Search tips
Search criteria 


Logo of headpainSpringerOpen.comSubmit OnlineRegisterThis journalThis article
J Headache Pain. 2010 April; 11(2): 167–169.
Published online 2010 January 9. doi:  10.1007/s10194-009-0182-7
PMCID: PMC3452282

Angiotensin II receptor antagonists against migraine in pregnancy: fatal outcome


A pregnant young woman with a severe migraine is prescribed candesartan, an angiotensin II type 1 receptor antagonist (AT II antagonists). This has a positive effect—except for severe maldevelopment of her fetus. There is an increase in the use of the fetotoxic drugs, AT II antagonists and angiotensin-converting enzyme inhibitors, as prophylactic treatment of migraines, in addition to their use as hypertensives.

Keywords: Migraine, Pregnancy, Fetotoxic medication, Angiotensin II receptor antagonist, Angiotensin-converting enzyme inhibitor, Hypertension

Full Text

The Full Text of this article is available as a PDF (101K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
1. Kato K, Okuda M, Ishikawa H, Takahashi T, Hirahara F. Oligohydramnios and pulmonary hypoplasia: a case in which involvement of an angiotensin II receptor antagonist was suspected. J Obstet Gynaecol Res. 2008;34(2):242–246. doi: 10.1111/j.1447-0756.2008.00762.x. [PubMed] [Cross Ref]
2. Serreau R, Luton D, Macher MA, Delezoide AL, Garel C, Jacqz-Aigrain E. Developmental toxicity of the angiotensin II type 1 receptor antagonists during human pregnancy: a report of ten cases. BJOG. 2005;112(6):710–712. doi: 10.1111/j.1471-0528.2004.00525.x. [PubMed] [Cross Ref]
3. Regional medicines information centres. Norwegian database of adverse effects
4. Ramadan NM. Current trends in migraine prophylaxis. Headache. 2007;47(Suppl 1):S52–S57. doi: 10.1111/j.1526-4610.2007.00677.x. [PubMed] [Cross Ref]
5. Lacoste M, Cai Y, Guicharnaud L, et al. Renal tubular dysgenesis, a not uncommon autosomal recessive disorder leading to oligohydramnios: role of the renin–angiotensin system. J Am Soc Nephrol. 2006;17(8):2253–2263. doi: 10.1681/ASN.2005121303. [PubMed] [Cross Ref]
6. Norwegian Medicines Agency. Summary of product characteristics (SPC), Atacand
7. Tronvik E, Stovner LJ, Helde G, Sand T, Bovim G. Prophylactic treatment of migraine with an angiotensin II receptor blocker: a randomized controlled trial. JAMA. 2003;289(1):65–69. doi: 10.1001/jama.289.1.65. [PubMed] [Cross Ref]
8. Schrader H, Stovner LJ, Helde G, Sand T, Bovim G. Prophylactic treatment of migraine with angiotensin converting enzyme inhibitor (lisinopril): randomised, placebo controlled, crossover study. BMJ. 2001;322(7277):19–22. doi: 10.1136/bmj.322.7277.19. [PubMed] [Cross Ref]
9. Etminan M, Levine MA, Tomlinson G, Rochon PA. Efficacy of angiotensin II receptor antagonists in preventing headache: a systematic overview and meta-analysis. Am J Med. 2002;112(8):642–646. doi: 10.1016/S0002-9343(02)01100-2. [PubMed] [Cross Ref]
10. Bender WI. ACE inhibitors for prophylaxis of migraine headaches. Headache. 1995;35(8):470–471. doi: 10.1111/j.1526-4610.1995.hed3508470.x. [PubMed] [Cross Ref]
11. Owada K. Efficacy of candesartan in the treatment of migraine in hypertensive patients. Hypertens Res. 2004;27(6):441–446. doi: 10.1291/hypres.27.441. [PubMed] [Cross Ref]
12. Silberstein SD. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2000;55(6):754–762. [PubMed]
13. Evers S, Afra J, Frese A, et al. EFNS guideline on the drug treatment of migraine—report of an EFNS task force. Eur J Neurol. 2006;13(6):560–572. doi: 10.1111/j.1468-1331.2006.01411.x. [PubMed] [Cross Ref]
14. Modi S, Lowder DM. Medications for migraine prophylaxis. Am Fam Phys. 2006;73(1):72–78.
15. Stark RJ, Stark CD. Migraine prophylaxis. Med J Aust. 2008;189(5):283–288. [PubMed]
16. Sanchez SI, Seltzer AM, Fuentes LB, Forneris ML, Ciuffo GM. Inhibition of Angiotensin II receptors during pregnancy induces malformations in developing rat kidney. Eur J Pharmacol. 2008;588(1):114–123. doi: 10.1016/j.ejphar.2008.04.014. [PubMed] [Cross Ref]
17. Guron G, Sundelien B, Wickman A, Friberg P. Angiotensin-converting enzyme inhibition in piglets induces persistent renal abnormalities. Clin Exp Pharmacol Physio. 1988;25(2):88–91. doi: 10.1111/j.1440-1681.1998.tb02182.x. [Cross Ref]

Articles from The Journal of Headache and Pain are provided here courtesy of Springer