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Generic name

Trade Name

Pregnancy AAP Risk approved?* Category**

Lactation Risk Category**

Analgesics (Pain-killers) [more] Acetaminophen Colchicine Nefopam Tylenol Colchicine Acupan Approved Approved Approved B D L1 L4 NR

Non-steroidal anti-inflammatory analgesics (NSAIDs) [more] Azapropazone (apazone) Dipyrone (banned in the US & UK) Flufenamic acid Ibuprofen Rheumox Approved Approved L2 NR

Advil, Nuprin, Motrin, Pediaprofin

Approved Approved

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

NR L1

Indomethacin

Indocin

Approved

L3

Ketorolac

Toradol, Acular

Approved

L2

Mefenamic acid Naproxen

Ponstan, Ponstel Anaprox, Naprosyn, Naproxen, Aleve

Approved Approved

NR L3 L4 (for chronic use)

References Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Phenylbutazone Piroxicam Suprofen Tolmetin Narcotic analgesics [more] Butorphanol

Butazolidine Feldene Profenal Tolectin

Approved Approved Approved Approved

B C

NR L2 NR L3

Stadol

Approved

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

L3

Codeine Fentanyl Meperidine

Tylenol #3, #4 Sublimaze Demerol

Approved Approved Approved

L3 L2 L2 L3 (if used early postpartum) L3 L3 L2

Methadone Morphine Propoxyphene

Dolophine Morphine Darvocet N, Propacet, Darvon

Approved Approved Approved

B B C

Anesthesia, Anesthetics [more] Halothane Lidocaine Methohexital Thiopental Antacids, GI meds Cimetidine (Antacid)
References

[contents] Fluothane Xylocaine Brevital Pentothal Approved Approved Approved Approved C C B C L2 L2 L3 L3 [contents] Tagamet Approved B L2

Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Cisapride (GI tract stimulant)

Propulsid

Approved Approved

C -

L2 L1

Domperidone (used for nausea Motilum & vomiting, stimulates lactation) [more] Antibiotics Amoxicillin Aztreonam Cefadroxil Cefazolin Cefotaxime Cefoxitin Cefprozil Ceftazidime Larotid, Amoxil Azactam Ultracef, Duricef Ancef, Kefzol Claforan Mefoxin Cefzil Ceftazidime, Fortaz, Taxidime Rocephin Cipro Cleocin E-Mycin, Erytab, ERYC, Ilosone Garamycin Kebecil, Kantrex Moxam Macrobid

[contents] Approved Approved Approved Approved Approved Approved Approved Approved B B B B B B C B L1 L2 L1 L1 L2 L1 L1 L1

Ceftriaxone Ciprofloxacin [more] Clindamycin Erythromycin

Approved Approved Approved Approved

B C B B

L2 L3 L3 L1 L3 early postnatal NR L2 L2 NR L2

Fleroxacin Gentamicin Kanamycin Moxalactam Nitrofurantoin


References

Approved Approved Approved Approved Approved

C D B

Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Ofloxacin Penicillin Streptomycin Sulbactam Sulfisoxazole

Floxin Streptomycin Gantrisin, AzoGantrisin Achromycin, Sumycin, Terramycin Ticarcillin, Ticar, Timentin

Approved Approved Approved Approved Approved

C B D C

L2 L1 L3 NR L2

Tetracycline

Approved

L2

Ticarcillin

Approved

L1

Trimethoprim/sulfamethoxazole Proloprim, Trimpex Anticoagulants Bishydroxycoumarin (dicumarol) Warfarin -

Approved

L3

[contents] Approved NR

Coumadin, Panwarfin

Approved

L2

Anticonvulsants Carbamazepine Ethosuximide Magnesium sulfate Phenytoin Valproic acid Tegretol, Epitol Zarontin Epsom salt Dilantin Depakene, Depakote Approved Approved Approved Approved Approved C C B D D

[contents] L2 L4 L1 L2 L2

Antifungals
References

[contents]

Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Fluconazole [more] Ketoconazole

Diflucan Nizoral Shampoo, Nizoral

Approved Approved

C C

L2 L2

Antihistamines [more] Dexbrompheniramine maleate with d-isoephedrine Fexofenadine Loratadine Terfenadine Triprolidine Antivirals Acyclovir [more] Interferon-alpha [more] Zovirax Alferon N, Interferon Alpha Approved Approved C C Approved -

