Migraine with aura

Migraine subtype with focal neurological aura (visual, sensory, speech) preceding or accompanying headache. Associated with increased ischemic stroke risk, particularly when combined with estrogen-containing contraception.

ICD-10 G43.11 drug

Also known as: Classic migraine

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

FEthinylestradiolNot recommended · Estrogens. Natural and semisynthetic estrogens, plainIn women with migraine with aura, combined hormonal contraception with ethinylestradiol is contraindicated (CDC USMEC 2016 category 4) due to increased ischemic stroke risk. Alternatives: progestin-only methods, barrier methods, copper IUD. In migraine without aura, the decision is individualized based on age and other risk factors (USMEC categories 2–3).

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit