Can I take sumatriptan while pregnant or breastfeeding?

8.1 Pregnancy Risk Summary Data from a prospective pregnancy exposure registry and epidemiological studies of pregnant women have not detected an increased frequency of birth defects or a consistent pattern of birth defects among women exposed to sumatriptan compared with the general population (see Data) . In developmental toxicity studies in rats and rabbits, oral administration of sumatriptan to pregnant animals was associated with embryolethality, fetal abnormalities, and pup mortality. When administered by the intravenous route to pregnant rabbits, sumatriptan was embryolethal (see Data) . In the U.S. general population, the estimated background risk of major birth defects and of miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

Prescribing label, section “8.1 Pregnancy” (opening excerpt): Sumatriptan (oral), Preferred Pharmaceuticals, Inc. Read the full section on DailyMed. Quoted verbatim; US labels are written for US prescribers and patients.

Because of the low levels of sumatriptan in breastmilk, amounts ingested by the infant are small. It also has poor oral bioavailability, further decreasing infant exposure to the drug. Some authors have suggested that withholding breastfeeding for 8 hours after a single subcutaneous injection would virtually eliminate infant exposure to the drug.[1] The manufacturer recommends withholding breastfeeding for 12 hours after a dose. Withholding breastfeeding might be helpful in extreme cases, such as in the mother of a preterm infant, but sumatriptan would not be expected to cause any adverse effects in most breastfed infants and has been recommended as a triptan of choice in breastfeeding.[1] Painful, burning nipples and breast pain have been reported after doses of sumatriptan and other triptans. This has occasionally been accompanied by a decrease in milk production.

“Summary of Use during Lactation”, LactMed record “Sumatriptan” (LM387), quoted verbatim. Everything LactMed reports about Sumatriptan while breastfeeding.

8.2 Lactation Risk Summary Sumatriptan is excreted in human milk following subcutaneous administration. There is no information regarding sumatriptan concentrations in milk from lactating women following administration of sumatriptan tablets. There are no data on the effects of sumatriptan on the breastfed infant or the effects of sumatriptan on milk production. Use of sumatriptan may be associated with transient breast pain [see Adverse Reactions (6.2) ]. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for sumatriptan tablets and any potential adverse effects on the breastfed infant from sumatriptan or from the underlying maternal condition. Clinical Considerations Infant exposure to sumatriptan can be minimized by avoiding breastfeeding for 12 hours after treatment with sumatriptan tablets.

Prescribing label, section “8.2 Lactation”: Sumatriptan (oral), Preferred Pharmaceuticals, Inc. Label on DailyMed. Quoted verbatim; US labels are written for US prescribers and patients.