DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

dari sumber URL : http://www.kellymom.com/health/meds/aap-approved-meds.html

Kelompok Analgetik, NSAIDS, Obat Batuk dan Pilek,
Anti Alergi dan Asma, Anestesi
Obat untuk Penghilang Rasa Sakit (Pain Killer)
Nama Obat AAP approved?* Kategori Risiko Kehamilan** Risiko Menyusui** Notes
Acetaminophen (Tylenol) Approved B L1
C (1st, 2nd trim.)
Aspirin Caution L3 1
D (3rd trim.)
Azapropazone (Rheumox) Approved - L2
Butalbital (Fioricet, Fiorinal, Bancap, Two-dyne) NR D L3 2
B (1st, 2nd trim.)
Butorphanol (Stadol) Approved L3
D (3rd trim.)
Celecoxib (Celebrex)) NR C L2
Codeine (in Tylenol #3, #4) Approved C L3 3
Colchicine Approved D L4
Diclofenac (Cataflam, Voltaren) NR B L2
Fentanyl (Sublimaze) Approved B L2
B (1st, 2nd trim.)
Flurbiprofen (Ansaid, Froben, Ocufen) NR L2
C (3rd trim.)
Hydrocodone (Lortab, Vicodin) NR B L3 4
Hydromorphone (Dilaudid) NR C L3 5
B (1st, 2nd trim.)
Ibuprofen (Advil, Nuprin, Motrin, Pediaprofen) Approved L1
D (3rd trim.)
B (1st, 2nd trim.)
Indomethacin (Indocin) Approved L3
D (3rd trim.)
B (1st, 2nd trim.)
Ketorolac (Toradol, Acular) Approved L2
D (3rd trim.)
L2;
Meperidine (Demerol) Approved B 6
L3 early postpartum
Methadone (Dolophine) Approved B L3 7
Morphine (Duramorph, Infumorph, Epimorph,
Approved B L3 8
MS Contin)
Nalbuphine (Nubain) NR B L2
Naproxen (Anaprox, Naprosyn, Naproxen, L3;
Approved B 9
Aleve) L4 for chronic use
Nefopam (Acupan) Approved - NR
Oxycodone (Tylox, Percodan,Oxycontin,
NR B L3 10
Roxicet, Endocet, Roxiprin, Percocet)
Pentosan polysulfate (Elmiron) NR B L2
Piroxicam (Feldene) Approved B L2
Propoxyphene (Darvocet N, Propacet, Darvon) Approved C L2 11
Rofecoxib (Vioxx) Withdrawn from the market 12
Secobarbital (Seconal) Approved D L3 13
Tolmetin (Tolectin) Approved C L3
Tramadol HCL (Ultram, Ultracet) NR C L3 14
Valdecoxib (Bextra) Withdrawn from the market more
* 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).
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)
 NR: Not Reviewed. This drug has not yet been reviewed by Hale.
1. Aspirin use is discouraged in children and nursing mothers due to the risk of Reyes syndrome and internal bleeding.
2. Fioricet (Fiorinal, Bancap, Two-dyne) contains acetaminaphen or asprin, caffeine, and butalbital. Per Hale, baby should be observed for sedation.
3. Hale suggests weakened or premature infants be observed for sedation and apnea.
4. Hale suggests newborns be observed for sedation, apnea, constipation.
5. Per Hale, use of frequent, higher dose may result in infant sedation.
6. Per Hale, Meperidine use during labor or early postpartum has been associated with sedation, poor sucking reflex, and neurobehavioral delay in infants.
7. Per Hale, observe infant for sedation, respiratory depression, addiction, withdrawal syndrome.
8. Per Hale, higher doses may result in infant sedation.
9. Per Hale, should be used with caution due to its long half-life and its effect on babys cardiovascular system, kidneys and GI tract; short-term, infrequent
or occasional use is not necessarily incompatible with breastfeeding.
10. Roxicet, Endocet, Roxiprin, Percocet also contain acetaminophen. Per Hale, observe infant for sedation.
11. Per Hale, observe infant for sedation.
12. Per Hale, observe infant for GI cramping, distress, diarrhea.
13. Per Hale, observe infant for sedation.
14. Per Hale, observe infant for sedation.
Non-steroidal anti-inflammatory analgesics (NSAIDs) [more]
Kategori Risiko
Nama Generik Nama Dagang
AAP approved?* Kehamilan** Risiko Menyusui**
Azapropazone (apazone) Rheumox Approved - L2
Dipyrone (banned in the US & UK) - Approved - NR

