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 ObatAAP

approved?*Kategori Risiko

Kehamilan**Risiko

Menyusui**Notes

Acetaminophen  (Tylenol) Approved B L1  

Aspirin CautionC (1st, 2nd trim.)

D (3rd trim.)L3 1

Azapropazone  (Rheumox)Approved

 - L2  

Butalbital (Fioricet, Fiorinal, Bancap, Two-dyne)

NR D L3 2

Butorphanol  (Stadol) ApprovedB (1st, 2nd trim.)

D (3rd trim.)L3  

Celecoxib (Celebrex)) NR C L2  

Codeine (in Tylenol #3, #4) Approved C L3 3

Colchicine Approved D L4  

Diclofenac (Cataflam, Voltaren)

NR B L2  

Fentanyl  (Sublimaze) Approved B L2  

Flurbiprofen (Ansaid, Froben, Ocufen)

NRB (1st, 2nd trim.)

C (3rd trim.)L2  

Hydrocodone (Lortab, Vicodin)

NR B L3 4

Hydromorphone (Dilaudid)

NR C L3 5

Ibuprofen (Advil, Nuprin, Motrin, Pediaprofen)

ApprovedB (1st, 2nd trim.)

D (3rd trim.)L1  

Indomethacin (Indocin) ApprovedB (1st, 2nd trim.)

D (3rd trim.)L3  

Ketorolac (Toradol, Acular) ApprovedB (1st, 2nd trim.)

D (3rd trim.)L2  

Meperidine (Demerol) Approved BL2;

L3 early postpartum

6

Methadone (Dolophine) Approved B L3 7

Morphine (Duramorph, Infumorph, Epimorph, MS Contin)

Approved B L3 8

Nalbuphine (Nubain) NR B L2  

Naproxen (Anaprox, Naprosyn, Naproxen, Aleve)

Approved BL3;

L4 for chronic use

9

Nefopam (Acupan) Approved - NR  

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

NR B L3 10

Pentosan polysulfate (Elmiron)

NR B L2  

Piroxicam (Feldene) Approved B L2  

Propoxyphene (Darvocet N, Propacet, Darvon)

Approved C L2 11

Rofecoxib (Vioxx) Withdrawn from the market 12

Secobarbital (Seconal) Approved D L3 13

Tolmetin (Tolectin) Approved C L3  

Tramadol HCL (Ultram, Ultracet)

NR C L3 14

Valdecoxib  (Bextra) Withdrawn from the market more

*  Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on

Some Nursing Infants and Should Be Given to Nursing Mothers With Caution

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

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories   Pregnancy Risk Categories 

L1 (safest)

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]

Nama Generik Nama Dagang AAP approved?*

Kategori Risiko

Kehamilan**Risiko

Menyusui**

Azapropazone (apazone) Rheumox Approved - L2

Dipyrone (banned in the US & UK)

- Approved - NR

         

Flufenamic acid - Approved - NR

IbuprofenAdvil, Nuprin, Motrin, Pediaprofin

ApprovedB (1st, 2nd

trim.)D (3rd trim.)

L1

Indomethacin Indocin ApprovedB (1st, 2nd

trim.)D (3rd trim.)

L3

Ketorolac Toradol, Acular ApprovedB (1st, 2nd

trim.)D (3rd trim.)

L2

Mefenamic acid Ponstan, Ponstel Approved - NR

NaproxenAnaprox, Naprosyn, Naproxen, Aleve

Approved BL3

L4 (for chronic use)

Phenylbutazone Butazolidine Approved - NR

Piroxicam Feldene Approved B L2

Suprofen Profenal Approved - NR

Tolmetin Tolectin Approved C L3

    Steroid [contents]

Methylprednisolone[ high dosage methylprednisolone]

Solu-Medrol, Depo-Medrol, Medrol

Approved C L2

Prednisolone - Approved C L2

Prednisone Deltasone, Meticorten, Approved C L2

Orasone

         

Obat Asma [contents]

DyphyllineDilor, Lufyllin, Dyphylline

Approved C L3

Terbutaline Bricanyl, Brethine Approved B L2

TheophyllineAminophylline, Quibron, Theo-Dur

Approved C L3

         

     Analgetik Narkotik  [more]

Butorphanol Stadol ApprovedB (1st, 2nd

trim.)D (3rd trim.)

