DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU

HAMIL DAN MENYUSUI

Disusun kembali oleh dr.Abu Hana
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

Acetaminophen (Tylenol)

Aspirin

AAP
approved?*

Kategori Risiko
Kehamilan**

Risiko
Notes
Menyusui**

Approved

L1

Caution

C (1st, 2nd trim.)

D (3rd trim.)

L3

Approved
Azapropazone (Rheumox)

L2

Butalbital (Fioricet,
Fiorinal, Bancap, Twodyne)

NR

L3

Butorphanol (Stadol)

Approved

B (1st, 2nd trim.)

D (3rd trim.)

L3

Celecoxib (Celebrex))

NR

L2

Codeine (in Tylenol #3, #4)

Approved

L3

Colchicine

Approved

L4

Diclofenac (Cataflam,
Voltaren)

NR

L2

Fentanyl (Sublimaze)

Approved

L2

Flurbiprofen (Ansaid,
Froben, Ocufen)

NR

B (1st, 2nd trim.)

C (3rd trim.)

L2

Hydrocodone (Lortab,
Vicodin)

NR

L3

Hydromorphone
(Dilaudid)

NR

L3

Approved

B (1st, 2nd trim.)

D (3rd trim.)

L1

Approved

B (1st, 2nd trim.)

L3

Ibuprofen (Advil, Nuprin,

Motrin, Pediaprofen)
Indomethacin (Indocin)

D (3rd trim.)

Ketorolac (Toradol, Acular)

Approved

B (1st, 2nd trim.)

D (3rd trim.)

L2

Meperidine (Demerol)

Approved

L2;
L3 early
postpartum

Methadone (Dolophine)

Approved

L3

Morphine (Duramorph,
Infumorph, Epimorph, MS
Contin)

Approved

L3

NR

L2

Nalbuphine (Nubain)

Naproxen (Anaprox,
Naprosyn, Naproxen,
Aleve)

Approved

L3;
L4 for chronic
use

Nefopam (Acupan)

Approved

NR

Oxycodone (Tylox,
Percodan,Oxycontin,
Roxicet, Endocet, Roxiprin,
Percocet)

NR

L3

Pentosan polysulfate
(Elmiron)

NR

L2

Piroxicam (Feldene)

Approved

L2

Propoxyphene (Darvocet
N, Propacet, Darvon)

Approved

L2

10

11

Rofecoxib (Vioxx)

Withdrawn from the market

12

Secobarbital (Seconal)

Approved

L3

Tolmetin (Tolectin)

Approved

L3

NR

L3

Tramadol HCL (Ultram,

Ultracet)
Valdecoxib (Bextra)

Withdrawn from the market

13

14

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]

Nama Generik

Nama Dagang

Kategori
AAP
Risiko
approved?* Kehamilan**

Risiko
Menyusui**

Azapropazone (apazone) Rheumox

Approved

L2

Dipyrone (banned in the

US & UK)

Approved

NR

Flufenamic acid

Approved

NR

Ibuprofen

Advil, Nuprin, Motrin,

Approved
Pediaprofin

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

L1

L3

Indomethacin

Indocin

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

Ketorolac

Toradol, Acular

Approved

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

L2

Mefenamic acid

Ponstan, Ponstel

Approved

NR

Naproxen

Anaprox, Naprosyn,
Naproxen, Aleve

Approved

L3
L4 (for chronic
use)

Phenylbutazone

Butazolidine

Approved

NR

Piroxicam

Feldene

Approved

L2

Suprofen

Profenal

Approved

NR

Tolmetin

Tolectin

Approved

Steroid

L3

[contents]

Methylprednisolone
[ high dosage
methylprednisolone]

Solu-Medrol, DepoMedrol, Medrol

Approved

L2

Prednisolone

Approved

L2

Prednisone

Deltasone, Meticorten,
Approved
Orasone

L2

Obat Asma

[contents]

Dyphylline

Dilor, Lufyllin,
Dyphylline

Approved

L3

Terbutaline

Bricanyl, Brethine

Approved

L2

Theophylline

Aminophylline,
Quibron, Theo-Dur

Approved

L3

Analgetik Narkotik [more]

Butorphanol

Stadol

Approved

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

L3

Codeine

Tylenol #3, #4

Approved

L3

Fentanyl

Sublimaze

Approved

L2

Meperidine

Demerol

Approved

L2
L3 (if used early
postpartum)

