Which of the following headache treatment options has Black Box Warnings for cardiovascular risk and for gastrointestinal bleeding risk?

A. ergotamine tartrate: Ergotamine is an older antimigraine agent that causes vasoconstriction of cranial blood vessels. It carries risks such as peripheral ischemia and contraindications in cardiovascular disease, but it does not have a formal FDA Black Box Warning for combined cardiovascular and gastrointestinal bleeding risks. B. acetaminophen, aspirin, caffeine: This combination is commonly used for mild to moderate headaches. Acetaminophen does not carry cardiovascular or GI bleeding Black Box Warnings, while aspirin poses some risk for gastrointestinal bleeding but not formal Black Box Warnings in standard OTC doses. C. sumatriptan: Sumatriptan is a selective 5-HT1 receptor agonist used for acute migraine. It carries warnings for cardiovascular events such as myocardial infarction or stroke, particularly in patients with preexisting cardiovascular disease, but it does not carry a Black Box Warning for gastrointestinal bleeding. D. sumatriptan and naproxen: The combination of sumatriptan (cardiovascular risk) and naproxen (NSAID with GI bleeding risk) includes both major risks that have warranted FDA Black Box Warnings individually. When combined in therapy, the clinician must monitor for both cardiovascular and gastrointestinal adverse effects.