First line | Second line | Third line |
Analgesic Paracetamol33—recommended to use the lowest effective dose for the shortest time, as it might alter fetal development86 | Triptan if severe (sumatriptan has no documented teratogenicity87)33 36 88 | Opiates—for limited use due to risks including:
|
Antiemetic (short-term use) Cyclizine first line36 (alternatives metoclopramide or prochlorperazine)36 88 91 | Ibuprofen—avoid in third trimester due to risk of premature closure of ductus arteriosus33 | |
Non-pharmacological treatments36 92:
| Greater occipital nerve blocks36 94 |