How safe are beta-blockers for treating headaches during pregnancy?

Among headache preventive medications, beta-blockers have the best track record for a combination of effectiveness and safety in pregnant women. Propranolol (Inderal) is considered the best first-choice prevention drug during pregnancy for most women. Even though it is considered relatively safe, some problems have been noticed with women using blood pressure medications during pregnancy.

Beta-blockers, such as propranolol, can increase the baby's risk of having low blood sugar, slow heart rate, low blood pressure, or slowed breathing at birth. Ideally, beta-blockers should be tapered within the last few weeks of pregnancy (starting around week 36) to minimize effects on labor and the newborn baby. Early use of another beta-blocking medication, atenolol (Tenormin) at conception or during the first trimester has been linked to low birth weight.

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