Flufenamic acid - Approved - NR

B (1st, 2nd trim.)
Ibuprofen Advil, Nuprin, Motrin, Pediaprofin Approved L1
D (3rd trim.)
B (1st, 2nd trim.)
Indomethacin Indocin Approved L3
D (3rd trim.)
B (1st, 2nd trim.)
Ketorolac Toradol, Acular Approved L2
D (3rd trim.)
Mefenamic acid Ponstan, Ponstel Approved - NR
L3
Naproxen Anaprox, Naprosyn, Naproxen, Aleve Approved B
L4 (for chronic use)
Phenylbutazone Butazolidine Approved - NR
Piroxicam Feldene Approved B L2
Suprofen Profenal Approved - NR
Tolmetin Tolectin Approved C L3
Steroid [contents]
Methylprednisolone
Solu-Medrol, Depo-Medrol, Medrol Approved C L2
[ high dosage methylprednisolone]
Prednisolone - Approved C L2
Prednisone Deltasone, Meticorten, Orasone Approved C L2

Obat Asma [contents]

Dyphylline Dilor, Lufyllin, Dyphylline Approved C L3
Terbutaline Bricanyl, Brethine Approved B L2
Theophylline Aminophylline, Quibron, Theo-Dur Approved C L3

Analgetik Narkotik [more]

B (1st, 2nd trim.)
Butorphanol Stadol Approved L3
D (3rd trim.)
Codeine Tylenol #3, #4 Approved C L3
Fentanyl Sublimaze Approved B L2
L2
Meperidine Demerol Approved B
L3 (if used early postpartum)
Methadone Dolophine Approved B L3
Morphine Morphine Approved B L3
Propoxyphene Darvocet N, Propacet, Darvon Approved C L2
Obat Batuk
Nama Obat AAP approved?* Risiko Menyusui**
Codeine yes L3 (moderately safe)
Dextromethorphan not reviewed L1 (safest)
Guaifenesin not reviewed L2 (safer)
Dekongestan (Obat Pilek)
Nama Obat AAP approved?* Risiko Menyusui**
Phenylephrine not reviewed L3 (moderately safe)
L3 (moderately safe) for acute use
Pseudoephedrine (Sudafed, Actifed) yes
L4 (possibly hazardous) for chronic use due to potential for decreasing milk supply
* Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.
** Per Medications and Mothers Milk by Thomas Hale, PhD (2006 edition)
Nasal Sprays (Spray Hidung)
AAP
Nama Obat Risiko Menyusui**
approved?*
Beclomethasone (Vanceril, Beclovent,
not reviewed L2 (safer)
Beconase, Vancenase)
Cromlyn sodium (Nasalcrom) not reviewed L1 (safest)
Fluticasone (Flonase) not reviewed L3 (moderately safe)
Mometasone (Nasonex) not reviewed L3 (moderately safe)
Phenylephrine (in some forms of
not reviewed L3 (moderately safe)
Sinex and Neo-Synephrine)
Triamcinolone Acetonide (Nasacort) not reviewed L3 (moderately safe)
Antihistamin (Anti Alergi)
AAP
Nama Obat Risiko Menyusui**
approved?*
Brompheniramine not reviewed L3 (moderately safe)
Chlorpheniramine (Chlor-Trimeton)
not reviewed L3 (moderately safe)
CTM
Cetirizine (Zyrtec) not reviewed L2 (safer)
Dexbrompheniramine maleate
yes not reviewed
with d-isoephedrine
Diphenhydramine (Benadryl) not reviewed L2 (safer)
Doxylamine not reviewed L4 (possibly hazardous)
Fexofenadine (Allegra) yes L3 (moderately safe)
Loratadine (Claritin) yes L2 (safer)
Terfenadine (Seldane) yes not reviewed
Triprolidine (Actidil, Actifed) yes L1 (safest)
* Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.
** Per Medications and Mothers Milk by Thomas Hale, PhD (2002 edition)