L3

Codeine Tylenol #3, #4 Approved C L3

Fentanyl Sublimaze Approved B L2

Meperidine Demerol Approved BL2

L3 (if used early postpartum)

Methadone Dolophine Approved B L3

Morphine Morphine Approved B L3

PropoxypheneDarvocet N, Propacet, Darvon

Approved C L2

Obat Batuk

Nama ObatAAP

approved?*Risiko Menyusui**

Codeine yes L3 (moderately safe)

Dextromethorphan not reviewed L1 (safest)

Guaifenesin not reviewed L2 (safer)

Dekongestan (Obat Pilek)

Nama ObatAAP

approved?*Risiko Menyusui**

Phenylephrine not reviewed L3 (moderately safe)

Pseudoephedrine (Sudafed, Actifed)

yesL3 (moderately safe) for acute use

L4 (possibly hazardous) for chronic use due to potential for decreasing milk supply

*  Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2006 edition)

Nasal Sprays (Spray Hidung)

Nama ObatAAP

approved?*Risiko Menyusui**

Beclomethasone (Vanceril, Beclovent, Beconase, Vancenase)

not reviewed L2 (safer)

Cromlyn sodium (Nasalcrom)

not reviewed L1 (safest)

Fluticasone (Flonase) not reviewed L3 (moderately safe)

Mometasone (Nasonex)

not reviewed L3 (moderately safe)

Phenylephrine (in some forms of Sinex and Neo-Synephrine)

not reviewed L3 (moderately safe)

Triamcinolone Acetonide (Nasacort)

not reviewed L3 (moderately safe)

Antihistamin (Anti Alergi)

 Nama ObatAAP

approved?*Risiko Menyusui**

 Brompheniramine not reviewed L3 (moderately safe)

 Chlorpheniramine (Chlor-Trimeton) CTM

not reviewed L3 (moderately safe)

 Cetirizine (Zyrtec) not reviewed L2 (safer)

 Dexbrompheniramine maleatewith d-isoephedrine

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)

 *  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 ObatAAP

approved?*Kategori Risiko

Kehamilan**Risiko

Menyusui**Notes

     Local anesthetics

Articaine (Septocaine) NR - NR more

Bupivacaine (Marcaine) NR C L2  

Lidocaine (Xylocaine) Approved C L2  

Mepivacaine (Carbocaine, Polocaine)

NR C L3 more

Procaine HCL (Novocaine) NR C L3  

     General anesthetics

Halothane (Fluothane) Approved C L2 more

Isoflurane (Forane) NR - NR 1

Ketamine NR - NR more

Methohexital (Brevital) Approved B L3  

Nitrous oxide NR - L3  

Sevoflurane (Ultane) NR B L3  

Thiopental (Pentothal) Approved C L3  

     Other medications often used during anesthesia

Sedatives

Diazepam (Valium) Concern D L3; L4 for chronic use

 

Midazolam (Versed) Concern D L3  

Propofol (Diprivan) NR B L2 more

Triazolam (Halcion) NR X L3  

Narcotic Analgesics

Alfentanil (Alfenta) NR C L2  

Fentanyl (Sublimaze) Approved B L2  

Hydromorphone (Dilaudid) NR C L3  

Morphine Approved B L3  

Reversal Medication

Flumazenil (Romazicon) NR C NR 2

Naloxone (Narcan) NR C NR 3

Steroids

Decadron (Dexamethasone) NR C NR more

Stimulants

Epinephrine (Adrenaline) NR C L1  

Anti-nausea

Promethazine (Phenergan) NR C L2  

*  Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but

May Be of Concern

Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some Nursing Infants and Should Be Given to Nursing Mothers With Caution

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

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories   Pregnancy Risk Categories 

L1 (safest)

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

Nama Generik Nama Dagang AAP approved?*

Kategori Risiko

Risiko Menyusui**

Kehamilan**

Antasida [contents]

Cimetidine (Antacid) Tagamet Approved B L2

Cisapride (GI tract stimulant) Propulsid Approved C L2

Domperidone (used for nausea & vomiting, stimulates lactation) [more]