Methadone

Dolophine

Approved

L3

Morphine

Morphine

Approved

L3

Propoxyphene

Darvocet N, Propacet,
Approved
Darvon

L2

Obat Batuk
AAP
approved?*

Risiko Menyusui**

yes

L3 (moderately safe)

Dextromethorphan

not reviewed

L1 (safest)

Guaifenesin

not reviewed

L2 (safer)

Nama Obat

Codeine

Dekongestan (Obat Pilek)

Nama Obat

AAP
approved?*

Risiko Menyusui**

Phenylephrine

not reviewed

L3 (moderately safe)

yes

L3 (moderately safe) for acute use

L4 (possibly hazardous) for chronic use due to

Pseudoephedrine
(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)
Nama Obat

AAP
approved?*

Risiko Menyusui**

Beclomethasone
(Vanceril, Beclovent, not reviewed
Beconase, Vancenase)

L2 (safer)

Cromlyn sodium
(Nasalcrom)

L1 (safest)

not reviewed

Fluticasone (Flonase) not reviewed

L3 (moderately safe)

Mometasone
(Nasonex)

not reviewed

L3 (moderately safe)

Phenylephrine (in
some forms of Sinex not reviewed
and Neo-Synephrine)

L3 (moderately safe)

Triamcinolone
not reviewed
Acetonide (Nasacort)

L3 (moderately safe)

Antihistamin (Anti Alergi)

Nama Obat

AAP
approved?*

Risiko Menyusui**

Brompheniramine

not reviewed

L3 (moderately safe)

Chlorpheniramine
(Chlor-Trimeton)
CTM

not reviewed

L3 (moderately safe)

Cetirizine (Zyrtec)

not reviewed

L2 (safer)

yes

not reviewed

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)

Dexbrompheniramin
e maleate
with d-isoephedrine

* 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

Nama Obat

AAP
approved?*

Kategori Risiko
Kehamilan**

NR

Risiko
Menyusui* Notes
*

Local anesthetics
Articaine (Septocaine)

NR

more

Bupivacaine (Marcaine)

NR

L2

Approved

L2

Mepivacaine (Carbocaine,
Polocaine)

NR

L3

Procaine HCL (Novocaine)

NR

L3

Approved

L2

more

Isoflurane (Forane)

NR

NR

Ketamine

NR

NR

more

Approved

L3

Nitrous oxide

NR

L3

Sevoflurane (Ultane)

NR

L3

Approved

L3

L3; L4 for
chronic use

L3

Lidocaine (Xylocaine)

more

General anesthetics
Halothane (Fluothane)

Methohexital (Brevital)

Thiopental (Pentothal)

Other medications often used during anesthesia

Sedatives
Diazepam (Valium)
Concern

Midazolam (Versed)
Concern

Propofol (Diprivan)

NR

L2

more

Triazolam (Halcion)

NR

L3

NR

L2

Approved

L2

NR

L3

Approved

L3

Flumazenil (Romazicon)

NR

NR

Naloxone (Narcan)

NR

NR

NR

NR

more

NR

L1

NR

L2

Narcotic Analgesics
Alfentanil (Alfenta)

Fentanyl (Sublimaze)

Hydromorphone (Dilaudid)

Morphine
Reversal Medication

Steroids
Decadron (Dexamethasone)
Stimulants
Epinephrine (Adrenaline)
Anti-nausea
Promethazine (Phenergan)

* 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

Nama Generik

Kategori
Risiko
Risiko
Nama Dagang
AAP approved? Kehamilan* Menyusui*
*
*
*

Antasida

[contents]

Cimetidine (Antacid)

Tagamet

Approved

L2

Cisapride (GI tract stimulant)

Propulsid

Approved

L2

Approved

L1

Domperidone (used for nausea

& vomiting, stimulates
Motilum
lactation) [more]
Antibiotika

[contents]

Amoxicillin

Larotid, Amoxil

Approved

L1

Aztreonam

Azactam

Approved

L2

Cefadroxil

Ultracef, Duricef

Approved

L1

Cefazolin

Ancef, Kefzol

Approved

L1

Cefotaxime

Claforan

Approved

L2

Cefoxitin

Mefoxin
Approved

L1

Cefprozil

Cefzil

Approved

L1

Ceftazidime

Ceftazidime,
Fortaz, Taxidime

Approved

L1

Ceftriaxone

Rocephin

Approved

L2

Ciprofloxacin [more]

