Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

 The following tables summarize safety of drug use in pregnancy and lactation.
 Medications of herbal origin are excluded from the list.
 Under the column "Drug-Pregnancy Categories", letters A, B, C, D, and X signify the FDA Pregnancy
categories.
 These five categories indicate the potential of a systemically-absorbed drug to cause birth defects;
the key differentiation among the categories rests upon the reliability of documentation and the
risk: benefit ratio.

FDA Pregnancy Categories:

A : Controlled studies in pregnant women fail to demonstrate a risk to the fetus in the first
trimester with no evidence of risk in later trimesters. The possibility of fetal harm
appears remote.
B : Either animal-reproductive studies have not demonstrated a fetal risk but there are no
controlled studies in pregnant women, or animal-reproduction studies have shown an
adverse effect (other than a decrease in fertility) that was not confirmed in controlled
studies in women in the first trimester and there is no evidence of risk in later
trimesters.
C : Either studies in animals have revealed adverse effects on the fetus (teratogenic or
embryocidal effects or other) and there are no controlled studies in women, or studies
in women and animals are not available. Drugs should be given only if the potential
benefits justify the potential risk to the fetus.
D : There is positive evidence of human fetal risk, but the benefit from use in pregnant
women may be acceptable despite the risk (If the drug is needed for life threatening
situations or for serious diseases for which safer drugs can not be used or are
ineffective).
X : Studies in animals or human beings have demonstrated fetal abnormalities or there is
evidence of fetal risk based on human experience, or both, and the risk of the use of the
drug in pregnant women clearly outweighs any possible benefit. The drug is
contraindicated in women who are or may become pregnant.

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Drug Use in Pregnancy &

Lactation

 For drugs not FDA approved; other classification systems were used to identify the pregnancy
categories, whenever possible, the two other systems used are:
1. Micromedex Pregnancy Ratings:

Fetal risk cannot be Available evidence is inconclusive or is inadequate for determining

ruled out fetal risk when used in pregnant women or women of childbearing
potential. Weigh the potential benefits of drug treatment against
potential risks before prescribing this drug during pregnancy.

Fetal risk has been Evidence has demonstrated fetal abnormalities or risks when used
demonstrated during pregnancy or in women of childbearing potential. An
alternative to this drug should be prescribed during pregnancy or
in women of childbearing potential.

Fetal risk is minimal The weight of an adequate body of evidence suggests this drug
poses minimal risk when used in pregnant women or women of
childbearing potential.

2. Australian Drug Evaluation Committee (ADEC) Pregnancy Category Definitions

A : Drugs which have been taken by a large number of pregnant women and women of
childbearing age without any proven increase in the frequency of malformations or
other direct or indirect harmful effects on the fetus having been observed.
B1 : Drugs which have been taken by only a limited number of pregnant women and women
of childbearing age, without an increase in the frequency of malformation or other
direct or indirect harmful effects on the human fetus having been observed. Studies in
animals have not shown evidence of an increased occurrence of fetal damage.
B2 : Drugs which have been taken by only a limited number of pregnant women and women
of childbearing age, without an increase in the frequency of malformation or other
direct or indirect harmful effects on the human fetus having been observed. Studies in
animals are inadequate or may be lacking, but available data show no evidence of an
increased occurrence of fetal damage.
B3 : Drugs which have been taken by only a limited number of pregnant women and women
of childbearing age, without an increase in the frequency of malformation or other
direct or indirect harmful effects on the human fetus having been observed. Studies in
animals have shown evidence of an increased occurrence of fetal damage, the

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Drug Use in Pregnancy &

Lactation

significance of which is considered uncertain in humans.

C : Drugs which, owing to their pharmacological effects, have caused or may be suspected
of causing harmful effects on the human fetus or neonate without causing
malformations. These effects may be reversible. Accompanying texts should be
consulted for further details.
D : Drugs which have caused, are suspected to have caused, or may be expected to cause
an increased incidence of human fetal malformations or irreversible damage. These
drugs may also have adverse pharmacological effects. Accompanying texts should be
consulted for further details.
X : Drugs that have such a high risk of causing permanent damage to the fetus that they
should not be used in pregnancy or when there is a possibility of pregnancy.

 Note: For drugs in the B1, B2 and B3 categories, human data are lacking or inadequate and sub-
categorization is therefore based on available animal data. The allocation of a B category does not
imply greater safety than the C category. Drugs in category D are not absolutely contraindicated in
pregnancy (e.g. anticonvulsants). Moreover, in some cases the 'D' category has been assigned on
the basis of 'suspicion'.
 If there was no data under the previous three categorizations, the drug-pregnancy category is
assigned as "N/A"
 Data for medication use during breast feeding, are complied from FDA data, WHO data and
Micromedex Lactation Ratings:
1. WHO Lactation Ratings:
 Avoid breastfeeding
 Avoid breastfeeding if possible. May inhibit lactation
 Avoid breastfeeding if possible. Monitor infant for side effects
 Compatible with breastfeeding
 Compatible with breastfeeding. Monitor infant for side effects
 WHO documentation states insufficient data

2. Micromedex Lactation Ratings:

Infant risk cannot be Available evidence is inconclusive or is inadequate for determining

ruled out fetal risk when used in pregnant women or women of childbearing
potential. Weigh the potential benefits of drug treatment against
potential risks before prescribing this drug during breastfeeding

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Drug Use in Pregnancy &

Lactation

Infant risk has been Evidence and/or expert consensus has demonstrated harmful
demonstrated infant effects when used during breastfeeding. An alternative to
this drug should be prescribed or patients should be advised to
discontinue breastfeeding.
Infant risk is minimal The weight of an adequate body of evidence and/or expert
consensus suggests this drug poses minimal risk to the infant when
used during breastfeeding
Milk effects are Evidence suggests this drug may alter milk production or
possible composition. If an alternative to this drug is not prescribed,
monitor the infant for adverse effects and/or adequate milk intake

 Abbreviations used in the tables:

AAP: American Academy of Pediatrics

APR: Australian Pregnancy Ratings

FDA: U.S. Food and Drug Administration

IU: International Unit

N/A: no data available

MLR: Micromedex Lactation Ratings

MPR: Micromedex Pregnancy Ratings

RDA: Recommended daily allowance

WHO: World Health Organization

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/not
Abatacept C
recommended (Possible toxicity)
Abiraterone X Not indicated for use in women
Excretion in breast milk unknown/not
Acarbose B
recommended
Acetaminophen [Paracetamol] C Excreted in breast milk/use caution
Acetaminophen [Paracetamol] Refer to Individual
Refer to Individual Agents
and Codeine Agents
Acetaminophen [Paracetamol]
C Excreted in breast milk/not recommended
and Codeine and Caffeine
Acetaminophen [Paracetamol]
C Excreted in breast milk/not recommended
and Tramadol
Acetazolamide C Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Acetic Acid C
caution
Excretion in breast milk unknown/use
Acetylcysteine B
caution
Aciclovir [Acyclovir] (Systemic,
B Excreted in breast milk/use caution
Topical)
MPR: Fetal risk Excretion in breast milk unknown/use
Activated Charcoal
cannot be ruled out caution
Adalimumab B Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Adapalene C
caution
Excretion in breast milk unknown/not
Adefovir C
recommended
Excretion in breast milk unknown/not
Adenosine C
recommended
Excretion in breast milk unknown/not
Ado-Trastuzumab D
recommended
Aescin No data available No data available
Excretion in breast milk unknown/not
Aflibercept C
recommended
Agomelatine (P) ADEC*: B1 MLR: Infant risk cannot be ruled out
Albendazole C Excreted in breast milk/use caution
Albumin C MLR: Infant risk cannot be ruled out
Excretion in breast milk unknown/use
Alendronate C
caution
Alfacalcidol No data available Excreted in breast milk/not recommended

