I'm pregnant and take a med for migraines. Is it safe if only taken rarely?

[Papie098]

I'm only about 5 weeks pregnant. I get severe migraines from an accident (nerve damage) and am allergic to most migraine medications (was hospitalized for nearly having a stroke). After years of trying random meds, the only one that worked is Percocet. Now, I don't take it often--once or twice a month at most--so I am not addicted (I am extremely careful). Online it says Percocet can cause birth defects, but only talks about it in regards to constant everyday use and addicts. I'm not able to see my neurologist for a while in order to ask him, and my OB won't see me until I'm 10 weeks, so I was hoping for an answer sooner. The only other med that SOMETIMES works for my migraines I can't take. Is it okay to still take this on rare occasions?

[specialmom]

Congrats on your baby!  That's so exciting.  In your situation, I would not take the Percocet until you've gotten a green light from your doctor.  They may or may not give it to you.  Some women do use narcotics during pregnancy on a limited basis for pain management but that has to be doctor supervised.  I suffered migraines during my first pregnancy.  I only took acetaminophen which felt like almost nothing, right?  I'm sure you understand.  But that's what I took.  And then I worked to get extra sleep.  I did stretching of the neck and massage of the head and neck.  That helped me to some extent but ya, it was not the best time.  sleep really was my best friend during pregnancy.  

So, get in touch with your doctor and explain the situation and get guidance.  They need to know to chart it and to understand how to best help you.  Let us know what they say!

[Papie098]

That's what I think as well. I just didn't know if others had experience with it. I was a Pharmacy Tech for a number of years, so I know the dangers of narcotics and am extremely careful with how often I take it. My main concern is why I get the migraines. I was 17 when I was thrown from a snowmobile at 50mph. Even though it's been 14 years, I still get severe migraines and back/neck pain from the damage. Because it's mostly nerve damage, most medication can't touch the pain of my migraines. My Chiro helps a ton. I suppose I will have to rely on him a lot more now! And thank you!

[specialmom]

Hey, how are you feeling?  Any progress with the headaches?

[Emily_MHManager]

Percocet is in Category C for affects on the baby.  You probably already know the following, but just in case:

What is Category C?

Category C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

https://www.drugs.com/pregnancy-categories.html

https://www.rxlist.com/percocet-drug.htm#precautions

Teratogenic Effects: Pregnancy Category C

Animal reproductive studies have not been conducted with PERCOCET. It is also not known whether PERCOCET can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. PERCOCET should not be given to a pregnant woman unless in the judgment of the physician, the potential benefits outweigh the possible hazards.
Nonteratogenic Effects

Opioids can cross the placental barrier and have the potential to cause neonatal respiratory depression. Opioid use during pregnancy may result in a physically drug-dependent fetus. After birth, the neonate may suffer severe withdrawal symptoms.



Basically, call your doctor and ask about whether or not the risks outweigh the benefits here. Does your OB know you've nearly had a stroke? (Does that mean you had a blood clot, or...?)

If you're OB won't see you, or even talk to you on the phone, call your neuro. You're allowed to call doctors in between appointments, and this is definitely a time you want to call. Your neuro may want to see you since you're newly pregnant (and congrats!) and may want to monitor you. He/she can probably answer your question.

Congrats again, and let us know what they say. :)

[Papie098]

Thank you! My primary wanted me to consult my Neuro on the Percocet. It's been a long time since I've seen him and I have new insurance so I'm currently waiting on a referral so I can make the appointment. I've never seen an OB (My primary has always done exams and this was a surprise pregnancy!(I was told I can't have kids because of the damage to my spine from the accident, so I want to be sure this miracle baby stays healthy)) I called the OB office, but they won't talk to me or see me for an appointment until I am 10 weeks. The near stroke was due to migraine meds with the active ingredient in the class of Triptans. It was also about a decade ago, so other than saying I can't have that kind of medication, no doctor has ever really looked further into it. I'll respond again when I know more. Thank you!

[Emily_MHManager]

I really hate doctors sometimes lol. This one won't see you because of this rule, and the other won't see you because of that. I'm sorry.

Give a pharmacist a call. It doesn't even have to be your pharmacist - any pharmacist will answer your questions. I use BioFreeze on my neck when I get migraines. It's like IcyHot, but doesn't smell as bad.

https://www.drugs.com/pregnancy/menthol-topical.html

https://www.drugs.com/cdi/biofreeze-menthol-aerosol.html

Ask the pharmacist about it. It works better for me than most migraine meds. I just spray it on the back of my neck. Migraines are awful, and I hope the pharmacist gives you some good info.

[Papie098]

I use both Biofreeze and Cryoderm. Cryoderm is the same thing but stronger. They help distract from the pain, but never make it go away.

A Pharmacist might know better about it. I didn't actually think about that. Thank you!

[Papie098]

Okay so the Pharmacist said for someone who only uses it occasionally, there are risks, but nearly as high as a constant user. Primarily the risk is respiratory depression and is greater the further along in the pregnancy. She said to for sure talk to my Neuro about possible alternatives but that taking it once in a while may be fine so long as the Neuro agrees the benefit outweighs the risk. Also, that to probably avoid taking it closer to the end of pregnancy to avoid respiratory depression around time of delivery because that can be dangerous.

[Papie098]

NOT* nearly as high as a constant user.

[Emily_MHManager]

Oh I'm glad you called. Definitely get in touch with your neuro, which I know isn't always easy.

Cryoderm - I haven't heard of it, but thanks for mentioning it. I'll give it a try. Migraines do suck, don't they?

[Papie098]

If you're interested in the answer, I spoke with my Neuro. He said for migraines in pregnant women, the only two things approved are Tylenol and Opiates like Percocet. Of course, that isn't to say you take Percocet for every migraine (depending on frequency). I only take it once or twice a month, despite having migraines more frequently. He said once or twice a month is still considered safe for the baby.

[specialmom]

Good to know!  I hope the headaches stay under control for you.  I did massage during pregnancy.  That made a huge difference for me.  

[Emily_MHManager]

That's good to know! I hope you have a wonderful pregnancy, and we're here if you need us.