KNOWLEDGE
Treatment of migraine in pregnancy and lactation
Medicinsk godkendt artikel
Many of the types of medicines used for both preventive and seizure treatment cannot be used during pregnancy and lactation, either because they are harmful to the fetus or baby or because they are relatively new types of medicines and therefore we do not yet know if they are actually harmful.
During pregnancy, about 70% will experience significantly better migraines in the 2nd and 3rd trimesters. This applies primarily to migraines without aura and it probably happens because estrogen levels stabilize during pregnancy.
You can follow the advice below during pregnancy and breastfeeding.
Try using non-medical methods such as rest, bed rest, ice packs and the like. If you have severe seizures, you can take Paracetamol or Sumatriptan is used, but consumption should be limited as far as possible.
Other triptans, NSAIDs (e.g. ibuprofen, diclofenac, naproxen, tolfenamic acid) and acetylsalicylic acid preparations (Kodimagnyl, Treo and Triplo) should not be used. Codeine (e.g. Kodimagnyl) and Ergotamine must not be used.
If you are very troubled by nausea and vomiting associated with your migraine attacks, Ondansetron and Metoclopramide can be used if necessary.
During pregnancy, one should not resort to preventive treatment. Some experts believe that propranolol, metoprolol and magnesium can be used, but there is not a full consensus on this. Keep in mind that migraines most often improve in the last ⅔ of pregnancy.
Just like during pregnancy, the intake of medications should be limited. Therefore, give preference to non-medicinal methods such as rest, bed rest, ice packs and the like.
If seizure therapy is still needed, Paracetamol can be used as the first choice. It is also possible to use ibuprofen if necessary. Of triptans can Sumatriptan and Eletriptan used if necessary. If you use other types of triptans, breastfeeding is not recommended for 24 hours afterwards.
Avoid using preparations with acetylsalicylic acid (Kodimagnyl, Treo and Triplo), bezodiazepines (eg. Stesolide) as well as Ergotamine.
With nausea, metoclopramide, Ondansetron and Domperidone can be used if necessary.
If it can be avoided, preventive medicine should not be used. If it becomes necessary anyway, one may consider using propranolol, metoprolol or Amitriptyline.
In the period when you are actively trying to get pregnant, the recommendation is to do as if you were already pregnant.