[contents] NR

Allegra Claritin Seldane Actidil, Actifed

Approved Approved Approved Approved

C B C

L2 L1 NR L1 [contents] L2 L2

Arthritis meds (see also: pain meds) Gold salts Ridaura, Myochrysine, Solganal Approved C

[contents] L5

Asthma meds (see also: steroids) Dyphylline Dilor, Lufyllin, Dyphylline Bricanyl, Brethine Aminophylline, Quibron, TheoDur Approved C

[contents] L3

Terbutaline

Approved

L2

Theophylline

Approved

L3

References Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Contraceptives, Hormones [more] Estradiol Estratab, Permarin, Menest Approved X

[contents] L3 (may interfere with milk production) NR L3 (may interfere with milk production)

Clogestone Contraceptive pill with estrogen/progesterone

Preven, Seasonale, Norinyl, Norlestin, OrthoNovum, Ovral, Lunelle injection, OrthoEvra patch, etc. Norplant, Mirena, Plan B Provera, DepoProvera, Cycrin

Approved Approved

Levonorgestrel

Approved

L2

Medroxyprogesterone

Approved

L1 L4 (if used first 3 days postpartum) L2 L3

Norethynodrel Progesterone

Enovid Crinone, Prometrium

Approved Approved

X -

Cough meds [more] Codeine Noscapine Decongestants [more] Pseudoephedrine Sudafed, Halofed, Approved C Tylenol #3, #4 Approved Approved C -

[contents] L3 NR [contents] L3 (for acute use)

References Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Novafed, Actifed

L4 (for chronic use) [contents]

Diabetes meds

Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk category = L1. Tolbutamide Oramide, Orinase Approved D L3

Diarrhea meds Loperamide Imodium, Pepto Diarrhea Control, Maalox Antidiarrheal Caplets, Kaopectate II Caplets, Immodium Advanced Approved B

[contents] L2

** Note: Pepto-Bismol & Kaopectate (bismuth subsalicylate is the active ingredient in both) are not recommended for routine use by nursing moms, due to the association of salicylates with Reyes syndrome in children. [more] Diuretics Acetazolamide Dazamide, Diamox Naturetin Approved C [contents] L2

Bendroflumethiazide

Approved

L4 (may inhibit lactation) L3 L3 L2

Chlorothiazide Chlorthalidone Hydrochlorothiazide


References

Hydrodiuril Hygroton Hydrodiuril,

Approved Approved Approved

D D D

Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Esidrix, Oretic Spironolactone Aldactone Approved D L2 [contents] Approved L1 [contents]

Galactagogues (milk supply) [more] Domperidone Motilum

Heart, Blood Pressure meds (Antiarrhythmics, Antihypertensives, Cardiac stimulants) Antiarrhythmics Disopyramide Norpace, Napamide Tambocor Mexitil Pronestyl, Procan Quinaglute, Quinidex Approved C

L2

Flecainide Mexiletine Procainamide

Approved Approved Approved

C B C

L3 L2 L3

Quinidine

Approved

L2

Antihypertensives Captopril Capoten Approved D L3 (if used after 30 days) L3

Diltiazem/Diltiazem HCL

Cardizem Sr, Dilacor-XR, Diltiazem, Cardizem CD Vasotec

Approved

Enalapril/Enalapril Maleate

Approved

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

L2

Hydralazine
References

Apresoline

Approved

L2

Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Labetalol

Trandate, Normodyne Aldomet Toprol XL, Lopressor Loniten, Minodyl, Rogaine Corgard, Nadolol Adalat, Procardia Apsolox, SlowTrasicor, Trasicor Inderol Betapace Blocadren Calan, Isoptin, Covera-HS

Approved

L2

Methyldopa Metoprolol

Approved Approved

C B

L2 L3

Minoxidil

Approved

L2(topically) L3 (orally)

Nadolol Nifedipine Oxprenolol

Approved Approved Approved

C C -

L4 L2 NR

Propranolol Sotalol Timolol Verapamil

Approved Approved Approved Approved

C B C C

L2 L3 L2 L2

Cardiac stimulants Digoxin Lanoxin, Lanoxicaps Approved C L2

Laxatives [more] Cascara/Cascara Sagrada Danthron Magnesium sulfate Senna


References

[contents] Epsom salt Approved Approved Approved Approved C B L3 NR L1 L3

Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Malaria meds Chloroquine Aralen, Novochloroquine Plaquenil Daraprim Quinamm Approved C

