression, irritability, spasms, or convulsions Caution