Kategori Resiko Kehamilan dan Menyusui dalam

Penggunaan Obat Obatan

Oleh :

Nama

: Mulia Dewanti

NIM

: G1A111008

PROGRAM STUDI PENDIDIKAN DOKTER

UNIVERSITAS JAMBI
2010/2011

Kategori Resiko Kehamilan dan Menyusui dalam Penggunaan Obat

Obatan

Lactation Risk Categories

Pregnancy Risk Categories

L1 (safest)

A (controlled studies show no risk)

L2 (safer)

B (no evidence of risk in humans)

L3 (moderately safe)

C (risk cannot be ruled out)

L4 (possibly hazardous)

D (positive evidence of risk)

L5 (contraindicated)

X (contraindicated in pregnancy)

A. Antihipertensi dan Obat Jantung Lainnya

1. Antihipertensi
Nama Obat

Nama Dagang

Captopril

Capoten

Diltiazem/Diltiazem
HCL
Enalapril/Enalapril
Maleate

Resiko Kehamilan
D

Resiko Menyusui
L3 (if used after
30 days)

Cardizem Sr, DilacorXR, Diltiazem,

L3

Cardizem CD
Vasotec

C (1st trim.)
D (2nd, 3rd trim.)

L2

Hydralazine

Apresoline

L2

Labetalol

Trandate, Normodyne

L2

Methyldopa

Aldomet

L2

Metoprolol

Toprol XL, Lopressor

L3

Minoxidil

Loniten, Minodyl,
Rogaine

L2 (topically)
L3 (orally)

Nadolol

Corgard, Nadolol

L4

Nifedipine

Adalat, Procardia

L2

NR

L2

Oxprenolol
Propranolol

Apsolox, SlowTrasicor, Trasicor

Inderol

Sotalol

Betapace

L3

Timolol

Blocadren

L2

L2

Verapamil

Calan, Isoptin,
Covera-HS

2. Anti Aritmia
Nama Obat

Nama Dagang

Resiko Kehamilan

Resiko Menyusui

Disopyramide

Norpace, Napamide

L2

Flecainide

Tambocor

L3

Mexiletine

Mexitil

L2

Procainamide

Pronestyl, Procan

L3

Quinidine

Quinaglute, Quinidex

L2

3. Cadiac Stimultan
Nama Obat

Nama Dagang

Digoxin

Lanoxin, Lanoxicaps

Resiko Kehamilan
C

Resiko Menyusui
L2

B. Antiemetik
Nama Obat

Nama Dagang

Domperidone

Motilum

Resiko Kehamilan
-

Resiko Menyusui
L1

C. Antimicobial
1. Antibiotic
Nama Obat

Nama Dagang

Resiko Kehamilan

Resiko Menyusui

Amoxicillin

Larotid, Amoxil

L1

Aztreonam

Azactam

L2

Cefadroxil

Ultracef, Duricef

L1

Cefazolin

Ancef, Kefzol

L1

Cefotaxime

Claforan

L2

Cefoxitin

Mefoxin

L1

Cefprozil

Cefzil

L1

Ceftazidime

Ceftazidime, Fortaz,

L1

Taxidime
Ceftriaxone

Rocephin

L2

Ciprofloxacin

Cipro

L3

Clindamycin

Cleocin

L3

Erythromycin

E-Mycin, Ery-tab,

L1

ERYC, Ilosone

L3 early postnatal

Fleroxacin

NR

Gentamicin

Garamycin

L2

Kanamycin

Kebecil, Kantrex

L2

Moxalactam

Moxam

NR

Nitrofurantoin

Macrobid

L2

Ofloxacin

Floxin

L2

Penicillin

L1

Streptomycin

Streptomycin

L3

Sulbactam

NR

L2

L2

L1

L3

Sulfisoxazole

Tetracycline

Ticarcillin
Trimethoprim/sulfam
ethoxazole

Gantrisin,
AzoGantrisin
Achromycin,
Sumycin, Terramycin
Ticarcillin, Ticar,
Timentin
Proloprim, Trimpex