Cipro

Approved

L3

Clindamycin

Cleocin

Approved

L3

Erythromycin

E-Mycin, Erytab, ERYC,

Ilosone

Approved

L1
L3 early
postnatal

Fleroxacin

Approved

NR

Gentamicin

Garamycin

Approved

L2

Kanamycin

Kebecil, Kantrex

Approved

L2

Moxalactam

Moxam

Approved

NR

Nitrofurantoin

Macrobid

Approved

L2

Ofloxacin

Floxin

Approved

L2

Penicillin

Approved

L1

Streptomycin

Streptomycin

Approved

L3

Sulbactam

Approved

NR

Sulfisoxazole

Gantrisin, AzoGantrisin

Approved

L2

Tetracycline

Achromycin,
Sumycin,
Terramycin

Approved

L2

Ticarcillin

Ticarcillin,
Ticar, Timentin

Approved

L1

Approved

L3

Trimethoprim/sulfamethoxazol Proloprim,
e
Trimpex
Antikoagulan

[contents]

Bishydroxycoumarin
(dicumarol)

Approved

NR

Warfarin

Coumadin,
Panwarfin

Approved

L2

Antikonvulsan (Anti kejang)

[contents]

Carbamazepine

Tegretol, Epitol

Approved

L2

Ethosuximide

Zarontin

Approved

L4

Magnesium sulfate

Epsom salt

Approved

L1

Phenytoin

Dilantin

Approved

L2

Valproic acid

Depakene,
Depakote

Approved

L2

Anti Jamur

[contents]

Fluconazole [more]

Diflucan

Approved

L2

Ketoconazole

Nizoral
Shampoo,
Nizoral

Approved

L2

Antivirus

[contents]

Acyclovir [more]

Zovirax

Approved

L2

Interferon-alpha [more]

Alferon N,
Interferon Alpha

Approved

L2

Arthritis meds (see also: pain meds)

Gold salts

Ridaura,
Myochrysine,
Solganal

[contents]

Approved

Kontrasepsi, Hormon

L5

[contents]

Estradiol

Estratab,
Permarin,
Menest

Approved

L3 (may
interfere
with milk
production)

Clogestone

Approved

NR

Contraceptive pill with

estrogen/progesterone

Preven,
Seasonale,
Norinyl,
Norlestin,
Ortho-Novum,
Ovral, Lunelle
injection, OrthoEvra patch, etc.

Approved

L3 (may
interfere
with milk
production)

Levonorgestrel

Norplant,
Mirena, Plan B

Approved

L2

Medroxyprogesterone

Provera, DepoProvera, Cycrin

Approved

L1
L4 (if used
first 3 days
postpartum)

Norethynodrel

Enovid

Approved

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

Obat Diare

Oramide,
Orinase

Approved

L3

[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]

Acetazolamide

Dazamide,
Diamox

Approved

L2

Bendroflumethiazide

Naturetin

Approved

L4 (may
inhibit
lactation)

Chlorothiazide

Hydrodiuril

Approved

L3

Chlorthalidone

Hygroton

Approved

L3

Hydrochlorothiazide (HCT)

Hydrodiuril,
Esidrix, Oretic

Approved

L2

Spironolactone

Aldactone

Approved

L2

Anti Muntah [more]

Domperidone

[contents]

Motilum

Approved

Anti Hipertensi, Obat Jantung

L1

[contents]

Anti aritmia
Disopyramide

Norpace,
Napamide

Approved

L2

Flecainide

Tambocor

Approved

L3

Mexiletine

Mexitil
Approved

L2

Procainamide

Pronestyl,
Procan

Approved

L3

Quinidine

Quinaglute,
Quinidex

Approved

L2

Anti Hipertensi

Captopril

Capoten

Approved

L3 (if used
after 30
days)

Diltiazem/Diltiazem HCL

Cardizem Sr,
Dilacor-XR,
Diltiazem,
Cardizem CD

Approved

L3

Enalapril/Enalapril Maleate

Vasotec

Approved

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

L2

Hydralazine

Apresoline

Approved

L2

Labetalol

Trandate,
Normodyne

Approved

L2

Methyldopa

Aldomet

Approved

L2

Metoprolol

Toprol XL,
Lopressor

Approved

L3

Minoxidil

Loniten,
Minodyl,
Rogaine

Approved

L2
(topically)
L3 (orally)

