CGRP Medications and Pregnancy: What the Research Says

CGRP monoclonal antibodies (Aimovig, Ajovy, Emgality, Vyepti) have been revolutionary for migraine prevention, providing relief to many who suffer from chronic and episodic migraine. However, if you are pregnant or planning to conceive, you may wonder whether it’s safe to continue using these medications. This guide explores current research and recommendations regarding CGRP inhibitors and pregnancy.

What Are CGRP Monoclonal Antibodies?

CGRP (calcitonin gene-related peptide) plays a crucial role in migraine attacks by promoting inflammation and widening blood vessels in the brain. CGRP monoclonal antibodies work by blocking this peptide or its receptor, reducing the frequency and severity of migraine attacks.

Are CGRP Medications Safe During Pregnancy?

The safety of CGRP inhibitors during pregnancy is still being studied, but here’s what we currently know:

• Limited Pregnancy Registry Data: Because CGRP inhibitors are relatively new (approved in 2018–2020), there is limited data on their effects during pregnancy.
• GENESIS Pregnancy Registry: Aimovig has an ongoing pregnancy registry, but conclusive data is not yet available.
• Long Half-Life Considerations: These medications remain in the system for a long time—about 5 to 6 months for complete elimination.

When Should You Stop CGRP Medications Before Pregnancy?

Given the long half-life of CGRP inhibitors, most experts recommend stopping them at least 5 to 6 months before trying to conceive. This ensures the drug is cleared from your system before pregnancy.

Alternative Treatment Options During Pregnancy

If you stop CGRP inhibitors, alternative migraine treatments may help manage your symptoms:

• Gepants (Qulipta, Ubrelvy, Nurtec): These newer medications have shorter half-lives and may be safer alternatives before pregnancy.
• Safe Medications: Acetaminophen (Tylenol), triptans, and an anti-nausea medication (Reglan) are often recommended.
• Supplements: Riboflavin (B2) and magnesium can be used safely for migraine prevention.
• Lifestyle Adjustments: Managing hydration, sleep, and diet can help reduce migraine frequency.

Final Thoughts

If you are considering pregnancy and currently use CGRP inhibitors, discuss your treatment options with your healthcare provider. While research is ongoing, stopping CGRP monoclonal antibodies 5 to 6 months before conception is the most conservative approach.

At Haven Headache, we understand the challenges of managing migraine attacks during pregnancy. Contact us today to develop a personalized treatment plan that ensures both your well-being and your baby’s safety.

Disclaimer: This article is for informational purposes only and does not replace professional medical advice. Always consult your healthcare provider before making changes to your migraine treatment plan.