Obat Anestesi
Risiko
Nama Obat AAP approved?* Kategori Risiko Kehamilan** Notes
Menyusui**
Local anesthetics
Articaine (Septocaine) NR - NR more
Bupivacaine (Marcaine) NR C L2
Lidocaine (Xylocaine) Approved C L2
Mepivacaine (Carbocaine, Polocaine) NR C L3 more
Procaine HCL (Novocaine) NR C L3
General anesthetics
Halothane (Fluothane) Approved C L2 more
Isoflurane (Forane) NR - NR 1
Ketamine NR - NR more
Methohexital (Brevital) Approved B L3
Nitrous oxide NR - L3
Sevoflurane (Ultane) NR B L3
Thiopental (Pentothal) Approved C L3
Other medications often used during anesthesia
Sedatives
Diazepam (Valium) Concern D L3; L4 for
chronic use
Midazolam (Versed) Concern D L3
Propofol (Diprivan) NR B L2
more
Triazolam (Halcion) NR X L3
Narcotic Analgesics
Alfentanil (Alfenta) NR C L2
Fentanyl (Sublimaze) Approved B L2
Hydromorphone (Dilaudid) NR C L3
Morphine Approved B L3
Reversal Medication
Flumazenil (Romazicon) NR C NR 2
Naloxone (Narcan) NR C NR 3
Steroids
Decadron (Dexamethasone) NR C NR more
Stimulants
Epinephrine (Adrenaline) NR C L1
Anti-nausea
Promethazine (Phenergan) NR C L2
* 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
Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May Be of Concern
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).
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)
NR: Not Reviewed. This drug has not yet been reviewed by Hale.
1. Isoflurane (Forane) is used for c-sections and directly in newborns. Induction of and recovery from isoflurane anesthesia are rapid, so the majority of the
medication is out of the body (and milk) very quickly. More here.
2. Flumazenil (Romazicon) is used directly in children aged 12 months and up.
3. Naloxone (Narcan) is used directly in newborns and children.
4. Many forms of Robitussin, Delsym and Benylin are considered compatible with breastfeeding. Always check the active ingredients, as there are many
versions.
Kelompok Antasida, Antibiotik, Antivirus, Antijamur, Kontrasepsi, Obat jantung & Hipertensi, Vitamin, dll
Kategori Risiko
Nama Generik Nama Dagang
AAP approved?* Kehamilan** Risiko Menyusui**
Antasida [contents]
Cimetidine (Antacid) Tagamet Approved B L2
Cisapride (GI tract stimulant) Propulsid Approved C L2
Domperidone (used for nausea & vomiting, stimulates
Motilum Approved - L1
lactation) [more]
Antibiotika [contents]
Amoxicillin Larotid, Amoxil Approved B L1
Aztreonam Azactam Approved B L2
Cefadroxil Ultracef, Duricef Approved B L1
Cefazolin Ancef, Kefzol Approved B L1
Cefotaxime Claforan Approved B L2
Cefoxitin Mefoxin Approved B L1
Cefprozil Cefzil Approved C L1
Ceftazidime, Fortaz,
Ceftazidime Approved B L1
Taxidime
Ceftriaxone Rocephin Approved B L2
Ciprofloxacin [more] Cipro Approved C L3
Clindamycin Cleocin Approved B L3
E-Mycin, Ery-tab, ERYC, L1
Erythromycin Approved B
Ilosone L3 early postnatal
Fleroxacin - Approved - NR
Gentamicin Garamycin Approved C L2
Kanamycin Kebecil, Kantrex Approved D L2
Moxalactam Moxam Approved - NR
Nitrofurantoin Macrobid Approved B L2
Ofloxacin Floxin Approved C L2
Penicillin - Approved B L1
Streptomycin Streptomycin Approved D L3
Sulbactam - Approved - NR
Sulfisoxazole Gantrisin, Azo-Gantrisin Approved C L2
Achromycin, Sumycin,
Tetracycline Approved D L2
Terramycin
Ticarcillin Ticarcillin, Ticar, Timentin Approved B L1
Trimethoprim/sulfamethoxazole Proloprim, Trimpex Approved C L3
Antikoagulan [contents]
Bishydroxycoumarin (dicumarol) - Approved - NR
Warfarin Coumadin, Panwarfin Approved D L2
Antikonvulsan (Anti kejang) [contents]
Carbamazepine Tegretol, Epitol Approved C L2
Ethosuximide Zarontin Approved C L4
Magnesium sulfate Epsom salt Approved B L1
Phenytoin Dilantin Approved D L2
Valproic acid Depakene, Depakote Approved D L2
Anti Jamur [contents]
Fluconazole [more] Diflucan Approved C L2
Ketoconazole Nizoral Shampoo, Nizoral Approved C L2
Antivirus [contents]
Acyclovir [more] Zovirax Approved C L2
Alferon N, Interferon
Interferon-alpha [more] Approved C L2
Alpha
Arthritis meds (see also: pain meds) [contents]
Ridaura, Myochrysine,
Gold salts Approved C L5
Solganal
Kontrasepsi, Hormon [contents]
Estratab, Permarin, L3 (may interfere with
Estradiol Approved X
Menest milk production)
Clogestone - Approved - NR
Preven, Seasonale,
Norinyl, Norlestin, Ortho-
L3 (may interfere with
Contraceptive pill with estrogen/progesterone Novum, Ovral, Lunelle Approved X
milk production)
injection, Ortho-Evra
patch, etc.
Levonorgestrel Norplant, Mirena, Plan B Approved X L2
L1
Provera, Depo-Provera,
Medroxyprogesterone Approved D L4 (if used first 3 days
Cycrin
postpartum)
Norethynodrel Enovid Approved X L2
Progesterone Crinone, Prometrium Approved - L3
Obat Diabetes [contents]
Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk category = L1.
Tolbutamide Oramide, Orinase Approved D L3
