9/10/07 #5 - Managing Migraines during pregnancy?

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  • Full Question:
    I'm 34 and trying to conceive and am concerned about how to manage my migraines during this process. I get a nasty 3 day migraine twice per month - it's basically hormonal but can be worsened by stress and food etc. I understand that taking sumatriptan is not a good idea during pregnancy or breastfeeding, but I'm wondering whether I should bite the bullet and decide not take them at all. And if so, what should I do to manage the pain?

    Aside from the danger to the embryo once implanted, I'm wondering if it's likely that by constricting my body's blood vessels, sumatriptan will affect the proliferation of my uterine lining or the maturing follicle prior to ovulation. Also, is there anyway the blastocyst could be affected prior to implantation?

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    Let me say that sumatriptan gave me my life back (if I use them early enough) and that laying in bed for three days twice a month doesn't appeal to me! Do you have an advice for how I should approach this problem and my fears of hurting my chances of a healthy pregnancy? Thanks and best regards, Bonnie.





    Dear Bonnie;


    I think in general that it is a great idea to avoid all medications at least in the first 45 to 50 days of pregnancy, because this is when all of baby’s organs are being formed. First of all, sumatriptan is pregnancy category C. Therefore, if the benefit outweighs the risk, it is acceptable to use the medication, providing your obstetrician agrees. Otherwise, commonly used items during pregnancy include antinauseants such as Reglan, opiates such as hydrocodone; IV magnesium may also be an acceptable abortive migraine treatment. Sumatriptan does not affect to any great extent any blood vessels in the uterus, as far as we know. There is also a pregnancy Registry for sumatriptan, as well as all other triptans. So far, there has been no evidence of any harmful effects of sumatriptan on the fetus.


    Good luck,
    John Claude Krusz and Teri Robert


    If you need to find a headache and Migraine specialist, please see our listing of patient recommended specialists.



    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.


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    © Teri Robert and J.C. Krusz, 2007.

Published On: September 09, 2007