Motilum Approved - L1

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

CeftazidimeCeftazidime, Fortaz, Taxidime

Approved B L1

Ceftriaxone Rocephin Approved B L2

Ciprofloxacin [more] Cipro Approved C L3

Clindamycin Cleocin Approved B L3

ErythromycinE-Mycin, Ery-tab, ERYC, Ilosone

Approved BL1

L3 early postnatal

Fleroxacin - Approved - NR

Gentamicin Garamycin Approved C L2

Kanamycin Kebecil, Kantrex Approved D L2

Moxalactam Moxam Approved - NR

Nitrofurantoin Macrobid Approved B L2

Ofloxacin Floxin Approved C L2

Penicillin - Approved B L1

Streptomycin Streptomycin Approved D L3

Sulbactam - Approved - NR

SulfisoxazoleGantrisin, Azo-Gantrisin

Approved C L2

TetracyclineAchromycin, Sumycin, Terramycin

Approved D L2

TicarcillinTicarcillin, Ticar, Timentin

Approved B L1

Trimethoprim/sulfamethoxazoleProloprim, Approved C L3

Trimpex

Antikoagulan [contents]

Bishydroxycoumarin (dicumarol)

- Approved - NR

WarfarinCoumadin, Panwarfin

Approved D L2

Antikonvulsan (Anti kejang) [contents]

Carbamazepine Tegretol, Epitol Approved C L2

Ethosuximide Zarontin Approved C L4

Magnesium sulfate Epsom salt Approved B L1

Phenytoin Dilantin Approved D L2

Valproic acidDepakene, Depakote

Approved D L2

Anti Jamur [contents]

Fluconazole [more] Diflucan Approved C L2

KetoconazoleNizoral Shampoo, Nizoral

Approved C L2

Antivirus [contents]

Acyclovir [more] Zovirax Approved C L2

Interferon-alpha [more]Alferon N, Interferon Alpha

Approved C L2

Arthritis meds (see also: pain meds) [contents]

Gold saltsRidaura, Myochrysine, Solganal

Approved C L5

Kontrasepsi, Hormon [contents]

EstradiolEstratab, Permarin, Menest

Approved X

L3 (may interfere with milk

production)

Clogestone - Approved - NR

Contraceptive pill with estrogen/progesterone

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

Approved X

L3 (may interfere with milk

production)

Levonorgestrel Norplant, Approved X L2

Mirena, Plan B

MedroxyprogesteroneProvera, Depo-Provera, Cycrin

Approved D

L1L4 (if used first 3 days postpartum)

Norethynodrel Enovid Approved X L2

ProgesteroneCrinone, Prometrium

Approved - L3

Obat Diabetes [contents]

Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk category = L1.

TolbutamideOramide, Orinase

Approved D L3

Obat Diare [contents]

Loperamide

Imodium, Pepto Diarrhea Control, Maalox Antidiarrheal Caplets, Kaopectate II Caplets, Immodium Advanced

Approved B L2

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

Diuretik (Peluruh Kencing) [contents]

AcetazolamideDazamide, Diamox

Approved C L2

Bendroflumethiazide Naturetin Approved DL4 (may inhibit

lactation)

Chlorothiazide Hydrodiuril Approved D L3

Chlorthalidone Hygroton Approved D L3

Hydrochlorothiazide (HCT)Hydrodiuril, Esidrix, Oretic

Approved D L2

Spironolactone Aldactone Approved D L2

Anti Muntah  [more] [contents]

Domperidone Motilum Approved - L1

Anti Hipertensi, Obat Jantung [contents]

     Anti aritmia

DisopyramideNorpace, Napamide

Approved C L2

Flecainide Tambocor Approved C L3

Mexiletine Mexitil Approved B L2

ProcainamidePronestyl, Procan

Approved C L3

QuinidineQuinaglute, Quinidex

Approved C L2

   Anti Hipertensi

Captopril Capoten Approved DL3 (if used

after 30 days)

Diltiazem/Diltiazem HCL

Cardizem Sr, Dilacor-XR, Diltiazem, Cardizem CD

Approved C L3

Enalapril/Enalapril Maleate Vasotec ApprovedC (1st trim.)D (2nd, 3rd

trim.)L2

Hydralazine Apresoline Approved C L2

LabetalolTrandate, Normodyne

Approved C L2

Methyldopa Aldomet Approved C L2

MetoprololToprol XL, Lopressor

Approved B L3

MinoxidilLoniten, Minodyl, Rogaine

Approved CL2

(topically)L3 (orally)

