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Is it safe to take migraine medication during pregnancy?

Migraine medication must be used with caution in pregnant women.

Narcotics, such as codeine (paired with Tylenol), are generally considered low risk, and acetaminophen (also sold under the brand name Tylenol) has a long history of safe use during pregnancy. But most of the other medications used for migraines are problematic.

There's not a lot of data on the safety of migraine medications in pregnancy. (For safety reasons, few studies are conducted on pregnant women.) For example, we don't have sufficient data on triptans (such as Imitrex or Maxalt) to say that they're safe or low risk.

Here's what we know about other migraine medications:

Ibuprofen and other nonsteroidal anti-inflammatories (NSAIDS) are not considered safe during pregnancy, especially in the third trimester.

And I wouldn't recommend any medications that contain caffeine (migraine medications typically do), because each pill is equal to a cup of coffee. If you take more than two a day, that's more caffeine than you should have during pregnancy.

Doctors often prescribe Fiorinal for migraines, but that not only has caffeine, it also contains a barbiturate that shouldn't be used in pregnancy.

I'd also steer clear of divalproex sodium (Depakote) since it's been shown to cause neural tube defects, such as spina bifida.

Finally, you'll want to avoid beta-blockers during pregnancy since they can cause reduced blood flow to the placenta and baby. Daily use of beta-blockers can result in intrauterine growth restriction (IUGR).

It's always a good idea to call your doctor before taking any over-the-counter medicine during pregnancy to make sure it's safe for you and your baby.

Read more about managing headaches during pregnancy.

Show sources

Briggs, Gerald. 2014. Drugs in Pregnancy and Lactation. 10th ed. Lippincott Williams & Wilkins.

FDA. 2015. Drug Safety Communication: FDA has reviewed possible risks of pain medicine use during pregnancy. [Accessed January 2016]


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