Extensive evidence of its safety in pregnancy

Inexpensive

May be used in combination with other drugs

Maximum of 4 g daily to avoid liver toxicity

Up to 200 mg daily considered safe in pregnancy

Can be used in combination with acetaminophen

Often helpful with headache reduction and alleviates associated nausea

Can cause dystonic reaction

Not used in first trimester due to possible teratogenicity

Safe in second trimester

Use in third trimester should be limited to 48 h or less due to possible premature ductal closure, platelet dysfunction, and oligohydramnios.

Should be used for short duration because dependence can develop in the mother or fetus with high doses over long duration

Can cause constipation and worsen nausea/vomiting associated with migraines

No teratogenic effects associated with opioids

For severe attacks that do not respond to first-line agents

Studies show no association with triptans and birth defects.

Use in third trimester associated with slight increased risk of uterine atony and increased blood loss at delivery

1 or 2 g IV over 15 min

Associated with hypertonic uterine contractions