Nadolol Corgard, Nadolol Approved C L4

Nifedipine Adalat, Procardia Approved C L2

OxprenololApsolox, Slow-Trasicor, Trasicor

Approved - NR

Propranolol Inderol Approved C L2

Sotalol Betapace Approved B L3

Timolol Blocadren Approved C L2

VerapamilCalan, Isoptin, Covera-HS

Approved C L2

     Cardiac stimulants

DigoxinLanoxin, Lanoxicaps

Approved C L2

Laksan (Pelancar BAB) [more] [contents]

Cascara/Cascara Sagrada - Approved C L3

Danthron - Approved - NR

Magnesium sulfate Epsom salt Approved B L1

Senna - Approved - L3

Obat malaria [contents]

ChloroquineAralen, Novo-chloroquine

Approved C L3

Hydroxychloroquine Plaquenil Approved C L2

Pyrimethamine Daraprim Approved C L4

Quinine Quinamm Approved D L2

Medical Testing [more] [contents]

Diatrizoate - Approved - NR

Fluorescein - Approved C L3

Gadopentetic (Gadolinium) - Approved C L2

Iohexol Omnipaque Approved B L2

Iopanoic acid Telepaque Approved D L2

Metrizamide Amipaque Approved B L2

Metrizoate Isopaque Approved B L2

Obat Migren [more] [contents]

Sumatriptan Imitrex Approved C L3

Obat Sedativ [more] [contents]

Chloral hydrateAquachloral, Noctec

Approved C L3

Methyprylon (withdrawn from use in US & Canada)

- Approved - NR

Bromide - Approved D L5

Secobarbital Seconal Approved D L3

Obat Tidur [contents]

Zolpidem/Zolpidem Tartrate Ambien Approved B L3

Obat Anti Tiroid  [more] [contents]

Carbimazole - Approved D L3

Methimazole (active metabolite of carbimazole)

Tapazole Approved D L3

Propylthiouracil PTU Approved D L2

Thiouracil - Approved - NR

Levothyroxine Synthroid, Levothroid, Thyroid, Levo-T,

Approved A L1

Levoxyl

Obat TBC [contents]

Cycloserine Seromycin Approved C L3

EthambutolEthambutol, Myambutol

Approved B L2

Isoniazid INH, Laniazid Approved C L3

RifampinRifadin, Rimactane

Approved C L2

VITAMIN [more] [contents]

B-1 (thiamin) - Approved - NR

B-12 (Cyanocobalamin) - Approved A L1

B-6 (pyridoxine) - Approved A

L2; L4 in high doses

(may inhibit lactation)

D, vitaminCalciferol, Delta-d

Approved AL3 (do not overdose)

Folic acid - ApprovedA (1st, 2nd

trim.)C (3rd trim.)

L1

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

AllopurinolZyloprim, Lopurin

Approved C L2

Antimony - Approved - NR

Atropine (Anticholinergic, drying agent)

Belladonna, Atropine

Approved C L3

Azapropazone/apazone (Antirheumatic)

Rheumox Approved - L2

Baclofen (muscle relaxant) Lioresal, Atrofen Approved C L2

Barbiturate - Approved - NR

Caffeine [more]Vivarin, NoDoz, Coffee

Approved B L2

Carbetocin (Antihemorrhagic) Duratocin Approved - NR

Chloroform - Approved - NR

Cisplatin (Anti-cancer) Platinol Approved D L4

Dapsone (Antileprosy) Avlosulfon, DDS Approved C L4

Hydroxychloroquine (Antirheumatic, lupus)

Plaquenil Approved C L2

Iodides - Approved - NR

Iodine - Approved - NR

Iodine (povidone-iodine, eg, in a vaginal douche)

- Approved - NR

Ivermectin (Antiparasitic) Mectizan Approved C L3

Nalidixic acid (Urinary Anti-infective)

NegGram Approved B L4

Norsteroids - Approved - NR

Pyridostigmine (Muscle stimulant)

