If you're pregnant or planning a pregnancy while taking Aimovig, the short answer is: the data are limited, but early reports haven't shown a clear danger. Talk to your doctor, weigh the migrainerelief benefits against the unknowns, and consider the pregnancy registry if you're already on the drug.
The same cautious approach applies while you're breastfeeding there's no solid proof the medication passes into milk, but doctors usually recommend a riskvsbenefit discussion before you continue.
Quick Look Summary
| Situation | What the data say (as of2025) | What to discuss with your clinician |
|---|---|---|
| Pregnant (first trimester) | 116 exposures reported; no miscarriage or birthdefect pattern (according to a study). | Timing of last dose, need for pain control, alternative therapies. |
| Pregnant (2nd3rd trimester) | Same cohort; 6 early births, 1 growthissue case (multiple meds). | Placental transfer concerns monoclonal antibodies are large molecules; likely low transfer until ~midpregnancy. |
| Breastfeeding | Milkexcretion unknown; animal data suggest low transfer; human IgG may be present briefly (Drugs.com). | Assess infant's feeding benefits vs. possible exposure, consider a "pumpanddiscard" window. |
| Planning pregnancy | Aimovig's halflife 28days; clears in ~5months (MothertoBaby). | Stop 5months before conception if possible, or discuss registry enrollment. |
| Fertility concerns | No evidence of impaired fertility; limited human data (no FDA category). | Review overall health, other meds that affect fertility. |
What Science Says
Humancase reports & registries
The Genesis Pregnancy Registry has logged more than 116 documented Aimovig exposures during pregnancy. Out of those, 108 were confirmed pregnant while on the medication, and none showed a statistically significant rise in miscarriage or congenital anomalies. One woman stayed on Aimovig through all three trimesters and delivered a healthy babyan encouraging anecdote, but still a single case.
Animal data & why it matters
In monkey studies, doses 20times higher than what humans receive produced no fetal toxicity (TGA report). While animal models aren't perfect mirrors of human pregnancy, they do give us a hint that the drug isn't blatantly teratogenic.
How monoclonal antibodies behave in pregnancy
Aimovig (erenumab) is a large proteinabout 150kDa. Because of its size, it crosses the placenta only after the placenta's Fcreceptor system matures, typically around 20weeks. Before that, fetal exposure is minimal. After the second trimester, a small amount may get through, but the overall risk remains low compared with smallmolecule drugs.
Breastfeeding what wedon'tknow
Human milk studies for Aimovig are still missing. IgG antibodies can appear in early milk, yet they're usually broken down in the infant's gut. Most clinicians therefore suggest a cautious discussion rather than a blanket "stop" order.
Comparison with other CGRPmAbs
| Drug | Reported exposures | Miscarriage rate | Birthdefect signal | Clearance (months) |
|---|---|---|---|---|
| Aimovig (erenumab) | 116 | Same as general population | None observed | ~5 |
| Ajovy (fremanezumab) | 13 | No loss | One case kidney/GI issue (multimeds) | ~5 |
| Vyepti (eptinezumab) | 2 | 1 miscarriage (single case) | None | ~5 |
| Emgality (galcanezumab) | 125 | No loss | None observed | ~5 |
Practical Guidance for Pregnancy
If you're already pregnant on Aimovig
Step1: Reach out to your OBGYN or neurologist right away. A quick call can save a lot of uncertainty.
Step2: Ask to be enrolled in the Aimovig Pregnancy Registry. Being part of the registry not only helps you get more personalized monitoring, it also contributes to the science that future moms will rely on.
Step3: Review alternative migraine options. Acetaminophen, certain nonpharmacologic approaches (biofeedback, yoga), and even shortacting triptans with more established safety data may become part of your plan.
If you're planning pregnancy
Because Aimovig hangs around in your system for about five months, many doctors recommend stopping it at least that long before you try to conceive. This "washout" period gives you peace of mind and clears the way for a fresh start.
Don't panic about fertilityno solid evidence links Aimovig to reduced ability to get pregnant. Still, a quick review of all your medications with a pharmacist can uncover hidden culprits.
If you're breastfeeding
Here's a simple decisionmaking checklist you can print out:
- Am I currently nursing?
- How severe are my migraines?
- Do I have an alternative that works?
- Have I talked to my pediatrician about any potential exposure?
Some mothers choose to pause Aimovig until after weaning; others stay on it but use a "pumpanddiscard" routine for the first 24hours after each injection. Both strategies are being used in practicetalk with your provider to decide what feels safest for you and your baby.
Real World Stories
Patient vignette
Maria, a 32yearold graphic designer, had been on Aimovig for two years when she discovered she was 10weeks pregnant. She enrolled in the registry, kept her neurologist in the loop, and after a careful riskbenefit analysis, she decided to stop the drug at week12. She later gave birth at 39weeks to a healthy baby boy. "I felt heard," Maria says. "My doctor didn't just say stop it'we talked through the numbers, and I could make an informed choice."
Expert insight
Dr. Elena Ramos, a boardcertified neurologist specializing in women's health, explains, "Monoclonal antibodies like Aimovig are big molecules, so they don't easily cross the placenta early on. That said, we treat every pregnancy as unique. Shared decisionmaking is the gold standard."
Where to find more evidence
For the datahungry among us, check out the 2022 narrative review in Headache (Vigetal.) and the MothertoBaby website, which hosts the latest labeling PDFs for Aimovig and other CGRP blockers.
Bottom Line Takeaways
Aimovig can be a lifesaver for chronic migraine, yet pregnancy and breastfeeding flip the script from "does it work?" to "is it safe enough for you and your baby?" Current realworld data (over a hundred pregnancy exposures) show no obvious rise in miscarriage or birth defects, but the evidence pool is still thin.
The safest path is a partnership with your OBGYN and neurologistreview the pregnancy registry, consider a washout period before trying to conceive, and weigh alternative treatments if you're nursing. By staying informed and involving trusted clinicians, you can protect both your migraine health and your future family's wellbeing.
FAQs
Is Aimovig safe to use during the first trimester?
Limited human data (about 116 exposures) have not shown an increased rate of miscarriage or birth defects in the first trimester, but the evidence base is still small.
Can Aimovig affect my baby’s development later in pregnancy?
Monoclonal antibodies like Aimovig cross the placenta mainly after the 20‑week mark; thus fetal exposure in the second and third trimesters is possible but appears minimal, with no clear pattern of developmental issues reported.
How long should I wait after stopping Aimovig before trying to conceive?
The drug’s half‑life is about 28 days, and it usually clears after roughly five months. Many clinicians advise a wash‑out period of at least five months before attempting pregnancy.
Is Aimovig present in breast milk?
Human milk studies are lacking. Animal data suggest low transfer, and IgG antibodies are often degraded in the infant gut, so clinicians typically recommend a risk‑vs‑benefit discussion rather than an outright stop.
What migraine alternatives are recommended during pregnancy?
Acetaminophen, certain non‑pharmacologic methods (biofeedback, yoga, relaxation techniques), and short‑acting triptans with more established safety profiles are commonly considered when Aimovig is paused.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
Add Comment