[contents] L3

Hydroxychloroquine Pyrimethamine Quinine Medical Testing [more] Diatrizoate Fluorescein Gadopentetic (Gadolinium) Iohexol Iopanoic acid Metrizamide Metrizoate

Approved Approved Approved

C C D

L2 L4 L2 [contents]

Omnipaque Telepaque Amipaque Isopaque

Approved Approved Approved Approved Approved Approved Approved

C C B D B B

NR L3 L2 L2 L2 L2 L2 [contents]

Migraine meds (see also: pain meds) [more] Sumatriptan Sedatives [more] Chloral hydrate Aquachloral, Noctec Approved C Imitrex Approved C

L3 [contents] L3

Methyprylon (withdrawn from use in US & Canada) Bromide Secobarbital Sleep Aids Zolpidem/Zolpidem Tartrate
References

Approved

NR

Seconal

Approved Approved

D D

L5 L3 [contents]

Ambien

Approved

L3

Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Steroids Methylprednisolone [ high dosage methylprednisolone] Prednisolone Prednisone Solu-Medrol, Depo-Medrol, Medrol Deltasone, Meticorten, Orasone Approved C

[contents] L2

Approved Approved

C C

L2 L2

Thyroid meds [more] Carbimazole Methimazole (active metabolite of carbimazole) Propylthiouracil Thiouracil Levothyroxine Tapazole Approved Approved D D

[contents] L3 L3

PTU Synthroid, Levothroid, Thyroid, Levo-T, Levoxyl

Approved Approved Approved

D A

L2 NR L1

Tuberculosis meds Cycloserine Ethambutol Seromycin Ethambutol, Myambutol INH, Laniazid Rifadin, Rimactane Approved Approved C B

[contents] L3 L2

Isoniazid Rifampin

Approved Approved

C C

L3 L2

Vitamins [more] B-1 (thiamin)


References

[contents] Approved NR

Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

B-12 (Cyanocobalamin) B-6 (pyridoxine)

Approved Approved

A A

L1 L2; L4 in high doses (may inhibit lactation) L3 (do not overdose) L1

D, vitamin

Calciferol, Deltad -

Approved

Folic acid

Approved

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

K-1, vitamin (Phytonadione) Riboflavin/B2 Miscellaneous Acitretin (Anti-psoriasis) Alcohol/Ethanol [more] Allopurinol

Approved Approved

L1 L1 [contents]

Soriatane Zyloprim, Lopurin Belladonna, Atropine Rheumox

Approved Approved Approved

D C

NR L3 L2

Antimony Atropine (Anticholinergic, drying agent) Azapropazone/apazone (Antirheumatic) Baclofen (muscle relaxant) Barbiturate Caffeine [more]

Approved Approved

NR L3

Approved

L2

Lioresal, Atrofen Vivarin, NoDoz, Coffee

Approved Approved Approved

C B

L2 NR L2

References Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Carbetocin (Antihemorrhagic) Chloroform Cisplatin (Anti-cancer) Dapsone (Antileprosy) Hydroxychloroquine (Antirheumatic, lupus) Iodides Iodine

Duratocin Platinol Avlosulfon, DDS Plaquenil

Approved Approved Approved Approved Approved

D C C

NR NR L4 L4 L2

Approved Approved Approved

NR NR NR

Iodine (povidone-iodine, eg, in a vaginal douche) Ivermectin (Antiparasitic) Nalidixic acid (Urinary Antiinfective) Norsteroids Pyridostigmine (Muscle stimulant) Scopolamine (Motion sickness) Mectizan NegGram

Approved Approved

C B

L3 L4

Mestinon, Regonol Transderm Scope Dagenan Blocadren

Approved Approved

NR L2

Approved

L3

Sulfapyridine Timolol (glaucoma med)

Approved Approved

NR L3

* Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP. ** Per Medications and Mothers Milk by Thomas Hale, PhD (2004 edition).
References Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.

Lactation Risk Categories


Pregnancy Risk Categories


L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.

References Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. Hale, Thomas. Medications and Mothers Milk , 12th Edition. Hale Publishing, 2006. Dr. Hales website is located at http://neonatal.ttuhsc.edu/lact/index.html.