Mestinon, Regonol

Approved C L2

Scopolamine (Motion sickness)Transderm Scope

Approved C L3

Sulfapyridine Dagenan Approved - NR

Timolol (glaucoma med) Blocadren Approved D L3

*  Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on

Some Nursing Infants and Should Be Given to Nursing Mothers With Caution

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

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories   Pregnancy Risk Categories 

L1 (safest)

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

9999999999999999999999999

Generic name Trade NameAAP

approved?*

Pregnancy Risk

Category**

Lactation Risk

Category**

Analgesics (Pain-killers) [more]

Acetaminophen Tylenol Approved B L1

Colchicine Colchicine Approved D L4

Nefopam Acupan Approved - NR

Non-steroidal anti-inflammatory analgesics (NSAIDs) [more]

Azapropazone (apazone) Rheumox Approved - L2

Dipyrone (banned in the US & UK)

- Approved - NR

Flufenamic acid - Approved - NR

IbuprofenAdvil, Nuprin, Motrin, Pediaprofin

Approved

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

L1

Indomethacin Indocin Approved

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

L3

Ketorolac Toradol, Acular Approved

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

L2

Mefenamic acid Ponstan, Ponstel Approved - NR

NaproxenAnaprox, Naprosyn, Naproxen, Aleve

Approved BL3

L4 (for chronic use)

Phenylbutazone Butazolidine Approved - NR

Piroxicam Feldene Approved B L2

Suprofen Profenal Approved - NR

Tolmetin Tolectin Approved C L3

Narcotic analgesics [more]

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

L3

trim.)

Codeine Tylenol #3, #4 Approved C L3

Fentanyl Sublimaze Approved B L2

Meperidine Demerol Approved B

L2L3 (if used

early postpartum)

Methadone Dolophine Approved B L3

Morphine Morphine Approved B L3

PropoxypheneDarvocet N, Propacet, Darvon

Approved C L2

Anesthesia, Anesthetics [more] [contents]

Halothane Fluothane Approved C L2

Lidocaine Xylocaine Approved C L2

Methohexital Brevital Approved B L3

Thiopental Pentothal Approved C L3

Antacids, GI meds [contents]

Cimetidine (Antacid) Tagamet Approved B L2

Cisapride (GI tract stimulant) Propulsid Approved C L2

Domperidone (used for nausea & vomiting, stimulates lactation) [more]

Motilum Approved - L1

Antibiotics [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

CeftazidimeCeftazidime, Fortaz, Taxidime

Approved B L1

Ceftriaxone Rocephin Approved B L2

Ciprofloxacin [more] Cipro Approved C L3

Clindamycin Cleocin Approved B L3

Erythromycin E-Mycin, Ery-tab, ERYC, Ilosone

Approved B L1L3 early

postnatal

Fleroxacin - Approved - NR

Gentamicin Garamycin Approved C L2

Kanamycin Kebecil, Kantrex Approved D L2

Moxalactam Moxam Approved - NR

Nitrofurantoin Macrobid Approved B L2

Ofloxacin Floxin Approved C L2

Penicillin - Approved B L1

Streptomycin Streptomycin Approved D L3

Sulbactam - Approved - NR

SulfisoxazoleGantrisin, Azo-Gantrisin

Approved C L2

TetracyclineAchromycin, Sumycin, Terramycin

Approved D L2

TicarcillinTicarcillin, Ticar, Timentin

Approved B L1

Trimethoprim/sulfamethoxazole Proloprim, Trimpex Approved C L3

Anticoagulants [contents]

Bishydroxycoumarin (dicumarol) - Approved - NR

WarfarinCoumadin, Panwarfin

Approved D L2

Anticonvulsants [contents]

Carbamazepine Tegretol, Epitol Approved C L2

Ethosuximide Zarontin Approved C L4

Magnesium sulfate Epsom salt Approved B L1

Phenytoin Dilantin Approved D L2

Valproic acidDepakene, Depakote

Approved D L2

Antifungals [contents]

Fluconazole [more] Diflucan Approved C L2

KetoconazoleNizoral Shampoo, Nizoral

Approved C L2

Antihistamines [more] [contents]

