Migraine medications

[gam]

Hi,

I'm a breastfeeding mom of a 4mth old and suffer from migraine headaches, particularly menstrual migraines (yes, I started my period almost immediately after birth). I am wondering what the research suggests about use of sumatriptan (Imitrex) and the effects on baby through the mother's milk. I have thus far been relying on NSAIDS (Naproxyn, Ibuprofen) assuming those were okay. But, I would like to hear any information on the negative effects of those as well. Any other suggestions would be appreciated.

Thanks for any help!

[jewels_c411]

I too would love to know about this. After the birth of my son, I have developed terrible migraines accompanied by nausea, I'm assuming hormonal. I am breastfeeding my 8 month old son and am suffering. I have been alternating Tylenol and Advil, but with not much relief. I was wondering about the safety of Imitex and if it is necessary to pump and dump with this medication. My son only eats about every 5 hours at this point.

Thank you!

[mmilla]

Dear gam and jewels,
Sumatriptan (Imitrex) is probably safe to use while breastfeeding.
Although the drug does enter milk, the amount absorbed by the infant's
gut would be quite small. Also, it has a short half-life (this is the
amount of time it takes for half of the drug to be eliminated from your
circulation) of 2 hours. My advice is to take the medication after you
breastfeed and wait 2 hours to nurse. This would minimze exposure.
Potential adverse effects to watch for are dizziness and flushing. NSAIDS
such as Ibuprofen are the preferred analgesic to use while breastfeeding
and are probably safe as well. Hope this is helpful.
Maria Milla, MD
InfantRisk Center

[gam]

Thank you Dr. Milla. This is very helpful and I appreciate the service you and this forum provide.

[mommy78]

I too suffer from debilitating Migraines. I have a 5mth that I love breastfeeding I also have a 6 & 4yr old. The headaches have become more frequent and I am unable to control the pain. I have taken tylenol, ibuprofen, lorcet plus all to no avail! I was wondering if you had any suggestions about migraine medications. I have been told about topomax but I am alarmed when seeing the side effects especially since I seem to be struggling with depression right now. I have not spoken with my physician about the depression but upon your suggestion of meds I will do so. Thank you!

[mmilla]

Dear Mommy78,
Topamax does transfer into milk, however studies have not shown it to cause any major adverse effects in the breastfed infant. If taking this medication while breastfeeding you need to closely monitor the infant for sedation. Another drug you might want to talk to your doctor about is Imitrex (Sumatriptan Succinate). Although it does transfer into milk, the amount that would be absorbed by the infant is quite small. Hope this is helpful.
Maria Milla,MD
InfantRisk Center

[mommy78]

Thank you so very much Dr. Milla. So grateful my lactation specialist Kelli turned me in your direction!

[Careya]

Hi, Pls could you advise on preventative meds for migraine, my Dr has suggested propanalol a beta blocker but the evidence I can find advises against nursing ...... I had a migraine when I met my Dr and forgot to mention I am nursing my 26mnth old. I go back in 1 week.
I am currently taking naproxen and getting between 2 - 5 migraines a week!
I am in the UK so I am not sure of the drug name in USA.
Many thx
Careya

[admin]

Careya:

There are few good choices for the chronic therapy of migraine during pregnancy. Metoprolol is a beta blocker that has show minimal teratology in pregnant women. The tricyclic antidepressant Amitriptyline is another drug that seems to be quite safe during pregnancy. I would most certainly NOT use valproic acid at all, not the triptans such as sumatriptan or other members of this family. Naproxen is unlikely to help much at all either and should NOT be taken during the last trimester of pregnancy.

Confer with your physician about amitriptyline at bedtime, or perhaps metoprolol.

Sorry I don't have a better choice for you.

Tom Hale Ph.D.
Professor

[623mommy]

Is Zomig also safe while breastfeeding? If not, I will get an Imitrex RX.