daftar obat aman ibu hamil dan menyusui
DESCRIPTION
Obat BumilTRANSCRIPT
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Rofecoxib (Vioxx) Withdrawn from the market 12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Valdecoxib (Bextra) Withdrawn from the market more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.