Dexbrompheniramine maleate with d-isoephedrine

- Approved - NR

Fexofenadine Allegra Approved C L2

Loratadine Claritin Approved B L1

Terfenadine Seldane Approved - NR

Triprolidine Actidil, Actifed Approved C L1

Antivirals [contents]

Acyclovir [more] Zovirax Approved C L2

Interferon-alpha [more]Alferon N, Interferon Alpha

Approved C L2

Arthritis meds (see also: pain meds) [contents]

Gold saltsRidaura, Myochrysine, Solganal

Approved C L5

Asthma meds (see also: steroids) [contents]

DyphyllineDilor, Lufyllin, Dyphylline

Approved C L3

Terbutaline Bricanyl, Brethine Approved B L2

TheophyllineAminophylline, Quibron, Theo-Dur

Approved C L3

Contraceptives, Hormones [more] [contents]

EstradiolEstratab, Permarin, Menest

Approved X

L3 (may interfere with

milk production)

Clogestone - Approved - NR

Contraceptive pill with estrogen/progesterone

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

Approved X

L3 (may interfere with

milk production)

LevonorgestrelNorplant, Mirena, Plan B

Approved X L2

MedroxyprogesteroneProvera, Depo-Provera, Cycrin

Approved D

L1L4 (if used first 3 days postpartum)

Norethynodrel Enovid Approved X L2

ProgesteroneCrinone, Prometrium

Approved - L3

Cough meds [more] [contents]

Codeine Tylenol #3, #4 Approved C L3

Noscapine - Approved - NR

Decongestants [more] [contents]

PseudoephedrineSudafed, Halofed, Novafed, Actifed

Approved C

L3 (for acute use)

L4 (for chronic use)

Diabetes meds [contents]

Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk category = L1.

Tolbutamide Oramide, Orinase Approved D L3

Diarrhea meds [contents]

Loperamide

Imodium, Pepto Diarrhea Control, Maalox Antidiarrheal Caplets, Kaopectate II Caplets, Immodium Advanced

Approved B L2

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

Diuretics [contents]

Acetazolamide Dazamide, Diamox Approved C L2

Bendroflumethiazide Naturetin Approved DL4 (may inhibit

lactation)

Chlorothiazide Hydrodiuril Approved D L3

Chlorthalidone Hygroton Approved D L3

HydrochlorothiazideHydrodiuril, Esidrix, Oretic

Approved D L2

Spironolactone Aldactone Approved D L2

Galactagogues (milk supply) [more] [contents]

Domperidone Motilum Approved - L1

Heart, Blood Pressure meds (Antiarrhythmics, Antihypertensives, Cardiac stimulants)

[contents]

Antiarrhythmics

Disopyramide Norpace, Napamide Approved C L2

Flecainide Tambocor Approved C L3

Mexiletine Mexitil Approved B L2

Procainamide Pronestyl, Procan Approved C L3

QuinidineQuinaglute, Quinidex

Approved C L2

Antihypertensives

Captopril Capoten Approved DL3 (if used

after 30 days)

Diltiazem/Diltiazem HCL

Cardizem Sr, Dilacor-XR, Diltiazem, Cardizem CD

Approved C L3

Enalapril/Enalapril Maleate Vasotec ApprovedC (1st trim.)D (2nd, 3rd

trim.)L2

Hydralazine Apresoline Approved C L2

LabetalolTrandate, Normodyne

Approved C L2

Methyldopa Aldomet Approved C L2

MetoprololToprol XL, Lopressor

Approved B L3

MinoxidilLoniten, Minodyl, Rogaine

Approved CL2

(topically)L3 (orally)

Nadolol Corgard, Nadolol Approved C L4

Nifedipine Adalat, Procardia Approved C L2

OxprenololApsolox, Slow-Trasicor, Trasicor

Approved - NR

Propranolol Inderol Approved C L2

Sotalol Betapace Approved B L3

Timolol Blocadren Approved C L2

VerapamilCalan, Isoptin, Covera-HS

Approved C L2

Cardiac stimulants

DigoxinLanoxin, Lanoxicaps

Approved C L2

Laxatives [more] [contents]

Cascara/Cascara Sagrada - Approved C L3

Danthron - Approved - NR

Magnesium sulfate Epsom salt Approved B L1

Senna - Approved - L3

Malaria meds [contents]

