Can sumatriptan be used during pregnancy?/nA woman pregnant in week 12 has occasional migraine. She

Fråga: Can sumatriptan be used during pregnancy? A woman pregnant in week 12 has occasional migraine. She does not tolerate aspirin or non-steroidal antiinflammatory drugs. Can she use sumatriptan?

Sammanfattning: "Sumatriptan and other ""triptans"" cannot be recommended during pregnancy, as the documention concerning its possible teratogenicity is still limited. There is, however, no data so far indicating teratogenic properties of sumatriptan."

Svar: The use of sumatriptan cannot be recommended during pregnancy, as the documention concerning its possible teratogenicity is still limited. There is one published study, where a total of 96 pregnant women who were exposed to sumatriptan during the first trimester were followed up prospectively. No increase in the incidence of birth defects was seen. The incidence of miscarriage (11.5 percent) tended to be higher in the sumatriptan group, compared to a disease-matched control group (6.3 percent) and a control group without migraine (4.2 percent). The difference did not reach statistical significance and the incidence of miscarriage in a general population is about 10-15 percent (1). Thus, although the patient has passed the first trimester when the risk of teratogenic effects is largest, available data do not provide convincing evidence against an increased risk of miscarriage. It should also be noted that ergot alkaloids are contraindicated during pregnancy.

In a recently published review, acetaminophen 1000 mg is still considered the safest drug to use for the treatment of migraine during pregnancy (2).