Obat Diare [contents]
Loperamide Imodium, Pepto Diarrhea Approved B L2
Control, Maalox
 Antidiarrheal Caplets,
Kaopectate II Caplets,
Immodium Advanced
** 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]
Diuretik (Peluruh Kencing) [contents]
Acetazolamide Dazamide, Diamox Approved C L2
Bendroflumethiazide Naturetin Approved D L4 (may inhibit lactation)
Chlorothiazide Hydrodiuril Approved D L3
Chlorthalidone Hygroton Approved D L3
Hydrodiuril, Esidrix,
Hydrochlorothiazide (HCT) Approved D L2
Oretic
Spironolactone Aldactone Approved D L2
Anti Muntah [more] [contents]
Domperidone Motilum Approved - L1
Anti Hipertensi, Obat Jantung [contents]
Anti aritmia
Disopyramide Norpace, Napamide Approved C L2
Flecainide Tambocor Approved C L3
Mexiletine Mexitil Approved B L2
Procainamide Pronestyl, Procan Approved C L3
Quinidine Quinaglute, Quinidex Approved C L2
Anti Hipertensi
L3 (if used after 30
Captopril Capoten Approved D
days)
Cardizem Sr, Dilacor-XR,
Diltiazem/Diltiazem HCL Approved C L3
Diltiazem, Cardizem CD
C (1st trim.)
Enalapril/Enalapril Maleate Vasotec Approved L2
D (2nd, 3rd trim.)
Hydralazine Apresoline Approved C L2
Labetalol Trandate, Normodyne Approved C L2
Methyldopa Aldomet Approved C L2
Metoprolol Toprol XL, Lopressor Approved B L3
Loniten, Minodyl, L2 (topically)
Minoxidil Approved C
Rogaine L3 (orally)
Nadolol Corgard, Nadolol Approved C L4
Nifedipine Adalat, Procardia Approved C L2
Apsolox, Slow-Trasicor,
Oxprenolol Approved - NR
Trasicor
Propranolol Inderol Approved C L2
Sotalol Betapace Approved B L3
Timolol Blocadren Approved C L2
Calan, Isoptin, Covera-
Verapamil Approved C L2
HS
Cardiac stimulants
Digoxin Lanoxin, Lanoxicaps Approved C L2
Laksan (Pelancar BAB) [more] [contents]
Cascara/Cascara Sagrada - Approved C L3
Danthron - Approved - NR
Magnesium sulfate Epsom salt Approved B L1
Senna - Approved - L3
Obat malaria [contents]
Chloroquine Aralen, Novo-chloroquine Approved C L3
Hydroxychloroquine Plaquenil Approved C L2
Pyrimethamine Daraprim Approved C L4
Quinine Quinamm Approved D L2
Medical Testing [more] [contents]
Diatrizoate - Approved - NR
Fluorescein - Approved C L3
Gadopentetic (Gadolinium) - Approved C L2
Iohexol Omnipaque Approved B L2
Iopanoic acid Telepaque Approved D L2
Metrizamide Amipaque Approved B L2
Metrizoate Isopaque Approved B L2
Obat Migren [more] [contents]
Sumatriptan Imitrex Approved C L3
Obat Sedativ [more] [contents]
Chloral hydrate Aquachloral, Noctec Approved C L3
Methyprylon (withdrawn from use in US & Canada) - Approved - NR
Bromide - Approved D L5
Secobarbital Seconal Approved D L3
Obat Tidur [contents]
Zolpidem/Zolpidem Tartrate Ambien Approved B L3
Obat Anti Tiroid [more] [contents]
Carbimazole - Approved D L3
Methimazole (active metabolite of carbimazole) Tapazole Approved D L3
Propylthiouracil PTU Approved D L2
Thiouracil - Approved - NR
Synthroid, Levothroid,
Levothyroxine Approved A L1
Thyroid, Levo-T, Levoxyl
Obat TBC [contents]
Cycloserine Seromycin Approved C L3
Ethambutol Ethambutol, Myambutol Approved B L2
Isoniazid INH, Laniazid Approved C L3
Rifampin Rifadin, Rimactane Approved C L2
VITAMIN [more] [contents]
B-1 (thiamin) - Approved - NR
B-12 (Cyanocobalamin) - Approved A L1
L2; L4 in high doses
B-6 (pyridoxine) - Approved A
(may inhibit lactation)
D, vitamin Calciferol, Delta-d Approved A L3 (do not overdose)
A (1st, 2nd trim.)
Folic acid - Approved L1
C (3rd trim.)
K-1, vitamin (Phytonadione) - Approved C L1
Riboflavin/B2 - Approved A L1
Lain-lain [contents]
Acitretin (Anti-psoriasis) Soriatane Approved - NR
Alcohol/Ethanol [more] - Approved D L3
Allopurinol Zyloprim, Lopurin Approved C L2
Antimony - Approved - NR
Atropine (Anticholinergic, drying agent) Belladonna, Atropine Approved C L3
Azapropazone/apazone (Antirheumatic) Rheumox Approved - L2
Baclofen (muscle relaxant) Lioresal, Atrofen Approved C L2
Barbiturate - Approved - NR
Caffeine [more] Vivarin, NoDoz, Coffee Approved B L2
Carbetocin (Antihemorrhagic) Duratocin Approved - NR
Chloroform - Approved - NR
Cisplatin (Anti-cancer) Platinol Approved D L4
Dapsone (Antileprosy) Avlosulfon, DDS Approved C L4
Hydroxychloroquine (Antirheumatic, lupus) Plaquenil Approved C L2
Iodides - Approved - NR
Iodine - Approved - NR
Iodine (povidone-iodine, eg, in a vaginal douche) - Approved - NR
Ivermectin (Antiparasitic) Mectizan Approved C L3
Nalidixic acid (Urinary Anti-infective) NegGram Approved B L4
Norsteroids - Approved - NR
Pyridostigmine (Muscle stimulant) Mestinon, Regonol Approved C L2
Scopolamine (Motion sickness) Transderm Scope Approved C L3
Sulfapyridine Dagenan Approved - NR
Timolol (glaucoma med) Blocadren Approved D 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).
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)
NR: Not Reviewed. This drug has not yet been reviewed by Hale