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Alfuzosin B Excretion in breast milk unknown
Alirocumab No data available Excreted in breast milk/not recommended
Allopurinol C Excreted in breast milk/use caution
Alpha-Lipoic Acid No data available Excretion in breast milk unknown
ALPRAZolam (C) D Excreted in breast milk/not recommended
Alprostadil C (Muse) Not intended for use by lactating women
Excretion in breast milk unknown/use
Alteplase C
caution
Aluminum Hydroxide B MLR: Infant risk cannot be ruled out
Amantadine C Excreted in breast milk/not recommended
Ambroxol No data available Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Amethocaine (Tetracaine) C
caution
Amidotrizoate [Diatrizoate] Briggs: No human data; probably
C
Meglumine [P] compatible
Amikacin D Excreted in breast milk/not recommended
Amiloride B Excreted in breast milk/contraindicated
Excretion in breast milk unknown/use
Amino Acids C
caution
Aminophylline C Excreted in breast milk/not recommended
Amiodarone D Excreted in breast milk/not recommended
Amitriptyline C Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
Amlodipine C
recommended
Excretion in breast milk
Amlodipine and Atorvastatin X
unknown/contraindicated
Excretion in breast milk unknown/not
Amlodipine and Olmesartan D
recommended
Excretion in breast milk unknown/not
Amlodipine and Valsartan D
recommended
Amlodipine, Valsartan and Refer to Individual
Refer to Individual Agents
Hydrochlorothiazide Agents
Briggs: No human data; probably
Ammonium Chloride C
compatible
Amoxicillin B Excreted in breast milk/use caution
Amoxicillin and Clavulanic Acid B Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Amphotericin-B B
recommended

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Ampicillin B Excreted in breast milk/use caution
Ampicillin and Sulbactam B Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Anastrozole X
recommended
Excretion in breast milk unknown/use
Anidulafungin B
caution
Antihemophilic Factor (Human, Excretion in breast milk unknown/use
C
Recombinant) caution
Excretion in breast milk unknown/not
Apixaban B
recommended
Excretion in breast milk unknown/not
Apomorphine C
recommended
ARIPiprazole (P) C Excreted in breast milk/not recommended
Ascorbic Acid (Vitamin C) C Excreted in breast milk/use caution
Aspirin (Acetylsalicylic Acid) D Excreted in breast milk/use caution
Atenolol D Excreted in breast milk/use caution
Atenolol and Chlortalidone Excretion in breast milk unknown/use
D
[Chlorthalidone] caution
Excretion in breast milk unknown/use
Atomoxetine C
caution
Excretion in breast milk
AtorvaSTATin X
unknown/contraindicated
Atosiban No data available Excreted in breast milk/contraindicated
Atropine B/C (Product Specific) Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Axitinib D
recommended
Excretion in breast milk
AzaCITIDine (P) D
unknown/contraindicated
AzaTHIOprine D Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Azelaic Acid B
caution
Excretion in breast milk unknown/use
Azelastine C
caution
Excretion in breast milk unknown/use
Azithromycin (Ophthalmic) B
caution
Azithromycin (Systemic) B Excreted in breast milk/use caution
Bacitracin and Neomycin Refer to Individual Agents Refer to Individual Agents
C
Baclofen Excreted in breast milk/not recommended

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

MLR: Infant risk is minimal (Not absorbed
Barium Sulfate (P) MPR: Fetal risk is minimal
systemically)
Excretion in breast milk unknown/not
BCG C
recommended
Excretion in breast milk unknown/use
Beclomethasone C
caution
Excretion in breast milk unknown/not
Bemiparin No data available
recommended
Excretion in breast milk unknown/not
Bendamustine D
recommended
Benoxinate (Oxybuprocaine) C Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Benzocaine and Phenazone C
caution
Excretion in breast milk unknown/use
Benzoyl Peroxide C
caution
Benzylpenicillin [Penicillin G]
B Excreted in breast milk/use caution
(Parenteral/Aqueous)
Benzylpenicillin [Penicillin G]
B Excreted in breast milk/use caution
Benzathine
Excretion in breast milk unknown/use
Betahistine ADEC*: B2
caution
Excretion in breast milk unknown/use
Betamethasone (Systemic) C
caution
Excretion in breast milk unknown/use
Betamethasone (Topical) C
caution
Betamethasone and Clotrimazole Refer to Individual
Refer to Individual Agents
(Topical) Agents
Excretion in breast milk unknown/not
Bevacizumab C
recommended
Excretion in breast milk
Bicalutamide X
unknown/contraindicated
Excretion in breast milk unknown/use
Bimatoprost C
caution
Bisacodyl ADEC*: A MLR: Infant risk cannot be ruled out
Excretion in breast milk unknown/use
Bisoprolol C
caution
Bisoprolol and Refer to Individual
Refer to Individual Agents
Hydrochlorothiazide Agents
Excretion in breast milk unknown/use
Bivalirudin B
caution

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/not
Bleomycin D
recommended
Bosentan Contraindicated Not recommended
Excretion in breast milk unknown/not
Brimonidine B
recommended
Refer to Individual
Brimonidine and Timolol Refer to Individual Agents
Agents
Excretion in breast milk unknown/not
Bromazepam (C) ADEC*: C
recommended
Bromhexine ADEC*: A Excreted in breast milk/not recommended
C (Capsule, Tablet)/B
Excreted in breast milk/use caution
Budesonide (Nasal, Oral
(capsule, oral inhalation, tablet)
Inhalation)
Budesonide (Topical) C Excreted in breast milk/use caution
Refer to Individual
Budesonide and Formoterol Refer to Individual Agents
Agents
Excretion in breast milk unknown/not
Bumetanide C
recommended
Bupivacaine C Excreted in breast milk/not recommended
Bupreborphine
BuPROPion C Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Cabergoline B
recommended
Excretion in breast milk unknown/not
Cabozantinib D
recommended
Calcipotriol [Calcipotriene] and
C Do not apply to the breast if breast-feeding
Betamethasone
Excretion in breast milk unknown/use
Calcitonin C
caution
Calcium Acetate, Carbonate, MPR: Fetal risk
MLR: Infant risk cannot be ruled out
Chloride, Citrate, Gluconate cannot be ruled out
Calcium Dobesilate No data available No data available
Calcium Hydroxylapatite No data available No data available
Excretion in breast milk unknown/use
Calcium Polystyrene Sulphonate C
caution
Canagliflozin C Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Candesartan
D recommended

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Candesartan and Refer to Individual
Refer to Individual Agents
Hydrochlorothiazide Agents
Excretion in breast milk unknown/not
Capecitabine D
recommended
Captopril D Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Carbachol C
caution
CarBAMazepine D Excreted in breast milk/not recommended
Use in pregnancy
prior to delivery is
contraindicated.
Carbetocin induced
contractions are of a
longer duration than
those observed with
oxytocin and are not
stopped by
Carbetocin discontinuation of Excreted in breast milk/use caution
therapy. Improper
use during pregnancy
may produce
symptoms similar to
those observed with
oxytocin overdosage
(eg, hyperstimulation
of uterus, uterine
rupture).
Carbidopa and Levodopa C WHO: Avoid breastfeeding
Carbimazole ADEC*: C AAP: Compatible with breastfeeding
Excretion in breast milk unknown/not
Carbocisteine [Carbocysteine] No data available
recommended
Excretion in breast milk unknown/not
CARBOplatin D
recommended
Carboprost Trometamol
C Excretion in breast milk unknown
[Tromethamine]
Excretion in breast milk unknown/not
Carvedilol C
recommended
Excretion in breast milk unknown/use
Caspofungin C
caution
Cefalexin [Cephalexin] B Excreted in breast milk/use caution

