Abstract
Purpose
Breastfeeding women may suffer from migraine. While we have many drugs for its treatment and prophylaxis, the majority are poorly studied in breastfeeding women. We conducted a review of the most common anti-migraine drugs (AMDs) and we determined their lactation risk.
Methods
For each AMD, we collected all retrievable data from Hale’s Medications and Mother Milk (2012), from the LactMed database (2014) of the National Library of Medicine, and from a MedLine Search of relevant studies published in the last 10 years.
Results
According to our review, AMDs safe during breastfeeding are as follows: low-dose acetylsalicylic acid (ASA), ibuprofen, sumatriptan, metoprolol, propranolol, verapamil, amitriptyline, escitalopram, paroxetine, sertraline, acetaminophen, caffeine, and metoclopramide. AMDs compatible with breastfeeding but warranting caution are as follows: diclofenac, ketoprofen, naproxen, most new triptans, topiramate, valproate, venlafaxine, and cyproheptadine. Finally, high-dose ASA, atenolol, nadolol, cinnarizine, flunarizine, ergotamine, methysergide, and pizotifen are contraindicated.
Conclusions
According to our review, the majority of the revised AMDs were assessed to be compatible with breastfeeding.
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Acknowledgments
We thank Prof Thomas Hale, Texas Tech University, School of Medicine, Amarillo, Texas, for helpful advice.
Conflict of interest
This study was performed without any funding or grants. All authors declare that they have no competing interest and do not have any financial relationships with any biotechnology and/or pharmaceutical manufacturers.
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RD: conception and design. All authors: collection, assembly and analysis and interpretation of the data. GP, GF, and RD: drafting of the article. RD and JB: critical revision of the article for important intellectual content. All authors listed here have seen and approved the final version of the report.
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Davanzo, R., Bua, J., Paloni, G. et al. Breastfeeding and migraine drugs. Eur J Clin Pharmacol 70, 1313–1324 (2014). https://doi.org/10.1007/s00228-014-1748-0
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DOI: https://doi.org/10.1007/s00228-014-1748-0