Pembagian kategori tingkat keamanan obat (termasuk antibiotik) untuk kehamilan

Pembagian kategori tingkat keamanan obat (termasuk antibiotik) untuk kehamilan
Sebelumnya, perlu saya kemukakan pembagian kategori keamanan suatu obat untuk penggunaan pada ibu hamil :
Kategori A :
Obat-obat yang menurut studi terkontrol tidak menimbulkan resiko pada janin
Kategori B :
Untuk obat-obat yang berdasarkan studi pada binatang dan manusia tidak menunjukkan resiko yang bermakna. Termasuk disini adalah :
1. Dari studi pada binatang tidak menunjukkan resiko, tetapi belum ada studi pada manusia mengenai hal tersebut
2. Dari studi pada binatang menunjukkan adanya resiko, tetapi dari hasil studi yang terkontrol baik pada manusia menunjukkan tidak adanya resiko.
Kategori C :
Untuk obat-obat yang belum didukung studi adekuat, baik pada binatang maupun pada manusia atau obat-obat yang menunjukkan efek yang merugikan pada studi
binatang tetapi belum ada studi pada manusia
Kategori D :
Untuk obat-obat yang ada bukti resikonya pada janin tetapi manfaatnya jauh lebih besar

Kategori X :
Untuk obat-obat yang terbukti mempunyai resiko terhadap janin dan resiko itu lebih berat daripada manfaatnya
Antibiotik tidak ada yang termasuk kategori X. Umumnya masuk kategori B, kecuali beberapa yang masuk kategori C atau D.