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

DrugFDA ratingMaternal effectsFetal effectsCompatible with breastfeeding

ParacetamolBMedication overuseNoneYes
OpioidsB/COveruse/dependence
Constipation
??cleft palate/inguinal herniaYes
AspirinCIncreased risk bleedingNarrowing of ductus arteriosusYes
NSAIDsB/DInhibition of implantationPremature closure of ductus arteriosus
Restriction of renal blood flow
NEC and IVH in preterm foetuses
Yes
TriptansCLimited evidence possible increased miscarriage?Preterm birth and IUGR??
AntiemeticsB/CNoneNoneYes
CaffeineBOveruse/withdrawal headacheNoneHigh doses—miscarriage, IUGRYes
Ergot alkaloidsXUterine hypercontractility
Reduced placental perfusion
Miscarriage
Fetal compromise
Intestinal atresia
No
Beta blockersB/CNone?IUGR, fetal bradycardiaYes
AntiepilepticsC/DNoneMalformationsYes
AntidepressantsB/CNoneHigh doses—neonatal depression, irritability, spasms, or convulsionsCaution