Treatment of migraine in pregnancy

(Date: January 2023. Version: 3.0.1)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

Quick read

Migraine often improves in pregnancy. If not, it can be treated with some painkillers and anti-sickness medicines.

What is migraine?

Migraine causes severe headaches often accompanied by nausea and visual disturbance. Migraine is common in women of childbearing age.

How can I treat migraine in pregnancy?

Many women find that migraine becomes less severe in pregnancy, meaning that medicines may not be needed. If migraine continues, some women can manage without medicines, using techniques such as:

• Avoiding triggers for migraine (including stress and certain foods)
• Relaxation and deep breathing techniques
• Getting enough sleep
• Massage
• Use of ice packs

However, this does not work for everyone. If drug treatment in pregnancy is required, there are a number of options to ensure that migraine does not affect quality of life and interfere with daily activities. Medicines to treat migraine should only be used in pregnancy on the advice of a doctor, who will help to weigh up the benefits of treatment against any risks.


Paracetamol is the first-choice treatment for mild-to-moderate pain in pregnancy. It has an excellent overall safety profile. For more information please see the bump leaflet on Paracetamol.

Non-steroidal anti-inflammatory drugs (NSAIDs) might be recommended by a doctor in the first and second trimesters if paracetamol does not control migraine pain. It is very important that NSAIDs are not used after 30 weeks of pregnancy as, at this stage, they may affect the baby. For more information please see the bump leaflets on Ibuprofen, Diclofenac, and Naproxen. PLEASE BE AWARE: The advice about use of NSAIDs in pregnancy has recently changed. It is now recommended that prolonged use of NSAIDs should be avoided after 20 weeks of pregnancy. The advice to avoid any use of NSAIDs after 30 weeks of pregnancy has not changed. For more information, please see the information here. We will be updating this document as soon as possible to include the new advice.

Sumatriptan may be offered if paracetamol has not controlled the pain and an NSAID cannot be used. There is no evidence that use of sumatriptan in pregnancy is harmful to the baby. For more information please see the bump leaflet on Sumatriptan.

Codeine may be offered if other treatments have not worked. While the majority of exposed babies show no long-term effects, some studies have shown that certain birth defects are slightly more common after codeine use in early pregnancy. Codeine use in the weeks leading up to delivery can cause withdrawal symptoms in the baby after birth. For more information, please see the bump leaflet on Codeine.

Drug treatments for nausea and vomiting

Cyclizine, prochlorperazine, or metoclopramide may be offered for nausea and vomiting caused by migraine. These drugs are also used to treat pregnancy sickness and are not known to be harmful to a developing baby. For more information, please see the bump leaflets on Cyclizine, Prochlorperazine, and Metoclopramide.

Over-the-counter migraine treatments

The over-the-counter medicine Migraleve (which contains paracetamol, codeine, and the anti-sickness medicine buclizine) should only be used in pregnancy on advice from a doctor. This is because there is very little pregnancy safety information about buclizine.

Long-term treatments to prevent migraine

Migraine does not always improve in pregnancy and some women may need to keep taking preventative treatment to ensure that they can function well. Sometimes the medicine that was being taken before pregnancy to prevent migraine may need to be changed to an alternative that is safer for the baby.

Sodium valproate and a family of medicines called ACE inhibitors (including captopril, cilazapril, enalapril, fosinopril, imidapril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril) should not be used in pregnancy as they can harm the baby. Women taking these medicines to prevent migraine should urgently arrange to see their doctor, who will offer a safer alternative. For more information, please see the bump leaflets on Sodium valproate and ACE inhibitors.

Topiramate is also avoided in pregnancy as it is linked to a slightly increased risk of cleft lip and palate in the baby and might also affect the baby’s growth in the womb. For more information, please see the bump leaflet on Topiramate.

Gabapentin, venlafaxine, and botulinum toxin are only used in pregnancy to prevent migraine if other medicines have not worked or cannot be used. They are not known to harm the developing baby but more information on their pregnancy safety is ideally required. For more information, please see the bump leaflets on Gabapentin, Venlafaxine, and Botulinum toxin.

Low-dose aspirin, propranolol, amitriptyline, and verapamil can be used in pregnancy to prevent migraine. These drugs are also used to treat a number of other conditions in pregnant women and are not known to harm a developing baby. For more information, please see the bump leaflets on Aspirin, Propranolol, Amitriptyline, and Calcium channel blockers.

Will my baby need extra monitoring?

As part of their routine antenatal care, most women will be offered a very detailed scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

There is no evidence that taking medicines to treat migraine during pregnancy causes any problems that would require extra monitoring of your baby.

Are there any risks to my baby if the father has taken migraine treatments?

We would not expect any increased risk to your baby if the father took migraine treatments before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system allows women with a current or previous pregnancy to create a digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit to register.

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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