Can a 15-week pregnant woman take one dose of naproxen (nonsteroidal anti-inflammatory drug) for a migraine?

Can a Pregnant Woman at 15 Weeks Take One Dose of Naproxen for Migraine?

No, naproxen should be avoided at 15 weeks of pregnancy—acetaminophen (paracetamol) 1000 mg is the recommended first-line treatment for acute migraine during pregnancy. 1

Why Naproxen Is Not Recommended at 15 Weeks

While you are in the second trimester (15 weeks), the evidence regarding NSAID safety is conflicting and the risk-benefit calculation does not favor naproxen use:

• NSAIDs like naproxen can only be considered during the second trimester as a second-line option, not as first-line therapy 1
• The FDA drug label for naproxen classifies it as Pregnancy Category C, meaning animal studies show potential harm and there are no adequate well-controlled studies in pregnant women 2
• NSAIDs must be absolutely avoided during the third trimester due to risks of premature closure of the ductus arteriosus, persistent pulmonary hypertension in the newborn, renal dysfunction, and oligohydramnios 2, 3
• Even in the second trimester, NSAIDs should only be used episodically and for short periods, not as routine treatment 3, 4

What You Should Use Instead

Acetaminophen (paracetamol) 1000 mg is the safest and most appropriate choice:

• Acetaminophen is the first-line medication for acute migraine treatment during pregnancy with the best safety profile 1, 4
• The recommended dose is 1000 mg, preferably as a suppository for better absorption if nausea is present 4
• It can be repeated as needed while avoiding medication overuse (limit to <15 days per month) 1

If Acetaminophen Fails

If a single dose of acetaminophen is insufficient, consider these pregnancy-safe alternatives before resorting to NSAIDs:

• Metoclopramide 10 mg (oral or IV) can treat both migraine pain and associated nausea, and is safe particularly in the second and third trimesters 1, 3
• Prochlorperazine 25 mg (oral or suppository) can relieve both headache pain and nausea directly 1
• Caffeine combined with acetaminophen may provide additional benefit 5

Critical Timing Considerations

The 15-week timepoint is particularly important:

• You are early in the second trimester, where fetal organogenesis is still completing
• While the absolute contraindication to NSAIDs applies mainly to the third trimester, the second trimester window for NSAID use should be reserved for situations where acetaminophen has definitively failed 1, 4
• A single dose of naproxen in the second trimester carries less risk than third-trimester use, but this does not make it the appropriate first choice 3

Important Caveats

• Never use opioids or butalbital-containing medications for migraine in pregnancy due to dependency risks, rebound headaches, and potential fetal harm 1
• Triptans (like sumatriptan) should only be used sporadically under strict specialist supervision when other treatments fail, as they are not first-line options 1
• Ergotamine derivatives are absolutely contraindicated throughout pregnancy 1

Non-Pharmacological Approaches

Before or alongside any medication, implement these strategies:

• Ensure adequate hydration with regular fluid intake 1
• Maintain regular meals to avoid hypoglycemia as a trigger 1
• Rest in a quiet, dark environment 1
• Apply ice packs to the head or neck 4
• Identify and avoid specific migraine triggers 1