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untuk-ibu-hamil-dan-menyusui/

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU

HAMIL DAN MENYUSUI
Anti Alergi dan Asma, Anestesi

Obat untuk Penghilang Rasa Sakit (Pain Killer)

AAP Kategori Risiko Risiko
Nama Obat Notes
approved?* Kehamilan** Menyusui**
Acetaminophen (Tylenol) Approved B L1
C (1st, 2nd trim.)
Aspirin Caution L3 1
D (3rd trim.)
Approved
Azapropazone (Rheumox) - L2

Butalbital (Fioricet,
Fiorinal, Bancap, Two- NR D L3 2
dyne)
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,
NR B L2
Voltaren)
Fentanyl (Sublimaze) Approved B L2
Flurbiprofen (Ansaid, B (1st, 2nd trim.)
NR L2
Froben, Ocufen) C (3rd trim.)
Hydrocodone (Lortab,
NR B L3 4
Vicodin)
Hydromorphone
NR C L3 5
(Dilaudid)
Ibuprofen (Advil, Nuprin, B (1st, 2nd trim.)
Approved L1
Motrin, Pediaprofen) D (3rd trim.)
B (1st, 2nd trim.)
Indomethacin (Indocin) Approved L3
D (3rd trim.)
Ketorolac (Toradol, B (1st, 2nd trim.)
Approved L2
Acular) D (3rd trim.)
Meperidine (Demerol) Approved B L2; 6
 L3 early
postpartum
Methadone (Dolophine) Approved B L3 7
Morphine (Duramorph,
Infumorph, Epimorph, MS Approved B L3 8
Contin)
Nalbuphine (Nubain) NR B L2
Naproxen (Anaprox, L3;
Naprosyn, Naproxen, Approved B L4 for chronic 9
Aleve) use
Nefopam (Acupan) Approved - NR
Oxycodone (Tylox,
Percodan,Oxycontin,
NR B L3 10
Roxicet, Endocet, Roxiprin,
Percocet)
Pentosan polysulfate
NR B L2
(Elmiron)
Piroxicam (Feldene) Approved B L2
Propoxyphene (Darvocet
Approved C L2 11
N, Propacet, Darvon)
Rofecoxib (Vioxx) Withdrawn from the market 12
Secobarbital (Seconal) Approved D L3 13
Tolmetin (Tolectin) Approved C L3
Tramadol HCL (Ultram,
NR C L3 14
Ultracet)
Valdecoxib (Bextra) Withdrawn from the market more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)
 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.
 1. Aspirin use is discouraged in children and nursing mothers due to the risk of Reye’s
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 baby’s
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
Nama Generik Nama Dagang AAP Risiko Risiko
approved?* Kehamilan** Menyusui**
Azapropazone (apazone) Rheumox Approved - L2
Dipyrone (banned in the
- Approved - NR
US & UK)

Flufenamic acid - Approved - NR

B (1st, 2nd
Advil, Nuprin, Motrin,
Ibuprofen Approved trim.) L1
Pediaprofin
D (3rd trim.)
B (1st, 2nd
Indomethacin Indocin Approved trim.) L3
D (3rd trim.)
B (1st, 2nd
Ketorolac Toradol, Acular Approved trim.) L2
D (3rd trim.)
Mefenamic acid Ponstan, Ponstel Approved - NR
L3
Anaprox, Naprosyn,
Naproxen Approved B L4 (for chronic
Naproxen, Aleve
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-
[ high dosage Approved C L2
Medrol, Medrol
methylprednisolone]
Prednisolone - Approved C L2
Deltasone, Meticorten,
Prednisone Approved C L2
Orasone

Obat Asma [contents]

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

Analgetik Narkotik [more]

B (1st, 2nd
Butorphanol Stadol Approved trim.) 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
Darvocet N, Propacet,
Propoxyphene Approved C L2
Darvon

