Migraine treatment during pregnancy and breastfeeding
desire to become pregnant
In the first 14 days after the first day of the last menstruation (assuming a regular 28-day cycle!) it can be assumed that there is no pregnancy.
- With a regular cycle, ovulation occurs about 14 days before menstruation.
- 6 days after ovulation, the fertilized egg implants in the uterus and thus the first contact between “mother and child”.
- Drug treatment of migraine attacks is therefore possible for approximately the first 3 weeks after the first day of the last menstruation without endangering the fetus, because until then there is no contact with the mother's blood.
- An existing pregnancy can be diagnosed with newer pregnancy tests from the 6th to the 10th. The day AFTER ovulation can be detected, which means there are some “uncertain” days around 3 weeks after menstruation in which it is advisable to carry out a pregnancy test before taking acute medication.
Treatment of migraine attacks during pregnancy or breastfeeding
Paracetamol: Current warning against taking it during pregnancy
Paracetamol was previously considered the safest painkiller during pregnancy. Based on previous data, safety appeared to be beyond doubt. Pregnant women were recommended to take this painkiller almost without hesitation if they had pain during pregnancy. However, based on current studies, a careful rethinking of this recommendation is necessary.
The use of paracetamol by a pregnant woman and exposure of the unborn child to the drug appear to lead to a significantly increased risk of developing asthma and respiratory diseases in children and possible infertility in boys. In recent years there has been a significant increase in the frequency of asthma globally. Paracetamol is the most commonly used painkiller in Germany. It is number 1 among the most commonly used medicines. At the same time, the frequency of asthma in the population has increased significantly in recent years. Paracetamol can lead to a reduction in glutathione in the lungs. Glutathione is believed to play an important role in the development of asthma.
Of particular concern is the justified suspicion of a significantly increased risk of developing the positional anomaly of the testicle in boys (cryptorchidism). For those affected, this can later lead to reduced fertility and an increased risk of developing malignant testicular tumors. Sperm count and sperm vitality in later life can be reduced. The combined use of two painkillers in pregnant women was associated with a sevenfold increase in the rate of cryptorchidism in newborn boys. It is suspected that the effects of one 500 mg tablet of paracetamol could be more harmful to the unborn child than the ten most common environmental pollutants.
Paracetamol was previously considered a safe, harmless, tolerable and inexpensive painkiller in therapeutic doses. The risk that an overdose of more than 150 mg per kg of body weight can trigger irreversible liver cell damage and even liver failure has already led to a limitation in the pack size in the context of self-medication. The new studies justified a significant rethinking of its use in possible, planned or existing pregnancy.
In general, you should avoid taking painkillers during pregnancy and breastfeeding. In individual cases, if the pain is particularly severe, acute medication can be considered after medical advice. However, it must be taken into account that so-called simple painkillers such as paracetamol only have a partial and short effect on the severe attack of pain, but at the same time can cause lasting lifelong risks of complications for the unborn child. The studies were criticized because a causal connection had not yet been definitively proven. However, until the exact connection is clarified, the principle must apply: In case of doubt, for the unborn life and against taking paracetamol, especially in combination with other painkillers. Based on the new data, short-term benefits and long-term lifelong risks are not balanced in the case of possible or existing pregnancy.
Contrary to previous recommendations, it is therefore not recommended to take paracetamol in mono- and especially combination preparations if you are pregnant or are already pregnant.
- Magnesium iv (e.g.:Mg 5-sulfate amp. 10% injection solution)
infant
pregnancy
There have been no reports of adverse effects during pregnancy in humans.
lactation
There have been no reports of adverse effects during breastfeeding in humans.
or:
- Imigran 25mg/100mg (tablet, nasal spray)
pregnancy
Strict indications. There is no sufficient experience with its use in humans. The animal experiment did not provide any evidence of embryotoxic/teratogenic effects.
lactation
Avoid breastfeeding until 24 hours after use.
The substance passes into breast milk. An impairment of the baby has not yet become known.
Treatment of nausea
- Meclozin 25 mg (tablet)
pregnancy
Strict indications. After extensive use in humans, no embryotoxic/teratogenic effects were suspected. However, the animal experiment provided evidence of embryotoxic/teratogenic effects. These seem to be of no importance to humans.
lactation
Strict indications.
Substance probably passes into breast milk. Substance leads to a reduction in milk production or
- Dimenhydrinate 50mg/150 mg (coated tablets, suppositories)
pregnancy
Strict indications, especially in the 3rd trimester. After extensive use in humans, no embryotoxic/teratogenic effects were suspected.
lactation
Contraindicated.
Substance passes into breast milk. Depending on the dose, type of application and duration of medication, the infant's well-being may be temporarily affected or
- Metoclopramide 20 mg (drops, tablets, suppositories)
pregnancy
Strict indication in the 1st trimester. There is no sufficient experience with its use in humans. The animal experiment did not provide any evidence of embryotoxic/teratogenic effects.
lactation
Contraindicated. Substances only appear in small amounts in breast milk. Since the influence of dopamine antagonists on the child's nervous system is not clear, their use is contraindicated.
Migraine prevention:
- Magnesium 600 mg/day (capsule/drink granules)
pregnancy
There have been no reports of adverse effects during pregnancy in humans.
lactation
no reports of adverse effects during breastfeeding in humans
- Beta blockers (propranolol) 100-200mg/day
pregnancy
Bradycardia, hypotension, hypoglycemia and respiratory depression (neonatal asphyxia) are possible in the newborn. Therefore, stop therapy 48–72 hours before the expected due date. If this is not possible, newborns must be carefully monitored until 72 hours after delivery.
lactation
Strict indications. Depending on the concentration in breast milk, beta-blocking symptoms are possible (bradycardia, respiratory depression).