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Key takeaways
There is very limited research on the safety of Aimovig during pregnancy and lactation.
Because of limited data, most healthcare providers don’t recommend that people use Aimovig during pregnancy.
Alternatives to Aimovig include pregnancy-safe pain relievers, lifestyle modifications, and magnesium supplements.
Aimovig is the brand name for Erenumab, a drug that’s approved by the Food and Drug Administration (FDA) as a preventive migraine treatment in adults. The drug is administered once a month as an injection. Aimovig is in a class of drugs called calcitonin gene-related peptide (CGRP) antagonists. CGRP antagonists work by inhibiting calcitonin gene-related peptides, which are partially responsible for causing migraine headaches.
About 15%–20% of pregnant women experience migraine headaches, which can be debilitating at times. If you have taken Aimovig previously for migraine, you might be wondering: Can you take Aimovig while pregnant? Unfortunately, there isn’t robust data about its safety during pregnancy, leading most healthcare professionals to recommend that pregnant people do not take it or only take it when absolutely necessary.
Here, we’ll look at the ins and outs of Aimovig and pregnancy, including what the research says, what doctors recommend, and how you can safely and effectively manage migraine headaches during pregnancy.
Can you take Aimovig while pregnant?
When it comes to Aimovig and pregnancy, there are more questions than answers.
There simply isn’t enough data on Aimovig’s safety during pregnancy, says Andrew Youssouf, MD, double board-certified in addiction medicine and emergency medicine and medical director of Ikon Recovery. According to Aimovig’s manufacturer, Amgen Inc., animal studies of primates (monkeys) showed no harm to offspring when given Aimovig, but it’s hard to know if this data applies to humans. Additionally, the FDA hasn’t assigned Aimovig a specific pregnancy category, which indicates that its safety is not clear.
“Because there isn’t much information about Aimovig’s safety during pregnancy and breastfeeding, it’s not usually recommended unless it’s absolutely needed,” Dr. Youssouf says. “It’s important to talk to your healthcare provider about other options for managing migraine while also keeping the risks to your baby as low as possible.”
Noah Rosen, MD, a neurologist with Northwell Health in Great Neck, New York, shares similar sentiments. “We do not know the safety of Aimovig during pregnancy, nor do we know the safety of any of the CGRP antagonists during pregnancy,” he explains. “The reports that have come in are sporadic, do not assess people and children longitudinally, and are not adequate.”
Without satisfactory clinical studies, Dr. Rosen says that it’s not possible to create an adequate risk versus benefit analysis of Aimovig. “I do not recommend it to people and point them toward other more validated treatments,” Dr. Rosen shares.
Eboni January, MD, OB-GYN and a fellow of the American College of Obstetricians and Gynecologists (FACOG), has empathy for migraineurs during pregnancy. “Managing migraine during pregnancy and breastfeeding can be really tough,” she says. However, because of the lack of research on Aimovig and pregnancy, she only considers prescribing it to her patients in situations where the relief it would offer significantly outweighs any potential risks.
“This decision is always made together with my patients, ensuring they fully understand the potential benefits and risks,” Dr. January says.
What are the risks of taking Aimovig while pregnant?
It’s hard to understand the risks of a drug without robust research performed on humans. The primary issue with Aimovig is that there aren’t robust clinical studies about its risks during pregnancy, Dr. January says. “It’s unclear whether it crosses the placenta and what side effects it might have on the developing baby,” she notes. “Given these unknowns, I always prioritize the safety of both the mother and the baby and often opt for treatments that have a more established safety profile.”
RELATED: Aimovig side effects and how to avoid them
“Concerns about the risks of Aimovig are theoretical at this point, but there may be reasons to be concerned since it’s still unknown if Aimovig would cross the placenta or harm the baby,” Dr. Youssouf says. “Animal studies suggest it doesn’t, but human studies are lacking,” he shares. “Because of its role in affecting blood flow, there’s theoretical concern it might influence fetal development, but no definitive evidence exists yet.”
Can you take Aimovig while breastfeeding?
Similar unknowns exist when it comes to breastfeeding and Aimovig. As the FDA notes, there is no data on whether or not Aimovig gets into breast milk, how the drug might affect the nursing baby, and whether taking the drug could impact milk production.
According to the Drugs and Lactation Database, Aimovig is a large molecule, which means that it’s not likely that significant amounts of it would get into breast milk. Additionally, it’s likely that the baby’s digestive tract would at least partially destroy it and that its absorption into the baby’s body would be negligible. But this is all theoretical.
Only two babies whose mothers have taken Aimovig have been observed. While these babies didn’t have known adverse effects, this is too small a data pool to make any recommendations about whether or not it’s safe to breastfeed while taking Aimovig.
“When it comes to breastfeeding, we don’t have enough information to say whether Aimovig passes into breast milk or what impact it might have on a nursing infant,” Dr. January summarizes. “Because of these uncertainties, I usually recommend against using Aimovig during lactation unless it’s absolutely necessary and the benefits to the mother clearly outweigh the potential risks to the baby.”
What can I take instead of Aimovig during pregnancy?
It’s unlikely that you will be prescribed Aimovig during pregnancy. But that doesn’t mean you should suffer through your migraine attacks. Dr. January suggests the following alternatives for preventing and treating migraine while pregnant:
- Implement lifestyle changes such as staying well-hydrated, keeping a regular sleep schedule, and avoiding your personal migraine triggers.
- Consider taking over-the-counter Tylenol (acetaminophen) for pain, as this is generally safe during pregnancy.
- Consider taking magnesium supplements, which are both safe and effective for preventing migraine attacks during pregnancy.
- Try nonpharmacological treatments like biofeedback, cognitive behavioral therapy, acupuncture, and physical therapy for pain relief without medication.
- Ask your healthcare provider about beta blockers like propranolol, which can be used safely to prevent migraine during pregnancy.
- If you get nausea during migraines, consider taking antiemetics (anti-nausea and vomiting medication) like metoclopramide, which is generally considered safe during pregnancy.
Dr. January encourages pregnant patients not to give up on migraine treatments and to be upfront with their healthcare provider to find the right migraine treatment. “Finding the right balance between effective migraine relief and the safety of both mother and baby is so important,” she stresses.
RELATED: Aimovig alternatives: What can I take instead of Aimovig?
While Aimovig is usually not an option during pregnancy, seeking medical advice and exploring all options with a healthcare provider can make a huge difference, ensuring that you will be more comfortable during your pregnancy.
Sources
- FDA approves novel preventive treatment for migraine, Food and Drug Administration (2018)
- Migraine headaches during pregnancy, Children’s Hospital of Philadelphia
- AIMOVIG® (erenumab-aooe) injection, for subcutaneous use, Amgen Inc. (2021)
- Erenumab, Drugs and Lactation Database, LactMed (2023)
