“Unfortunately,” Smith says, “there are no category A headache preventive medications.” Category B medications have been proven safe in animal models and also have no observed or suspected complications in pregnancy. “By and large, the category B drugs are the ones that are preferred if medications are deemed necessary,” Smith says.
The risk of using medications in categories C, D and X grow higher. Category C drugs may be considered and used if absolutely necessary; they have shown some propensity for problems in animal models but there are no known concerns observed in humans. Categories D and X should be avoided in pregnancy with their suspected and known risks to the baby.
Angela, for example, was using Topamax for migraine prevention when she became pregnant. Topamax is a category C drug. She discussed with her OB/GYN the possibility of continuing the medication during her pregnancy, but, “we both felt it was just something I wasn’t willing to risk.” With the help of her neurologist, she was weaned from the drug within a few weeks of finding out she was pregnant. In Angela’s case, her OB/GYN and neurologist worked together to make sure Angela’s medications wouldn’t harm her baby. “It is my recommendation that physicians who treat pregnant migraineurs always collaborate with the patient’s obstetrician,” Smith says. In the end, the best course of action to take when considering medications for pregnant migraine patients is to pick a medication with the least amount of risk, the lowest dosage of the medication possible and to take it for the shortest amount of time. With the right information and by working closely with an OB/GYN and migraine specialist, women who suffer from migraine who are pregnant or who wish to become pregnant have many options and it’s possible to find the right pharmaceutical or comfort regimen that works for the expectant mother and can be safe for the developing baby.
For pregnant women who have accidentally or intentionally used a triptan while pregnant, you can contact a pregnancy registry to report your experiences:
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For Amerge and
Imitrex, contact Charles River Laboratories for GlaxoSmithKline
Phone: 1-800-336-2176 (toll-free). - For Maxalt, contact Merck & Company, Inc. Merck National Service Center, Phone: 1-800-986-8999 (toll-free).
- For Zomig, contact AstraZeneca at 1-800-236-9933 (toll free).