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

CeFAZolin B Excreted in breast milk/use caution
Cefdinir B Excretion in breast milk unknown
Cefepime B Excreted in breast milk/use caution
Cefixime B Excretion in breast milk unknown
Cefprozil B Excreted in breast milk/use caution
Ceftazidime B Excreted in breast milk/use caution
Ceftriaxone B Excreted in breast milk/use caution
Cefuroxime B Excreted in breast milk/use caution
C (Prior to 30 weeks
Celecoxib gestation)/D (≥30 Excreted in breast milk/use caution
weeks gestation)
Cephalexin B Excreted in breast milk/use caution
Certolizumab Use with caution Not excreted in breast milk/use caution
Cetirizine B MLR: Infant risk cannot be ruled out
Excretion in breast milk
Cetrorelix X
unknown/contraindicated
Excretion in breast milk unknown/not
Cetuximab C
recommended
Chloral Hydrate No data available Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
Chlorambucil D
recommended
Excretion in breast milk unknown/use
Chlorhexidine Gluconate B/C (Product Specific)
caution
Chloroquine C Excreted in breast milk/not recommended
Chlorphenamine
C WHO: Avoid breastfeeding
[Chlorpheniramine]
Chlorpromazine ADEC*: C Excreted in breast milk/not recommended
MPR: Fetal risk
Chlorzoxazone and Paracetamol MLR: Infant risk cannot be ruled out
cannot be ruled out
Chorionic Gonadotropin (Human, Excretion in breast milk unknown/use
X
Recombinant) caution
Excretion in breast milk unknown/use
Ciclesonide C
caution
CicloSPORINE [CycloSPORINE]
C Excreted in breast milk/not recommended
(Systemic)
Excretion in breast milk unknown/not
Cinacalcet C
recommended
Excretion in breast milk unknown/not
Cinnarizine No data available
recommended

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/use
Ciprofloxacin (Ophthalmic) C
caution
Ciprofloxacin (Systemic) C Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Cisatracurium B
caution
Cisplatin D Excreted in breast milk/not recommended
Excreted in breast milk/consider
Citalopram C
risk:benefit
Excretion in breast milk unknown/use
Clarithromycin C
caution
Clindamycin (Systemic, topical) B Excreted in breast milk/not recommended
Contraindicated in
Clobazam the first trimester of Present in breast milk
pregnancy
Excretion in breast milk unknown/use
Clomifene [ClomiPHENE] X
caution
ClomiPRAMINE C Excreted in breast milk/not recommended
ClonazePAM D Excreted in breast milk/not recommended
CloNIDine C Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Clopidogrel B
recommended
Clotrimazole C Excretion in breast milk unknown
Cloxacillin B WHO: Compatible with breastfeeding
Colchicine C Excreted in breast milk/use caution
MPR: Fetal risk
Colecalciferol [Cholecalciferol] Excreted in breast milk/use caution
cannot be ruled out
Colestyramine [Cholestyramine]
C Not excreted in breast milk/use caution
Resin
Colistimethate C Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Cosyntropin C
caution
Co-Trimoxazole [Sulfamethoxazole
D Excreted in breast milk/use caution
and Trimethoprim]
Crotamiton C Excretion in breast milk unknown
Cyanocobalamin (Vitamin B12) C Excreted in breast milk/compatible
Excretion in breast milk unknown/use
Cyclobenzaprine B
caution
Excretion in breast milk unknown/use
Cyclopentolate C
caution

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

CycloPHOSPHAMIDE D Excreted in breast milk/not recommended
Cyproterone ADEC*: B3 Not intended for use by lactating women
Cyproterone and Ethinylestradiol
X Excreted in breast milk/not recommended
[Ethinyl Estradiol]
Excretion in breast milk unknown/not
Cytarabin D recommended

Excretion in breast milk unknown/ Decision

Dapagliflozon C shall be made either to discontinue
breastfeeding or to discontinue the drug
Excretion in breast milk unknown/not
Dabigatran C
recommended
not indicated for use
Dapoxetine not indicated for use in women
in women
Excretion in breast milk unknown/not
Dacarbazine C
recommended
Excretion in breast milk unknown/not
DACTINomycin D
recommended
Excretion in breast milk unknown/not
Dalfampridine C
recommended
Dantrolene C Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Darbepoetin Alfa C
caution
Excretion in breast milk unknown/not
Deferasirox C
recommended
Excretion in breast milk unknown/not
Degarelix X
recommended
Excretion in breast milk unknown/not
Denosumab D (Xgeva®), X (Prolia®)
recommended
Desferrioxamine [Deferoxamine] C Excretion in breast milk unknown/use caution
Excretion in breast milk unknown/use
Desflurane B
caution
Desloratadine C Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Desmopressin B
caution
Desogestrel No data available Excreted in breast milk/use caution
Desvenlafaxine C Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Dexamethasone (Ophthalmic) C
caution

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/not
Dexamethasone (Systemic) C
recommended
Excretion in breast milk unknown/not
Dexlanzoprazole No data available
recommended
Excretion in breast milk unknown/use
Dexmedetomidine C
caution
Excretion in breast milk unknown/use
Dexpanthenol C
caution
Dextromethorphan ADEC*: A MLR: Infant risk is minimal
Dextrose C (Injection, Infusion) MLR: Infant risk cannot be ruled out
Dextrose and Sodium Chloride C Refer to Individual Agents
Diazepam (C) D Excreted in breast milk/not recommended
Diclofenac (Ophthalmic) C No data available
C/D ≥30 weeks
Diclofenac (Systemic) Excreted in breast milk/not recommended
gestation (Oral)
B (Topical Gel 3%) / C
(Topical Gel 1%,
Topical Solution,
Excretion in breast milk unknown/not
Diclofenac (Topical) Topical patch) / D
recommended
(Topical Patch and
Solution ≥30 weeks'
gestation)
Excretion in breast milk
Dienogest No data available
unknown/contraindicated
Digoxin C Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Digoxin Immune Fab C
caution
Dihydroergotamine X Excreted in breast milk/contraindicated
Diloxanide Furoate Not recommended No data available
Diltiazem C Excreted in breast milk/not recommended
DimenhyDRINATE B Excreted in breast milk/not recommended
Dimethindene No data available No data available
Excretion in breast milk unknown/use
Dimethyl Furmarate C
caution
Dinoprostone C Excretion in breast milk unknown
DiphenhydrAMINE (Systemic) B Excreted in breast milk/contraindicated
Diphtheria, Pertussis, Tetanus Excretion in breast milk unknown/use
B/C (Product Specific)
Vaccine caution

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Dipyridamole B Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Dobutamine B
caution
Excretion in breast milk unknown/not
DOCEtaxel D
recommended
Docusate ADEC*: A Excretion in breast milk unknown
Domperidone ADEC*: B2 Excreted in breast milk/not recommended
Donepezil C Excretion in breast milk unknown/use caution
Excretion in breast milk unknown/use
DOPamine C
caution
Dornase alpha B Infant risk cannot be ruled out
Excretion in breast milk unknown/not
Dorzolamide C
recommended
Refer to Individual
Dorzolamide and Timolol Refer to Individual Agents
Agents
Doxazosin C Excreted in breast milk/use caution
DOXOrubicin (Conventional) D Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
DOXOrubicin (Liposomal) No data available
recommended
Doxycycline D Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
Dulaglutide Not recommended
recommended
Duloxetine C Excreted in breast milk/use caution
Excretion in breast milk
Dutasteride X
unknown/contraindicated
Excretion in breast milk unknown/not
Dydrogesterone No data available
recommended
Excretion in breast milk unknown/use
Econazole C
caution
Eletriptan C Excreted in breast milk/use caution
Excretion in breast milk unknown/ Decision
Empagliflozon C shall be made either to discontinue
breastfeeding or to discontinue the drug
Enalapril D Excreted in breast milk/not recommended
Refer to Individual
Enalapril and Hydrochlorothiazide Refer to Individual Agents
Agents
Excretion in breast milk unknown/not
Enoxaparin B
recommended
Excretion in breast milk unknown/not
Entecavir (P) C
recommended