2. Antiviral
Nama Obat

Nama Dagang

Resiko Kehamilan

Resiko Menyusui

Abacavir

Ziagen

L4

Emtricitabine

Emtriva

L4

Lamivudine

Epivir

L3

Stavudine

Zerit

L3

Zidovudine

Retrovir

L4

3. Antifungal

Agent Antifungal Vaginal Topical

Nama Obat

Nama Dagang

Resiko Kehamilan

Resiko Menyusui

Nystatin

Candistin, Enystin,

L1

L1

Fungatin, Kandistin,
mycostatin
Miconazole

Miconazole,
Clearderma, Daktarin

Clotrimazole

Canesten

L1

Butonazole

Butonazole Nitrat

L1

Tarconazole

Terazol

L1

Tioconazole

Vagistat-1

L1

Nama Obat

Nama Dagang

Resiko Kehamilan

Resiko Menyusui

Mebendazole

Vermox

L2

Pirantel Pamoat

Pirantel

L2

Piparezin

Piperazidine

L3

Tiabendazole

Mintezol, Tresaderm

L3

Albendazole

Albenza

L1

Prazikuantel

Biltricide

L4

4. Antihelmintic

D. Antipiuretik, Analgesik Opioid dan Non Opioid

1. Obat untuk Penghilang Rasa Sakit (Pain Killer)
Nama Obat

Nama Dagang

Acetaminophen

Tylenol

Aspirin

Aspirin

Azapropazone

Rheumox

Butalbital
Butorphanol

Fioricet, Fiorinal,
Bancap, Two-dyne
Stadol

Resiko Kehamilan
B
C (1st, 2nd trim.)
D (3rd trim.)

Resiko Menyusui
L1
L3

L2

L3

B (1st, 2nd trim.)

L3

D (3rd trim.)
Celecoxib

Celebrex

L2

Codeine

in Tylenol #3, #4

L3

Colchicine

Colchin

L4

Diclofenac

Cataflam, Voltaren

L2

Fentanyl

Sublimaze

L2

Flurbiprofen

Ansaid, Froben,
Ocufen

B (1st, 2nd trim.)

C (3rd trim.)

L2

Hydrocodone

Lortab, Vicodin

L3

Hydromorphone

Dilaudid

L3

Ibuprofen

Advil, Nuprin,
Motrin, Pediaprofen

Indomethacin

Indocin

Ketorolac

Toradol, Acular

B (1st, 2nd trim.)

D (3rd trim.)
B (1st, 2nd trim.)
D (3rd trim.)
B (1st, 2nd trim.)
D (3rd trim.)

L1

L3

L2

2. Analgetik Narkotik
Nama Obat

Nama Dagang

Resiko Kehamilan

Butorphanol

Stadol

Codeine

Tylenol #3, #4

L3

Fentanyl

Sublimaze

L2

B (1st, 2nd trim.)

D (3rd trim.)

Resiko Menyusui
L3

L2
Meperidine

Demerol

L3 (if used early

postpartum)

Methadone

Dolophine

L3

Morphine

Morphine

L3

L2

Propoxyphene

Darvocet N, Propacet,
Darvon

3. NSAID-s
Nama Obat
Azapropazone
(apazone)
Dipyrone (banned in
the US & UK)

Flufenamic acid
Ibuprofen

Nama Dagang

Resiko Menyusui

Rheumox

L2

NR

NR

Advil, Nuprin, Motrin,

Pediaprofin

Indomethacin

Indocin

Ketorolac

Toradol, Acular

Mefenamic acid

Ponstan, Ponstel

Naproxen

Resiko Kehamilan

Anaprox, Naprosyn,
Naproxen, Aleve

B (1st, 2nd trim.)