ChloroquineAralen, Novo-chloroquine

Approved C L3

Hydroxychloroquine Plaquenil Approved C L2

Pyrimethamine Daraprim Approved C L4

Quinine Quinamm Approved D L2

Medical Testing [more] [contents]

Diatrizoate - Approved - NR

Fluorescein - Approved C L3

Gadopentetic (Gadolinium) - Approved C L2

Iohexol Omnipaque Approved B L2

Iopanoic acid Telepaque Approved D L2

Metrizamide Amipaque Approved B L2

Metrizoate Isopaque Approved B L2

Migraine meds (see also: pain meds) [more] [contents]

Sumatriptan Imitrex Approved C L3

Sedatives [more] [contents]

Chloral hydrateAquachloral, Noctec

Approved C L3

Methyprylon (withdrawn from use in US & Canada)

- Approved - NR

Bromide - Approved D L5

Secobarbital Seconal Approved D L3

Sleep Aids [contents]

Zolpidem/Zolpidem Tartrate Ambien Approved B L3

Steroids [contents]

Methylprednisolone[ high dosage methylprednisolone]

Solu-Medrol, Depo-Medrol, Medrol

Approved C L2

Prednisolone - Approved C L2

PrednisoneDeltasone, Meticorten, Orasone

Approved C L2

Thyroid meds [more] [contents]

Carbimazole - Approved D L3

Methimazole (active metabolite of carbimazole)

Tapazole Approved D L3

Propylthiouracil PTU Approved D L2

Thiouracil - Approved - NR

Levothyroxine

Synthroid, Levothroid, Thyroid, Levo-T, Levoxyl

Approved A L1

Tuberculosis meds [contents]

Cycloserine Seromycin Approved C L3

EthambutolEthambutol, Myambutol

Approved B L2

Isoniazid INH, Laniazid Approved C L3

Rifampin Rifadin, Rimactane Approved C L2

Vitamins [more] [contents]

B-1 (thiamin) - Approved - NR

B-12 (Cyanocobalamin) - Approved A L1

B-6 (pyridoxine) - Approved A

L2; L4 in high doses

(may inhibit lactation)

D, vitamin Calciferol, Delta-d Approved AL3 (do not overdose)

Folic acid - Approved

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

L1

K-1, vitamin (Phytonadione) - Approved C L1

Riboflavin/B2 - Approved A L1

Miscellaneous [contents]

Acitretin (Anti-psoriasis) Soriatane Approved - NR

Alcohol/Ethanol [more] - Approved D L3

Allopurinol Zyloprim, Lopurin Approved C L2

Antimony - Approved - NR

Atropine (Anticholinergic, drying agent)

Belladonna, Atropine

Approved C L3

Azapropazone/apazone (Antirheumatic)

Rheumox Approved - L2

Baclofen (muscle relaxant) Lioresal, Atrofen Approved C L2

Barbiturate - Approved - NR

Caffeine [more]Vivarin, NoDoz, Coffee

Approved B L2

Carbetocin (Antihemorrhagic) Duratocin Approved - NR

Chloroform - Approved - NR

Cisplatin (Anti-cancer) Platinol Approved D L4

Dapsone (Antileprosy) Avlosulfon, DDS Approved C L4

Hydroxychloroquine (Antirheumatic, lupus)

Plaquenil Approved C L2

Iodides - Approved - NR

Iodine - Approved - NR

Iodine (povidone-iodine, eg, in a vaginal douche)

- Approved - NR

Ivermectin (Antiparasitic) Mectizan Approved C L3

Nalidixic acid (Urinary Anti-infective)

NegGram Approved B L4

Norsteroids - Approved - NR

Pyridostigmine (Muscle stimulant)

Mestinon, Regonol Approved C L2

Scopolamine (Motion sickness) Transderm Scope Approved C L3

Sulfapyridine Dagenan Approved - NR

Timolol (glaucoma med) Blocadren Approved D L3

* Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on

Some Nursing Infants and Should Be Given to Nursing Mothers With Caution

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

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

Lactation Risk Categories Pregnancy Risk Categories

L1 (safest) A (controlled studies show no risk)

L2 (safer)

L3 (moderately safe)

L4 (possibly hazardous)

L5 (contraindicated)

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.