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Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/use
Epinastine C
caution
EPINEPHrine (Systemic, Oral Excretion in breast milk unknown/use
C
Inhalation) caution
Excretion in breast milk unknown/not
Epirubicin D recommended

Excretion in breast milk unknown/not

Eprosartan D
recommended
Eprosartan/Hydrochlorothiazide D Excreted in breast milk/not recommended
Eptacog Alfa Factor VIIa Excretion in breast milk unknown/not
C
(Recombinant) recommended
Excretion in breast milk unknown/not
Eribulin D
recommended
Excretion in breast milk unknown/not
ERLOtinib D
recommended
Ertapenem B Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Erythromycin (Ophthalmic) B
caution
Erythromycin (Systemic) B Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Erythropoietin /Epoetin Alpha C
caution
Excreted in breast milk/consider risk:
Escitalopram C
benefit
Excretion in breast milk unknown/not
Esmolol C
recommended
Esomeprazole C Excreted in breast milk/use caution
Estradiol (Systemic) X Excreted in breast milk/use caution
Estradiol (Systemic) No data available Excreted in breast milk/use caution
Etanercept B Excreted in breast milk/use caution
Ethambutol C Excreted in breast milk/use caution
Ethamsylate No data available No data available
Ethinylestradiol [Ethinyl
X Excreted in breast milk/not recommended
Estradiol] and Desogestrel
Ethinylestradiol [Ethinyl
X Excreted in breast milk/not recommended
Estradiol] and Drospirenone
Ethinylestradiol [Ethinyl
Estradiol] and Etonogestrel X Excreted in breast milk/not recommended

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Ethinylestradiol [Ethinyl
X Excreted in breast milk/not recommended
Estradiol] and Norelgestromin
Excretion in breast milk unknown/use
Etomidate C
caution
MPR: Fetal risk
Etonogestrel Excreted in breast milk/use caution
cannot be ruled out
Excretion in breast milk unknown/not
Etoposide D
recommended
C (Prior to 30 weeks
Excretion in breast milk
Etoricoxib gestation)/D (≥30
unknown/contraindicated
weeks gestation)
D (Afinitor®)/C Excretion in breast milk unknown/not
Everolimus
(Zortress®) recommended
Evolocumab No data available Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
Exemestane X
recommended
Excretion in breast milk unknown/use
Exenatide (P) C
caution
Excretion in breast milk unknown/not
Ezetimibe C
recommended
Ezetimibe and Simvastatin Refer to Individual Agents Refer to Individual Agents
Factor IX (Human) C No data available
Excretion in breast milk unknown/not
Famciclovir B
recommended
Excretion in breast milk unknown/not
Fampridine C
recommended
Fat Emulsion (Plant Based) C Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Febuxostat C
caution
Excretion in breast milk unknown/not
Felodipine C
recommended
Excretion in breast milk
Fenofibrate and Derivatives C
unknown/contraindicated
FentaNYL (N) C Excreted in breast milk/not recommended
Ferric Carboxymaltose C Excreted in breast milk/use caution
Ferrous Sulfate B WHO: Compatible with breastfeeding
Excretion in breast milk unknown/use
Fexofenadine C
caution
Excretion in breast milk unknown/use
Filgrastim C
caution

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk
Finasteride X
unknown/contraindicated
Excretion in breast milk unknown/not
Fingolimod C
recommended
C (Single dose for
Excreted in breast milk/use caution
Fluconazole vaginal candidiasis)/
D
Excretion in breast milk unknown/not
Fludarabine D
recommended
Excretion in breast milk unknown/use
Fludrocortisone C
caution
Excretion in breast milk unknown/use
Flumazenil C
caution
MPR: Fetal risk Excretion in breast milk unknown/not
Flunarizine
cannot be ruled out recommended
Fluorescein C Excreted in breast milk/use caution
Excretion in breast milk
FluoroURACIL (P) D
unknown/contraindicated
FLUoxetine C Excreted in breast milk/not recommended
Flutamide B Not intended for use by lactating women
Excretion in breast milk unknown/use
Fluticasone (Nasal) C
caution
Excretion in breast milk unknown/use
Fluticasone (Oral Inhalation) C
caution
Excretion in breast milk unknown/use
Fluticasone and Salmeterol C
caution
Fluticasone and Formetrol Avoid unless benefit
Not recommended
outweigh risk
Excretion in breast milk
Fluvastatin X
unknown/contraindicated
Excreted in breast milk/consider risk:
FluvoxaMINE C
benefit
Folic Acid A Excreted in breast milk/compatible
Excretion in breast milk unknown/not
Follitropin (Alfa & Beta) X
recommended
Excretion in breast milk unknown/use
Fondaparinux B
caution
Fosfomycin B Excreted in breast milk/not recommended
Fosinopril D Excreted in breast milk/not recommended

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/not
Fulvestrant D
recommended
Furosemide C Excreted in breast milk/use caution
Fusidic Acid (Ophthalmic & MPR: Fetal risk
Excreted in breast milk/use caution
Topical) cannot be ruled out
Refer to Individual
Fusidic Acid and Hydrocortisone Refer to Individual Agents
Agents
Gabapentin C Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Gadodiamide C
caution
Gadoterate Meglumine C Excretion in breast milk unknown/use caution
Excretion in breast milk unknown/not
Galantamine C
recommended
Excretion in breast milk unknown/use
Ganciclovir (Ophthalmic) C
caution
Excretion in breast milk unknown/not
Ganciclovir (Systemic) C
recommended
Excretion in breast milk unknown/use
Gatifloxacin (Systemic) C
caution
Excretion in breast milk unknown/not
GEMcitabine D
recommended
Excretion in breast milk unknown/not
Gemfibrozil C
recommended
Gentamicin (Systemic) D Excreted in breast milk/use caution
Glibenclamide [GlyBURIDE] B/C (Product Specific) Not recommended
Glibenclamide [GlyBURIDE] and Refer to Individual
Refer to Individual Agents
Metformin Agents
Excretion in breast milk
Gliclazide ADEC*: C
unknown/contraindicated
Excretion in breast milk unknown/not
Glimepiride C
recommended
Excretion in breast milk unknown/use
Glucagon B
caution
Glycerol [Glycerin] C MLR: Infant risk cannot be ruled out
Excretion in breast milk unknown/use
B (Injection)/C (Oral
Glycopyrrolate caution
Solution)
Excretion in breast milk unknown/not
Golimumab B recommended

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

X (Endometriosis,
Endometrial
Excretion in breast milk unknown/not
Goserelin Thinning); D
recommended
(Advanced Breast
Cancer)
Excretion in breast milk unknown/use
Granisetron B
caution
GuaiFENesin C Excretion in breast milk unknown
GuaiFENesin and Refer to Individual
Refer to Individual Agents
Dextromethorphan Agents
Refer to Individual Agents
GuaiFENesin, Dextromethorphan, Refer to Individual
and Phenylephrine Agents