D (3rd trim.)
B (1st, 2nd trim.)
D (3rd trim.)
B (1st, 2nd trim.)
D (3rd trim.)
-

L1

L3

L2
NR
L3

L4 (for chronic
use)

Phenylbutazone

Butazolidine

NR

Piroxicam

Feldene

L2

Suprofen

Profenal

NR

Tolmetin

Tolectin

L3

4. Steroid
Nama Obat
Methylprednisolone
[ high dosage
methylprednisolone]
Prednisolone
Prednisone

Nama Dagang
Solu-Medrol, DepoMedrol, Medrol
Deltasone,
Meticorten, Orasone

Resiko Kehamilan

Resiko Menyusui

L2

L2

L2

E. Obat Anastetik
Nama Obat

Nama Dagang

Resiko Kehamilan

Resiko Menyusui

Benzodiazepine

Valium

L4

Ketamine

Ketamine HCl

L3

Fentanyl

Actiq, Duragesic,

L4

Fentora, Lazanda,
Sublimaze

F. Obat yang Digunakan Untuk Astma dan Alergi Lainnya

1. Obat Astma
Nama Obat
Dyphylline
Terbutaline
Theophylline

Nama Dagang
Dilor, Lufyllin,
Dyphylline
Bricanyl, Brethine
Aminophylline,
Quibron, TheoDur

Resiko Kehamilan
C

L3

L2

L3

2. Anti Histamin
Nama Obat

Nama Dagang

Brompheniramine

Brompheniramin

Chlorpheniramine
Cetirizine

(Chlor-Trimeton)
CTM
Zyrtec

Resiko Menyusui
L3
L3
L2

Dexbrompheniramine
maleate

Dexbrompheniramin

Resiko Menyusui

with d-isoephedrine
Diphenhydramine

Benadryl

L2

Doxylamine

Doxylamin

L4

Fexofenadine

Allegra

L3

Loratadine

Claritin

L2

Terfenadine

Seldane

Triprolidine

Actidil, Actifed

L1

G. Antidepresan, Antipsycotic, Hipnotik Sedatif

1. Antidepresan
Nama Obat

Nama Dagang

Resiko Kehamilan

Resiko Menyusui

Fluoxetine

Prozac, Nopres,

L3 ( neonatus ),

ANSI

L2 ( older infant )

Citalopram

Cipram

L2

Paroxentine

Seroxat

L2

Sentraline

Zoloft, Fatral, Fridep

L2

Venlafaxine

Efexor-XR

L3

L2

TCAs

2. Antipsycotic

Generasi pertama antipsikotic

Nama Obat

Nama Dagang

Resiko Kehamilan

Chlorpromazine

Chlorpromazine,

Promactil
Fluphenazine

Anetensol

Haloperidol

Haloperidol, Dores,

Serenace
Loxapine

Loxapine

Perphenazine

Perphezanine,

Trifalon
Prochlorperazine

Prochlorperazine

Pimozide

Pimozide

Thioridazine

Melleril

Triflouperazine

Stelazine

Thiothixene

Thiothixene

Generasi kedua antipsikotic

Nama Obat

Nama Dagang

Resiko Kehamilan

Aripiprazole

Abilify

Asenapine

Asenapine

Clozapine

Clozapine

Iloperidone

Iloperidone

Olanzapine

Olanzapine

Lurasidone

Lurasidone

Nama Dagang

Resiko Kehamilan

3. Hipnotic Sedatif

Hipnotik

Nama Obat
Zolpidem/Zolpidem
Tartrate

Ambien

Resiko Menyusui
L3

Sedatif

Nama Obat

Nama Dagang

Resiko Kehamilan

Resiko Menyusui

Chloral hydrate

Aquachloral, Noctec

L3

Bromide

L5

Secobarbital

Seconal

L3

H. Laxative
Nama Obat
Cascara/Cascara

Nama Dagang

Resiko Kehamilan

Resiko Menyusui

L3

Danthron

NR

Magnesium sulfate

Epsom salt

L1

Senna

L3

Sagrada

I. Anticonvulsant
Nama Obat

Nama Dagang

Resiko Kehamilan

Resiko Menyusui

Carbamazepine

Tegretol, Epitol

L2

Ethosuximide

Zarontin

L4

Magnesium sulfate

Epsom salt

L1

Phenytoin

Dilantin

L2

Valproic acid

Depakene, Depakote

L2

J. Antidiabetic
Nama Obat

Nama Dagang

Sulfonylurea

Tulbotamid,

Resiko Kehamilan

Resiko Menyusui

L3

L3

L2

Tolazamid, Glipizid
PBiguanides

Fenformin, Bufomin,
Metformin

Glyburide

Daonil,
Glibenclamide

Metformin

Metformin

L2

Thiazolidinediones

Thiazolidinedione