Headache in Pregnancy: A Nuisance or a New Sense?

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