GuaiFENesin, Pseudoephedrine, Refer to Individual

and Dextromethorphan
Haloperidol
Heparin
Hepatitis A and Hepatitis B
Recombinant Vaccine
Hepatitis A vaccine
Hepatitis B Immune Globulin
(Human)
Hepatitis B Vaccine
(Recombinant)
Human Chorionic Gonadotropin
Hyaluronate and Derivatives
Hyaluronidase
HydrALAZINE
Hydrochlorothiazide
Hydrochlorothiazide and
Spironolactone
Hydrocortisone (Systemic &
Topical)
Hydrocortisone, Hydroquinone,
and Tretinoin
HYDROmorphone (N)
Refer to Individual Agents
Agents
C Excreted in breast milk/not recommended
C Not excreted in breast milk/use caution
Excretion in breast milk unknown/use
C
caution
Excretion in breast milk unknown/use
C
caution
Excretion in breast milk unknown/use
C
caution
Excretion in breast milk unknown/use
C
caution
X MLR: Infant risk cannot be ruled out
MPR: Fetal risk Excretion in breast milk unknown/not
cannot be ruled out recommended
Excretion in breast milk unknown/use
C
caution
C Excreted in breast milk/use caution
B Excreted in breast milk/not recommended
Refer to Individual
Refer to Individual Agents
Agents
C Excreted in breast milk/use caution
Excretion in breast milk unknown/use
C
caution
C Excreted in breast milk/not recommended

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Hydroquinone C Excretion in breast milk unknown/use caution
Hydroxycarbamide
D Excreted in breast milk/not recommended
[Hydroxyurea]
Hydroxychloroquine ADEC*: D Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
Hydroxyprogesterone B
recommended
Hyoscine Butylbromide
C Excreted in breast milk/use caution
[Scopolamine] (Systemic)
Excretion in breast milk unknown/use
Ibandronic Acid [Ibandronate] C
caution
C/D ≥30 weeks
Ibuprofen Excreted in breast milk/not recommended
gestation
Ifosfamide D Excreted in breast milk/not recommended
Imatinib D Excreted in breast milk/not recommended
Imipenem and Cilastatin C Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Imiquimod C
caution
Excretion in breast milk unknown/use
Immune Globulin C
caution
Excretion in breast milk unknown/not
Indapamide B
recommended
Indacaterol maleate / Excretion in breast milk unknown/use
C
Glycopyrronium bromide caution
C (<30 weeks
gestation); C/D (≥30
Indometacin [Indomethacin] weeks gestation Excreted in breast milk/not recommended
[manufacturer
specific])
Excretion in breast milk unknown/not
InFLIXimab B
recommended
Influenza Virus Vaccine Excretion in breast milk unknown/use
B/C (Product Specific)
(Inactivated) caution
Insulin Aspart B Briggs: Compatible with breastfeeding
Insulin Aspart Protamine and
B Briggs: Compatible with breastfeeding
Insulin Aspart
Insulin Detemir B Briggs: Compatible with breastfeeding
Insulin Degludec C Briggs: Compatible with breastfeeding
Insulin Glargine C Briggs: Compatible with breastfeeding
Insulin Glulisine C Briggs: Compatible with breastfeeding

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Insulin Lispro/Insulin Lispro
B Briggs: Compatible with breastfeeding
Protamine and Insulin Lispro
Insulin NPH B Briggs: Compatible with breastfeeding
Insulin NPH and Insulin Regular B Briggs: Compatible with breastfeeding
Insulin Regular B Briggs: Compatible with breastfeeding
C/X (In combination Excretion in breast milk unknown/not
Interferon Alfa-2a
with Ribavirin) recommended
C/X (In combination
Interferon Alfa-2b Excreted in breast milk/not recommended
with Ribavirin)
Interferon Beta-1a C Excreted in breast milk/use caution
Interferon Beta-1b C Excretion in breast milk unknown/not recommended
Briggs: No human data; probably
Iobitridol (P) B
compatible
Briggs: No human data; probably
Iodine (P) B
compatible
Briggs: No human data; probably
Iodixanol B
compatible
Briggs: No human data; probably
Iodoquinol No data available
compatible
Briggs: No human data; probably
Iohexol B
compatible
Briggs: No human data; probably
Iopamidol B
compatible
Excreted in breast milk/bottle feedings are
Iotalamate [Iothalamate] B/C (product
recommended for 24 hours after
Meglumine [P] dependent)
administration
Excretion in breast milk unknown/use
Ipratopium (Oral Inhalation) B
caution
Excretion in breast milk unknown/not
Irbesartan D
recommended
Irbesartan/Hydrochlorthiazide D Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
Irinotecan D
recommended
Excretion in breast milk unknown/use
Iron Sucrose B
caution
Isoniazid C Excreted in breast milk/compatible
Excretion in breast milk unknown/use
Isoprenaline /isoproterenol C caution

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Isosorbide Dinitrate C Excretion in breast milk unknown/use
Isosorbide mononitrate B/C (Product Specific) caution
Excretion in breast milk unknown/not
ISOtretinoin X
recommended
Itraconazole C Excreted in breast milk/not recommended
Excretion in breast milk
Ivabradine ADEC*: D
unknown/contraindicated
Kaolin and Pectin MPR: Fetal risk is minimal AAP: Compatible with breastfeeding
Ketamine ADEC*: A WHO: Compatible with breastfeeding
Excretion in breast milk unknown/use
Ketoconazole (Topical) C
caution
Ketorolac (Ophthalmic) C Excretion in breast milk unknown/use caution
Excretion in breast milk unknown/use
Ketotifen (Ophthalmic) C
caution
Ketotifen (Systemic) C Excreted in breast milk/not recommended
Labetalol C Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Lacosamide C
recommended
Excretion in breast milk unknown/use
Lactulose B
caution
LamiVUDine C Excreted in breast milk/contraindicated
LamoTRIgine C Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Lansoprazole B
recommended
Excretion in breast milk unknown/not
LAPAtinib D
recommended
Excretion in breast milk unknown/use
Latanoprost C
caution
Excretion in breast milk unknown/not
Leflunomide X
recommended
Excretion in breast milk
Lercanidipine No data available
unknown/contraindicated
Excretion in breast milk unknown/not
Letrozole X
recommended
Leucovorin Calcium [Calcium Excretion in breast milk unknown/use
C
Folinate] caution
Excretion in breast milk
Leuprorelin [Leuprolide] X
unknown/contraindicated
Levamisole C WHO: Avoid breastfeeding

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

LevETIRAcetam C Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
LevOCARNitine B
caution
Excretion in breast milk unknown/not
Levocetirizine B
recommended
Levodopa, Carbidopa, and
C WHO: Avoid breastfeeding
Entacapone
Levofloxacin C Excreted in breast milk/not recommended
Levonorgestrel X Excreted in breast milk/use caution
Levothyroxine A Excreted in breast milk/use caution
Lidocaine (Systemic) B Excreted in breast milk/use caution
Lidocaine (Topical) B Excreted in breast milk/use caution
Lidocaine and Epinephrine B Excreted in breast milk/use caution
Lidocaine and Prilocaine B Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Linagliptin B
caution
Linezolid C Excreted in breast milk/use caution
Liothyronine A Excreted in breast milk/use caution
X (Saxenda)/C Excretion in breast milk unknown/not
Liraglutide
(Victoza) recommended
Excretion in breast milk unknown/not
Lisinopril D
recommended
Lithium D Excreted in breast milk/not recommended
Loperamide C Excreted in breast milk/not recommended
Loratadine B AAP: Compatible with breastfeeding
C/D ≥30 weeks Excretion in breast milk unknown/not
Lornoxicam
gestation recommended
Excretion in breast milk unknown/not
Losartan D
recommended
Losartan and Refer to Individual
Refer to Individual Agents
Hydrochlorothiazide Agents
C/D ≥30 weeks
Loxoprofen No data available
gestation
Magnesium Citrate D AAP: Compatible with breastfeeding
Magnesium Oxide D AAP: Compatible with breastfeeding
Magnesium Sulfate D Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Mannitol C
caution