Obat Batuk
AAP
Nama Obat Risiko Menyusui**
approved?*
Codeine yes L3 (moderately safe)
Dextromethorphan not reviewed L1 (safest)
Guaifenesin not reviewed L2 (safer)
Dekongestan (Obat Pilek)
AAP
Nama Obat Risiko Menyusui**
approved?*
Phenylephrine not reviewed L3 (moderately safe)
L3 (moderately safe) for acute use
Pseudoephedrine
yes L4 (possibly hazardous) for chronic use due to
(Sudafed, Actifed)
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
not reviewed L1 (safest)
(Nasalcrom)
Fluticasone (Flonase) not reviewed L3 (moderately safe)
Mometasone
not reviewed L3 (moderately safe)
(Nasonex)
Phenylephrine (in
some forms of Sinex not reviewed L3 (moderately safe)
and Neo-Synephrine)
Triamcinolone
not reviewed L3 (moderately safe)
Acetonide (Nasacort)
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
not reviewed L2 (safer)
(Benadryl)
Doxylamine not reviewed L4 (possibly hazardous)
Fexofenadine
yes L3 (moderately safe)
(Allegra)
Loratadine (Claritin) yes L2 (safer)
Terfenadine
yes not reviewed
(Seldane)
Triprolidine (Actidil,
yes L1 (safest)
Actifed)
* 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
AAP Kategori Risiko Risiko
Nama Obat Notes
approved?* Kehamilan** Menyusui**
Local anesthetics
Articaine (Septocaine) NR - NR more
Bupivacaine (Marcaine) NR C L2
Lidocaine (Xylocaine) Approved C L2
Mepivacaine (Carbocaine,
NR C L3 more
Polocaine)
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)
 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.

