Can i take excedrin extra strength while pregnant

If you're pregnant and need medication for a headache, acetaminophen (Tylenol) is likely the safest choice. Experts consider it a low-risk medication during pregnancy.

Pregnancy comes with a lot of uncomfortable, or sometimes painful, sensations. Headaches may be one of these sensations. Headaches are experienced in about 35% of pregnancies. For many, headaches can become less frequent or intense during the second and third trimesters of pregnancy.

And while there are many headache medications available, pregnancy limits the choices. It’s important to know what medications are safe to take while pregnant.

In this article, we’ll discuss which headache medications you can and can’t take during pregnancy. We’ll also provide some helpful tips to relieve and manage your headaches.

What headache medications are safe during pregnancy?

There’s generally little information about safe headache medications to take during pregnancy. Still, up to 70% of pregnant women with a migraine condition take medications to find relief. Knowing which headache medications are safe during pregnancy is important. It can help lower the risk of pregnancy complications and health problems for your baby.

Always ask your healthcare provider before taking any medications during pregnancy. If you need medications, take the lowest amount needed to relieve your headache. And take them for the shortest period of time possible.

Acetaminophen (Tylenol)

Acetaminophen (Tylenol) is one of the most commonly used medications during pregnancy. Up to 65% of expectant mothers in the U.S. use this pain reliever. 

Some studies, however, suggest that taking acetaminophen during pregnancy may affect the growth and development of the unborn baby. These studies mostly suggest links between acetaminophen use during pregnancy and children more likely to be on the autism spectrum or to show signs of attention deficit-hyperactivity disorder (ADHD).

However, many of these studies have conflicting findings or are of low quality. Some were only conducted on animals (not humans). So we need more research to say for sure whether acetaminophen is safe in pregnancy.

A larger study comparing acetaminophen to nonsteroidal anti-inflammatory drugs (NSAIDs) is more reassuring. It showed acetaminophen is linked to fewer birth defects than NSAIDs. We’ll discuss NSAIDs more below.

This conflicting information can be confusing. Still, the American College of Obstetricians and Gynecologists (ACOG) recommends acetaminophen. They consider it a low-risk medication for treating pain during pregnancy. But they emphasize that medications should only be used when needed. It’s best to take as little as possible and only after speaking with a healthcare provider.

What headache medications are not safe during pregnancy?

There are several headache medications that aren’t safe during pregnancy. Some medications have risks of birth defects, miscarriage, and preterm birth. Preterm birth means giving birth earlier than 37 weeks of pregnancy. More research is needed for other headache medications to say whether they’re safe.

Here are some headache medications to discuss with your provider during pregnancy, or to avoid altogether.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are often used to relieve headache pain. These include over-the-counter (OTC) medications, such as ibuprofen (Advil), naproxen (Aleve), and aspirin. There are also prescription NSAIDs, like celecoxib (Celebrex).

The FDA recommends avoiding NSAIDs at 20 weeks of pregnancy or later. NSAIDs raise the risk of serious kidney problems in unborn babies. These medications can also cause low levels of amniotic fluid. Taking NSAIDs after 30 weeks of pregnancy raises the risk of heart issues in unborn babies.

It’s less clear if it’s safe to take these medications before hitting 20 weeks in your pregnancy. There’s some evidence that NSAID use in early pregnancy might lead to miscarriage. So some healthcare providers recommend avoiding NSAIDs during all stages of pregnancy.

Triptans

According to the American Academy of Family Physicians, sumatriptan (Imitrex) can be used for severe headaches during pregnancy. But you should only try sumatriptan after careful discussion with your healthcare provider.

Sumatriptan belongs to the triptan class of medications. It’s the most well-studied triptan in pregnancy. But there’s mixed information about how safe it is during pregnancy.

Studies of sumatriptan or rizatriptan (Maxalt) use during pregnancy showed reports of miscarriage. They also reported preterm births and infants with low birth weights. Other reports found that sumatriptan use in the third trimester caused umbilical cord problems. On the other hand, further studies didn’t show that triptans raised the risk of major birth defects.

These mixed results make it hard to say whether triptans are safe during pregnancy. It's best to discuss these risks with your healthcare provider first.

Ergot derivatives

Ergot derivatives, like dihydroergotamine (Migranal), are older migraine medications. They’re less commonly used today. These medications aren’t safe. And, you should avoid them at all stages of pregnancy.

Ergot derivatives relieve headaches by tightening blood vessels of the brain. But they also tighten blood vessels in the uterus. This could lower blood flow to an unborn baby, and subsequently lead to birth defects and low birth weight infants.

Ergot derivatives can also cause contractions. This can lead to preterm birth.

Other headache medications

Over the years, newer headache medications have become available. Examples include Ubrelvy (ubrogepant) and Nurtec ODT (rimegepant). These medications are relatively new. So there’s not enough information yet about their safety during pregnancy. Currently, it’s recommended to avoid taking these medications if you’re pregnant.

Caffeine-containing medications 

It might be wise to avoid medications that contain caffeine. An example of this kind of medication would be Excedrin Tension Headache (acetaminophen/caffeine). Avoiding these products helps limit the amount of caffeine you consume each day. 

ACOG has found that consuming less than 200 mg of caffeine a day is likely safe. This amount doesn’t seem to raise the risk of miscarriage or preterm birth. Drinking one 12-oz cup of coffee or less per day will keep you within this limit.

But other studies suggest otherwise. These studies found that even smaller amounts of caffeine during pregnancy may raise the risk of complications. This included miscarriages, stillbirths, and low birth weights.

Butalbital-containing medications

During pregnancy, don’t take any headache medications that contain butalbital. Examples include Bupap (butalbital/acetaminophen) and Fioricet (butalbital/acetaminophen/caffeine).

Butalbital is a barbiturate that helps you relax and lowers anxiety. It can pass through the placenta and affect your unborn baby. Studies suggest that butalbital use during pregnancy is linked to certain heart defects.

Butalbital can also be habit-forming if used long term. This can cause your unborn baby to become dependent on the medication. Once born, your baby may show signs of neonatal abstinence syndrome (NAS).

Signs of NAS include seizures, high-pitched crying, and poor feeding. If not treated, NAS can lead to long-term health problems.

What are other things I can do to treat a headache while I’m pregnant?

It’s recommended to take as little medication as possible during pregnancy. It’s suggested to try other methods to relieve headache pain first.

Certain lifestyle changes and alternative therapies can help ease headache symptoms. Below are some tips and non-medication options to relieve headache pain:

• Take a quick nap and remember to get enough good-quality sleep.

• Find a dark, quiet room with few distractions.

• Place hot or cold packs on your neck, head, or stomach to soothe pain.

• Massage your head or temples for temporary relief.

• Exercise for 30 to 60 minutes, 3 to 5 days a week.

• Eat regular, healthy meals and drink plenty of fluids to stay hydrated.

• Find stress-relieving activities to do, like breathing exercises and yoga.

• Try acupressure or acupuncture.

• Consider trying cognitive behavioral therapy (CBT).

The bottom line

Currently, acetaminophen is the safest choice for a headache during pregnancy. Other medications might cause harm to your baby. But it’s recommended to try medication-free remedies to help with headache pain first.

If you’re pregnant and have a headache, talk to your healthcare provider or pharmacist. They can help you decide which medications are safe to take. If you do need medication, it’s best to take the lowest dose for the shortest time possible.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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Can I take pain reliever extra strength while pregnant?

What can I take for headaches while pregnant?