Approved

L4

Nadolol

Corgard,
Nadolol

Nifedipine

Adalat,
Procardia

Approved

L2

Oxprenolol

Apsolox, SlowTrasicor,
Trasicor

Approved

NR

Propranolol

Inderol

Approved

L2

Sotalol

Betapace

Approved

L3

Timolol

Blocadren

Approved

L2

Verapamil

Calan, Isoptin,
Covera-HS

Approved

L2

Lanoxin,
Lanoxicaps

Approved

L2

Cardiac stimulants
Digoxin

Laksan (Pelancar BAB) [more]

[contents]

Cascara/Cascara Sagrada

Approved

L3

Danthron

Approved

NR

Magnesium sulfate

Epsom salt

Approved

L1

Senna

Approved

L3

Obat malaria

[contents]

Chloroquine

Aralen, Novochloroquine

Approved

L3

Hydroxychloroquine

Plaquenil

Approved

L2

Pyrimethamine

Daraprim

Approved

L4

Quinine

Quinamm

Approved

L2

Medical Testing [more]

[contents]

Diatrizoate

Approved

NR

Fluorescein

Approved

L3

Gadopentetic (Gadolinium)

Approved

L2

Iohexol

Omnipaque

Approved

L2

Iopanoic acid

Telepaque

Approved

L2

Metrizamide

Amipaque

Approved

L2

Metrizoate

Isopaque

Approved

L2

Obat Migren [more]

Sumatriptan

[contents]

Imitrex

Approved

L3

Obat Sedativ [more]

Chloral hydrate

[contents]
Aquachloral,
Noctec

Approved

L3

Methyprylon (withdrawn from

use in US & Canada)

Approved

NR

Bromide

Approved

L5

Secobarbital

Seconal

Approved

L3

Obat Tidur

Zolpidem/Zolpidem Tartrate

[contents]

Ambien

Approved

Obat Anti Tiroid [more]

Carbimazole

L3

[contents]

Approved

L3

Methimazole (active metabolite

Tapazole
of carbimazole)

Approved

L3

Propylthiouracil

PTU

Approved

L2

Thiouracil

Approved

NR

Levothyroxine

Synthroid,
Levothroid,
Thyroid, LevoT, Levoxyl

Approved

L1

Obat TBC

[contents]

Cycloserine

Seromycin

Approved

L3

Ethambutol

Ethambutol,
Myambutol

Approved

L2

Isoniazid

INH, Laniazid

Approved

L3

Rifampin

Rifadin,
Rimactane

Approved

L2

VITAMIN [more]

[contents]

B-1 (thiamin)

Approved

NR

B-12 (Cyanocobalamin)

Approved

L1

B-6 (pyridoxine)

Approved

L2; L4 in
high doses
(may inhibit
lactation)

D, vitamin

Calciferol,
Delta-d

Approved

L3 (do not
overdose)

L1

Folic acid

Approved

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

K-1, vitamin (Phytonadione)

Approved

L1

Riboflavin/B2

Approved

L1

Lain-lain

[contents]

Acitretin (Anti-psoriasis)

Soriatane

Approved

NR

Alcohol/Ethanol [more]

Approved

L3

Allopurinol

Zyloprim,
Lopurin

Approved

L2

Antimony

Approved

NR

Atropine (Anticholinergic,
drying agent)

Belladonna,
Atropine

Approved

L3

Azapropazone/apazone
(Antirheumatic)

Rheumox

Approved

L2

Baclofen (muscle relaxant)

Lioresal, Atrofen

Approved

L2

Barbiturate

Approved

NR

Caffeine [more]

Vivarin, NoDoz,
Coffee

Approved

L2

Carbetocin (Antihemorrhagic) Duratocin

Approved

NR

Chloroform

Approved

NR

Cisplatin (Anti-cancer)

Platinol

Approved

L4

Dapsone (Antileprosy)

Avlosulfon,
DDS

Approved

L4

Hydroxychloroquine
(Antirheumatic, lupus)

Plaquenil

Approved

L2

Iodides

Approved

NR

Iodine

Approved

NR

Iodine (povidone-iodine, eg, in

a vaginal douche)

Approved

NR

Ivermectin (Antiparasitic)

Mectizan

Approved

L3

Nalidixic acid (Urinary Antiinfective)

NegGram

Approved

L4

Norsteroids

Approved

NR

Pyridostigmine (Muscle
stimulant)

Mestinon,
Regonol

Approved

L2

Scopolamine (Motion sickness)

Transderm
Scope

Approved

L3

Sulfapyridine

Dagenan

Approved

NR

Timolol (glaucoma med)

Blocadren

Approved

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

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