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/use
Measles Virus Vaccine (Live) C
caution
Measles, Mumps, Rubella Excretion in breast milk unknown/use
C
Vaccine caution
Excretion in breast milk unknown/use
Mebendazole C
caution
Excretion in breast milk unknown/not
Mebeverine No data available
recommended
Meclizine and Pyridoxine B Excretion in breast milk unknown
MedroxyPROGESTERone X WHO: Compatible with breastfeeding
Mefenamic Acid C Excreted in breast milk/not recommended
Mefloquine B Excreted in breast milk/use caution
D (Tablet)/X
Megestrol Excreted in breast milk/not recommended
(Suspension)
C/D ≥30 weeks Excretion in breast milk unknown/not
Meloxicam
gestation recommended
Excretion in breast milk unknown/not
Melphalan D
recommended
Excretion in breast milk unknown/use
Memantine B
caution
Meningococcal (Groups A / C / Y
Excretion in breast milk unknown/use
and W-135) Diphtheria Conjugate B/C (Product Specific)
caution
Vaccine
Meningococcal Polysaccharide
Excretion in breast milk unknown/use
Vaccine (Groups A / C / Y and W- C
caution
135)
Excretion in breast milk unknown/not
Menotrophins [Menotropins] X
recommended
Excretion in breast milk unknown/use
Mepivacaine and Adrenaline C
caution
Fetal risk cannot be
Mepolizumab Infant risk cannot be ruled out
ruled out
Excretion in breast milk unknown/not
Mercaptopurine D
recommended
Meropenem B Excreted in breast milk/use caution
Mesalazine [Mesalamine] B/C (Product Specific) Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Mesna B
recommended
MetFORMIN B Excreted in breast milk/not recommended

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Methadone (N) C Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Methocarbamol C
caution
X (Psoriasis,
Methotrexate Excreted in breast milk/contraindicated
Rheumatoid arthritis)
Methoxy Polyethylene Glycol- Excretion in breast milk unknown/use
C
Epoetin Beta (P) caution
Methyldopa B/C (Injectable) Excreted in breast milk/use caution
WHO: Avoid breastfeeding
Methylene Blue X
Methylergometrine
C Excreted in breast milk/not recommended
[Methylergonovine]
Methylphenidate (C) C Excreted in breast milk/use caution
MethylPREDNISolone C Excreted in breast milk/use caution
Metoclopramide B Excreted in breast milk/use caution
Metolazone B Excreted in breast milk/not recommended
Metoprolol C Excreted in breast milk/use caution
MetroNIDAZOLE (Systemic) B Excreted in breast milk/not recommended
MetroNIDAZOLE (Topical) B Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Miconazole (Oral) C
caution
Excretion in breast milk unknown/use
Miconazole (Topical) No data available
caution
Micronized Purified Flavonoid Excretion in breast milk unknown/not
No data available
Fraction (MPFF) recommended
Midazolam (C) D Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Midodrine C
caution
Excretion in breast milk unknown/use
Milrinone C
caution
Minoxidil (Sytemic) C Excreted in breast milk/not recommended
Mirtazapine C Excreted in breast milk/use caution
Misoprostol X Excreted in breast milk/use caution
Excretion in breast milk unknown/not
MitoMYcin (Systemic) X
recommended
MitoXANtrone D Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Modafinil C
caution

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Mometasone (Nasal) C Excretion in breast milk unknown/use
Mometasone (Topical) C caution
Excretion in breast milk unknown/use
Montelukast B
caution
Excreted in breast milk/use caution (AAP
Morphine (N) C
rates compatible)
Excretion in breast milk unknown/use
Moxifloxacin (Ophthalmic) C
caution
Excretion in breast milk unknown/not
Moxifloxacin (Systemic) C
recommended
Moxonidine No data available Excreted in breast milk/Contraindicated
Excretion in breast milk unknown/use
Mupirocin B
caution
Excretion in breast milk unknown/not
Mycophenolate D
recommended
Naloxone B/C (Product Specific) Excretion in breast milk unknown/use caution
Excretion in breast milk unknown/use
Naphazoline and Pheniramine C
caution
Naproxen C Excreted in breast milk/not recommended
Natalizumab C Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Nebivolol C
recommended
Excretion in breast milk unknown/not
Neomycin D
recommended
Excretion in breast milk unknown/use
Neostigmine C
caution
Discontinue breastfeeding or to discontinue
Netupitant and Palonosetron C
the drug
NIFEdipine C Excreted in breast milk/not recommended
NiMODipine C Excreted in breast milk/not recommended
Nintedanib D Excreted in breast milk/not recommended
B (Contraindicated at Excreted in breast milk/not recommended
Nitrofurantoin
term) (infants <1 month)
Excretion in breast milk unknown/use
Nitroglycerin B/C (Product Specific)
caution
MPR: Fetal risk has
Nivolumab (P) MLR: Infant risk cannot be ruled out
been demonstrated
Excretion in breast milk unknown/use
Norepinephrine C
caution

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Norethisterone X Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Norfloxacin C
recommended
Excretion in breast milk unknown/use
Nystatin (Oral, Topical) C
caution
An effective
contraception should
be used during
Ocrelizumab Contraindicated
therapy and for 6
months after the last
infusion.
Octreotide B Excreted in breast milk/use caution
Oestrogens [Estrogens]
X Excreted in breast milk/use caution
(Conjugated/Equine, Systemic)
Excretion in breast milk unknown/not
Ofloxacin (Ophthalmic) C
recommended
Ofloxacin (Systemic) C Excreted in breast milk/not recommended
OLANZapine C Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
Olmesartan D
recommended
Olmesartan/Hydrochlorothiazide D Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Olopatadine (Ophthalmic) C
caution
Omalizumab (P) No data available No data available
Ombitasvir/Paritaprevir/Ritonavir Excretion in breast milk unknown/not
B
(P) recommended
Omega-3 Fatty Acids C Excreted in breast milk/use caution
Omeprazole C Excreted in breast milk/use caution
Omeprazole and Sodium Refer to Individual
Refer to Individual Agents
Bicarbonate Agents
OnabotulinumtoxinA [Botulinum Excretion in breast milk unknown/use
C
Toxin Type A] caution
Excretion in breast milk unknown/use
Ondansetron B
caution
Excretion in breast milk unknown/use
Orlistat X
caution
Oseltamivir C Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Oxaliplatin D
recommended

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

OXcarbazepine C Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Oxybutynin B
caution
OxyCODONE B/C (Product Specific) Excreted in breast milk/not recommended
OxyCODONE and Paracetamol Refer to Individual
Refer to Individual Agents
[Acetaminophen] Agents
Excretion in breast milk unknown/use
Oxymorphone (N) C
caution
Excretion in breast milk unknown/use
Oxytocin C (Product Specific)
caution
PACLItaxel (Conventional) D Excreted in breast milk/not recommended
PACLitaxel (Protein Bound) D Excreted in breast milk/not recommended
Palivizumab C No data available
Excretion in breast milk unknown/use
Pancrelipase C
caution
Excretion in breast milk unknown/not
Panitumumab C
recommended
Pantoprazole B Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Papaverine C
caution
Excretion in breast milk unknown/use
Papillomavirus (Types 16, 18)
B caution
Vaccine (Human, Recombinant)
Papillomavirus (Types 6, 11, 16,
Excretion in breast milk unknown/use
18) Vaccine (Human, B
caution
Recombinant)
Excretion in breast milk unknown/not
Paricalcitol C
recommended
PARoxetine D/X (Product Specific) Excreted in breast milk/use caution
Excretion in breast milk unknown/not
PAZOPanib D
recommended
Excretion in breast milk unknown/use
Pegfilgrastim C
caution
C/X (In combination Excretion in breast milk unknown/not
Peginterferon Alfa-2a/2b
with Ribavirin) recommended
Excretion in breast milk unknown/use
Peginterferon beta 1 A C
caution
Excretion in breast milk unknown/not
PEMEtrexed D
recommended