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
Nama Generik Nama Dagang AAP Risiko Risiko
approved?* Kehamilan** 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,
Ceftazidime Approved B L1
Fortaz, Taxidime
Ceftriaxone Rocephin Approved B L2
Ciprofloxacin [more] Cipro Approved C L3
Clindamycin Cleocin Approved B L3
E-Mycin, Ery- L1
Erythromycin tab, ERYC, Approved B L3 early
Ilosone 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
Gantrisin, Azo-
Sulfisoxazole Approved C L2
Gantrisin
Achromycin,
Tetracycline Sumycin, Approved D L2
Terramycin
Ticarcillin,
Ticarcillin Approved B L1
Ticar, Timentin
Proloprim,
Trimethoprim/sulfamethoxazole Approved C L3
Trimpex
Antikoagulan [contents]
Bishydroxycoumarin
- Approved - NR
(dicumarol)
Coumadin,
Warfarin Approved D L2
Panwarfin
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
Depakene,
Valproic acid Approved D L2
Depakote
Anti Jamur [contents]
Fluconazole [more] Diflucan Approved C L2
Nizoral
Ketoconazole Shampoo, Approved C L2
Nizoral
Antivirus [contents]
Acyclovir [more] Zovirax Approved C L2
Alferon N,
Interferon-alpha [more] Approved C L2
Interferon Alpha
Arthritis meds (see also: pain meds) [contents]
Ridaura,
Gold salts Myochrysine, Approved C L5
Solganal
Kontrasepsi, Hormon [contents]
L3 (may
Estratab,
interfere
Estradiol Permarin, Approved X
with milk
Menest
production)
Clogestone - Approved - NR
Preven,
Seasonale,
Norinyl, L3 (may
Contraceptive pill with Norlestin, Ortho- interfere
Approved X
estrogen/progesterone Novum, Ovral, with milk
Lunelle production)
injection, Ortho-
Evra patch, etc.
Norplant,
Levonorgestrel Approved X L2
Mirena, Plan B
L1
Provera, Depo- L4 (if used
Medroxyprogesterone Approved D
Provera, Cycrin first 3 days
postpartum)
Norethynodrel Enovid Approved X L2
Crinone,
Progesterone Approved - L3
Prometrium
Obat Diabetes [contents]
Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk
category = L1.
Oramide,
Tolbutamide Approved D L3
Orinase
Obat Diare [contents]
Imodium, Pepto
Diarrhea
Control, Maalox
Antidiarrheal
Loperamide Caplets, Approved B L2
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]
Dazamide,
Acetazolamide Approved C L2
Diamox
L4 (may
Bendroflumethiazide Naturetin Approved D inhibit
lactation)
Chlorothiazide Hydrodiuril Approved D L3
Chlorthalidone Hygroton Approved D L3
Hydrodiuril,
Hydrochlorothiazide (HCT) Approved D L2
Esidrix, Oretic
Spironolactone Aldactone Approved D L2
Anti Muntah [more] [contents]
Domperidone Motilum Approved - L1
Anti Hipertensi, Obat Jantung [contents]
Anti aritmia
Norpace,
Disopyramide Approved C L2
Napamide
Flecainide Tambocor Approved C L3
Mexiletine Mexitil Approved B L2
Pronestyl,
Procainamide Approved C L3
Procan
Quinaglute,
Quinidine Approved C L2
Quinidex
Anti Hipertensi
L3 (if used
Captopril Capoten Approved D after 30
days)
 Cardizem Sr,
Dilacor-XR,
Diltiazem/Diltiazem HCL Approved C L3
Diltiazem,
Cardizem CD
C (1st trim.)
Enalapril/Enalapril Maleate Vasotec Approved D (2nd, 3rd L2
trim.)
Hydralazine Apresoline Approved C L2
Trandate,
Labetalol Approved C L2
Normodyne
Methyldopa Aldomet Approved C L2
Toprol XL,
Metoprolol Approved B L3
Lopressor
Loniten, L2
Minoxidil Minodyl, Approved C (topically)
Rogaine L3 (orally)
Corgard,
Nadolol Approved C L4
Nadolol
Adalat,
Nifedipine Approved C L2
Procardia
Apsolox, Slow-
Oxprenolol Trasicor, Approved - NR
Trasicor
Propranolol Inderol Approved C L2
Sotalol Betapace Approved B L3
Timolol Blocadren Approved C L2
Calan, Isoptin,
Verapamil Approved C L2
Covera-HS
Cardiac stimulants
Lanoxin,
Digoxin Approved C L2
Lanoxicaps
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]
Aralen, Novo-
Chloroquine Approved C L3
chloroquine
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]
Aquachloral,
Chloral hydrate Approved C L3
Noctec
Methyprylon (withdrawn from
- Approved - NR
use in US & Canada)
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
Tapazole Approved D L3
of carbimazole)
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 Approved B L2
Myambutol
Isoniazid INH, Laniazid Approved C L3
Rifadin,
Rifampin Approved C L2
Rimactane
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, Approved A L3 (do not
 Delta-d overdose)
A (1st, 2nd
Folic acid - Approved trim.) 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
Zyloprim,
Allopurinol Approved C L2
Lopurin
Antimony - Approved - NR
Atropine (Anticholinergic, Belladonna,
Approved C L3
drying agent) Atropine
Azapropazone/apazone
Rheumox Approved - L2
(Antirheumatic)
Baclofen (muscle relaxant) Lioresal, Atrofen Approved C L2
Barbiturate - Approved - NR
Vivarin, NoDoz,
Caffeine [more] Approved B L2
Coffee
Carbetocin (Antihemorrhagic) Duratocin Approved - NR
Chloroform - Approved - NR
Cisplatin (Anti-cancer) Platinol Approved D L4
Avlosulfon,
Dapsone (Antileprosy) Approved C L4
DDS
Hydroxychloroquine
Plaquenil Approved C L2
(Antirheumatic, lupus)
Iodides - Approved - NR
Iodine - Approved - NR
Iodine (povidone-iodine, eg, in
- Approved - NR
a vaginal douche)
Ivermectin (Antiparasitic) Mectizan Approved C L3
Nalidixic acid (Urinary Anti-
NegGram Approved B L4
infective)
Norsteroids - Approved - NR
Pyridostigmine (Muscle Mestinon,
Approved C L2
stimulant) Regonol
Transderm
Scopolamine (Motion sickness) Approved C L3
Scope
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)
 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