What is the preferred triptan for the treatment of migraine in breastfeeding mothers?

· West Midlands Medicines Information Service
  • There is limited data about the safety of triptans in breastfeeding.
  • Sumatriptan is the drug of choice from this class as there are more data available. It is transferred into breast milk but with a short half life and low oral bioavailability, infant exposure and the risks of adverse effects are expected to be low.
  • Almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan and zolmitriptan should be used with more caution since data is lacking.
  • Adverse effects in breastfed infants would not be expected with triptans, especially considering their short term use. If the mother or clinicians wish to be more cautious a post dose wash out period of 8 hours after sumatriptan or 24 hours after other triptans could be observed before the mother resumes breastfeeding. However this is usually considered to be over-cautious.