Pharmacy & Therapeutic Committee- Sep 2018

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk
PenicillAMINE D
unknown/contraindicated
Pentoxifylline C Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Perampanel Contraindicated
caution
Excretion in breast milk unknown/use
Perindopril D
caution
Perindopril and Amlodipine D Refer to Individual Agents
Excretion in breast milk unknown/not
PERTuzumab D
recommended
Pethidine [Meperidine] (N) C Excreted in breast milk/not recommended
PHENobarbitone [PHENobarbital]
B/D (Product Specific) Excreted in breast milk/use caution
(C)
Phenoxymethylpenicillin
B MLR: Infant risk cannot be ruled out
[Penicillin V] Potassium
Excretion in breast milk
Phentermine (C) X
unknown/contraindicated
Phenylephrine (Ophthalmic, Excretion in breast milk unknown/use
C
Systemic) caution
Phenytoin D Excreted in breast milk/not recommended
Phytomenadione [Phytonadione;
C Excreted in breast milk/use caution
Vitamin K]
Excretion in breast milk unknown/not
Pilocarpine C
recommended
Excretion in breast milk unknown/not
Pimecrolimus C
recommended
Animal reproduction
studies and information
from human
pregnancies is not
available. The presence
of bromine in the
formulation poses a
Excretion in breast milk unknown/not
Pinaverium theoretical risk of
causing neurologic
recommended
effects (sedation,
hypotony) to newborns
if pinaverium is used
late in pregnancy,
though no such cases
have been reported

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/not
Pioglitazone C
recommended
Piperacillin and Tazobactam B Excreted in breast milk/use caution
Piracetam Not recommended Excreted in breast milk/Not recommended
Excretion in breast milk unknown/ Decision
Pirfenidone C shall be made either to discontinue
breastfeeding or to discontinue the drug
Excretion in breast milk unknown/use
Piribedil Not recommended
caution
Excretion in breast milk unknown/not
Pizotifen No data available
recommended
Excretion in breast milk unknown/use
Pneumococcal Conjugate Vaccine
B caution
(13-Valent)

Pneumococcal Polysaccharide Excretion in breast milk unknown/use

C
Vaccine (23-Valent) caution

It may be used during

pregnancy and breast
feeding only if strictly
indicated.
There have not been It may be used during pregnancy and
any studies of the breast feeding only if strictly indicated.
risks associated with There have not been any studies of the
use during pregnancy risks associated with use during pregnancy
Policresulen
in humans, but in humans, but animal studies have not
animal studies have yield any evidence of fetal malformation. It
not yield any is not known whether the active substance
evidence of fetal passes into milk.
malformation. It is
not known whether
the active substance
passes into milk.
Excretion in breast milk unknown/not
Polidocanol C
recommended
Poliovirus Vaccine
C MLR: Infant risk cannot be ruled out
(Live/Trivalent/Oral)

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/use
Polyethylene Glycol 3350 C
caution
Potassium Acetate C MLR: Infant risk cannot be ruled out
Potassium Chloride C Excreted in breast milk/not recommended
Excreted in breast milk/use caution (AAP
Potassium Iodide and Iodine D (Potassium Iodide)
rates compatible)
Excreted in breast milk/use caution (AAP
Potassium Phosphate C
rates compatible)
Excretion in breast milk unknown/not
Povidone-Iodine (Ophthalmic) C
recommended
Povidone-Iodine (Topical) No data available Excreted in breast milk/use caution
Pralidoxime (PAM) C Excretion in breast milk unknown/use caution
Excretion in breast milk unknown/not
Pramipexole C
recommended
Excretion in breast milk unknown/use
PrednisoLONE (Ophthalmic) C
caution
PrednisoLONE (Systemic) C/D (Product Specific) Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Pregabalin C
recommended
Primidone D Excreted in breast milk/not recommended
Procainamide C Excreted in breast milk/not recommended
Prochlorperazine ADEC*: C Excretion in breast milk unknown
Progesterone B (Oral) Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Promethazine C
recommended
Propofol B Excreted in breast milk/not recommended
Propranolol C Excreted in breast milk/use caution
Propylthiouracil D Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Protamine C
caution
Excretion in breast milk unknown/use
Protirelin C
caution
Excreted in breast milk/use caution (AAP
Pseudoephedrine ADEC*: B2
rates compatible)
Safe (Not absorbed
Psyllium AAP: Compatible with breastfeeding
systematically)
Pylera (Bismuth, Metronidazole,
Contraindicated Excreted in breast milk/not recommended
Tetracycline)
Pyrazinamide C Excreted in breast milk/use caution

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Pyridostigmine B/C (Product Specific) Excreted in breast milk/use caution
Pyridoxine (Vitamin B6) A Excreted in breast milk/compatible
QUEtiapine C Excreted in breast milk/not recommended
Excreted in breast milk/use caution (AAP
QuiNINE C
rates compatible)
Excretion in breast milk unknown/use
RABEprazole C
caution
Rabies Vaccine C Excretion in breast milk unknown
Excretion in breast milk
Raloxifene X
unknown/contraindicated
Excretion in breast milk unknown/not
Ramipril D
recommended
Excretion in breast milk unknown/use
Ranibizumab C
caution
Ranitidine B Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Rasburicase C
recommended
Excretion in breast milk
Regorafenib (P) D
unknown/contraindicated
Excretion in breast milk unknown/use
Remifentanil (N) C
caution
Excretion in breast milk unknown/not
Repaglinide C
recommended
Excretion in breast milk unknown/use
Rho(D) Immune Globulin C
caution
Excretion in breast milk unknown/not
Ribavirin X
recommended
Riboflavin, Ophthalmic No data available No data available
Rifampin C Excreted in breast milk/not recommended
Refer to Individual
Rifampin and Isoniazid Refer to Individual Agents
Agents
Excretion in breast milk unknown/not
Rimexolone C
recommended
RisperiDONE C Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
RiTUXimab C
recommended
Excretion in breast milk unknown/not
Rivaroxaban C
recommended
Excretion in breast milk unknown/not
Rivastigmine B
recommended

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/use
RIZAtriptan (P) C
caution
Rocuronium C MLR: Infant risk cannot be ruled out
Excretion in breast milk
Rosuvastatin X
unknown/contraindicated
Rotavirus Vaccine C AAP: Compatible with breastfeeding
Excretion in breast milk unknown/use
Rotigotine C
caution
Excretion in breast milk unknown/not
Salbutamol /Albuterol C
recommended
Salicylic Acid C Not recommended
Excretion in breast milk unknown/use
Saxagliptin B
caution
Refer to Individual
Saxagliptin and MetFORMIN Refer to Individual Agents
Agents
Secukinumab B Infant risk cannot be ruled out
Excretion in breast milk unknown/not
Selegiline C
recommended
Senna C AltMedDex®; Micromedex®: Compatible
Sertaconazole C Excretion in breast milk unknown/use caution
Sertraline C Excreted in breast milk/use caution
Sevelamer C MLR: Infant risk is minimal
MLR: Infant risk cannot be ruled out (for 24
Sevoflurane B
hours after anesthesia)
Excretion in breast milk unknown/use
Sildenafil B
caution
Excretion in breast milk unknown/not
Silver Sulfadiazine B
recommended
Silymarin No data available No data available
Safe (Not absorbed
Simeticone [Simethicone] AAP: Compatible with breastfeeding
systematically)
Excretion in breast milk
Simvastatin X
unknown/contraindicated
Excretion in breast milk unknown/use
SitaGLIPtin B
caution
Refer to Individual
Sitagliptin and Metformin Refer to Individual Agents
Agents
Sodium Acetate C Excreted in breast milk/compatible
Sodium Bicarbonate C Excreted in breast milk/compatible

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Sodium Chloride C Excreted in breast milk/use caution
Sodium Cromoglicate [Cromolyn] Excretion in breast milk unknown/use
B
(Ophthalmic) caution
Sodium Phosphate C Excreted in breast milk/compatible
Excretion in breast milk unknown/use
Sodium Polystyrene Sulfonate C
caution
Excretion in breast milk
Sodium Stibogluconate X
unknown/contraindicated
Sofosbuvir/Ledipasvir (P) B MLR: Infant risk cannot be ruled out
Excretion in breast milk unknown/not
Solifenacin C
recommended
B/C (Depending upon Excretion in breast milk unknown/use
Somatropin
manufacturer) caution
Excretion in breast milk unknown/not
SORAfenib D
recommended
Sotalol B Excreted in breast milk/not recommended
Spironolactone C Excreted in breast milk/not recommended
Streptomycin D Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Sucralfate B
caution
Excretion in breast milk unknown/use
SUFentanil (N) C
caution
Sugammadex No data available Excretion in breast milk unknown
SulfADIAZINE C Excreted in breast milk/contraindicated
SulfaSALAzine B Excreted in breast milk/use caution
Sulpiride Not recommended Excreted in breast milk/not recommended
SUMAtriptan C Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
SUNItinib D
recommended
Suxamethonium Excretion in breast milk unknown/use
C
[Succinylcholine] caution
TACrolimus (Systemic, Topical) C Excreted in breast milk/not recommended
Excretion in breast milk unknown/use
Tadalafil B
caution
Excretion in breast milk unknown/ Decision
Tafacitinib C shall be made either to discontinue
breastfeeding or to discontinue the drug
Talc (Sterile) B Excretion in breast milk unknown

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/not
Tamoxifen D
recommended
Tamsulosin B MLR: Infant risk cannot be ruled out
Excretion in breast milk unknown/use
Teicoplanin Not recommended
caution
B/X (in combination Excretion in breast milk unknown/not
Telaprevir
with ribavirin) recommended
Excretion in breast milk unknown/not
Telmisartan D
recommended
Telmisartan and Refer to Individual
Refer to Individual Agents
Hydrochlorothiazide Agents
Excretion in breast milk unknown/not
TEMOzolomide D
recommended
Excretion in breast milk unknown/not
Temsirolimus D
recommended
Tenofovir B Excreted in breast milk/contraindicated
Terbinafine (Systemic) B Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
Teriflunomide X
recommended
Excretion in breast milk unknown/not
Teriparatide C
recommended
Testosterone X Excreted in breast milk/contraindicated
Excretion in breast milk unknown/use
Tetanus Toxoid (Adsorbed) C
caution
Excretion in breast milk unknown/use
Tetracaine [Amethocaine] C
caution
Tetracosactide [Tetracosactrin, Excretion in breast milk unknown/use
C
Cosyntropin] caution
Excretion in breast milk unknown/use
Tetrastarch C
caution
Excretion in breast milk unknown/not
Thalidomide X
recommended
Theophylline C Excreted in breast milk/compatible
Thiamine A Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Thyrotropin Alfa C
caution
Excretion in breast milk
Tibolone X
unknown/contraindicated
Ticagrelor C MLR: Infant risk cannot be ruled out

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Excretion in breast milk unknown/use
Tigecycline D
caution
Excreted in breast milk/consider risk:
Timolol C
benefit
Tinidazole C Excreted in breast milk/contraindicated
Excretion in breast milk unknown/use
Tinzaparin B
caution
Tiotropium C Excretion in breast milk unknown/use caution
Excretion in breast milk unknown/not
Tirofiban B
recommended
TiZANidine C Excretion in breast milk unknown
Tobramycin (Ophthalmic) B Not recommended
Tobramycin and Dexamethasone Excretion in breast milk unknown/use
C
(Ophthalmic) caution
Excretion in breast milk unknown/not
Tocilizumab C
recommended
Excretion in breast milk unknown/not
Tofacitinib Not recommended
recommended
Excretion in breast milk unknown/not
Tolterodine C
recommended
Topiramate D Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Topotecan D
recommended
Refer to Individual
Trace Elements Refer to Individual Agents
Agents
TraMADol (C) C Excreted in breast milk/not recommended
Tranexamic Acid B Excreted in breast milk/use caution
Excretion in breast milk unknown/not
Trastuzumab D
recommended
Excretion in breast milk unknown/use
Travoprost C
caution
Excretion in breast milk unknown/use
Tretinoin (Topical) D
caution
Triamcinolone (Systemic) C Excreted in breast milk/use caution
Excretion in breast milk unknown/use
Triamcinolone (Topical) C
caution
Excretion in breast milk unknown/use
Trihexyphenidyl C
caution
Excretion in breast milk unknown/not
Trimetazidine No data available
recommended

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Trimethoprim C Excreted in breast milk/use caution
Triprolidine ADEC*: A MLR: Infant risk is minimal
Excretion in breast milk unknown/not
Triptorelin (LHRH) X
indicated for use in women
Excretion in breast milk unknown/use
Tropicamide C
caution
Excretion in breast milk unknown/use
Trospium C
caution
Excretion in breast milk unknown/use
Trypan Blue C
caution
Tuberculin Test C No data available
Excretion in breast milk unknown/use
Typhoid Vaccine C
caution
Umeclindium bromide and Excretion in breast milk unknown/use
C
Vilanterol caution
Urea B/C (Product Specific) Excretion in breast milk unknown/use caution
Excretion in breast milk unknown/use
Ursodiol B
caution
Excretion in breast milk unknown/use
Ustekinmab B
caution
ValACIclovir [ValACYclovir] B Excreted in breast milk/use caution
Excretion in breast milk unknown/not
ValGANciclovir C
recommended
X (Migraine
Valproic Acid and Derivatives prophylaxis)/D (All Excreted in breast milk/use caution
other indications)
Excretion in breast milk unknown/not
Valsartan D
recommended
Valsartan and Refer to Individual
Refer to Individual Agents
Hydrochlorothiazide Agents
Discontinue as soon
Excretion in breast milk unknown/not
Valsartan and Sacubitril as possible once
recommended
pregnancy is detected
Vancomycin B (Oral)/C (Injection) Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
Varenicline C
recommended
MPR: Fetal risk Excretion in breast milk unknown/use
Varicella Zoster Vaccine
cannot be ruled out caution
Excretion in breast milk unknown/use
Vasopressin C
caution

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 Department of Pharmaceutical Care

Drug Use in Pregnancy &

Lactation

Generic Name Pregnancy Category Breast Feeding Considerations

Vedolizumab B Infant risk cannot be ruled out
Venlafaxine C Excreted in breast milk/not recommended
Verapamil C Excreted in breast milk/not recommended
Vigabatrin C Excreted in breast milk/not recommended
Excretion in breast milk unknown/not
VILDAgliptin Not recommended
recommended
Refer to Individual
VILDAgliptin and MetFORMIN Refer to Individual Agents
Agents
Excretion in breast milk unknown/not
VinBLAStine D
recommended
Excretion in breast milk unknown/not
VinCRIStine D
recommended
Excretion in breast milk unknown/not
Vinorelbine D
recommended
Excreted in breast milk/use caution (AAP
Vitamin B - Complex A
rates compatible)
Vitamin E A MLR: Infant risk cannot be ruled out
Excretion in breast milk unknown/not
Voriconazole D
recommended
Vortioxetine C Data not available
D (Mechanical Heart
Warfarin Valves)/X (Other Not excreted in breast milk/use caution
Indications)
Xylometazoline C MLR: Infant risk cannot be ruled out
Zaleplon C Excreted in breast milk/not recommended
Zinc Sulfate C Excreted in breast milk/compatible
Excretion in breast milk unknown/not
Zoledronic acid D
recommended
Zolpidem (C) C Excreted in breast milk/use caution

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