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Daftar Pilihan Obat Ibu Hamil dan Menyusui (Selected List of Medications approved by the AAP for use in breastfeeding mothers) (sumber: American Academy of Pediatrics) Generic name
Trade Name
AAP
Pregnancy
Lactation Risk
approved
Risk
Category**
?*
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 &
-
Approved
-
NR
Flufenamic acid
-
Approved
-
NR
Ibuprofen
Advil, Nuprin, Motrin, Approved B (1st, 2nd
UK)
Pediaprofin
L1
trim.) D (3rd trim.)
Indomethacin
Indocin
Approved B (1st, 2nd
L3
trim.) D (3rd trim.) Ketorolac
Toradol, Acular
Approved B (1st, 2nd
L2
trim.) D (3rd trim.) Mefenamic acid
Ponstan, Ponstel
Approved
-
NR
Naproxen
Anaprox, Naprosyn, Approved
B
L3
Naproxen, Aleve
L4 (for chronic use)
Phenylbutazone
Butazolidine
Approved
-
NR
Piroxicam
Feldene
Approved
B
L2
Suprofen
Profenal
Approved
-
NR
Tolmetin
Tolectin
Approved
C
L3
Stadol
Approved B (1st, 2nd
Narcotic analgesics [more] Butorphanol
L3
trim.) D (3rd trim.) Codeine
Tylenol #3, #4
Approved
C
L3
Fentanyl
Sublimaze
Approved
B
L2
Meperidine
Demerol
Approved
B
L2 L3 (if used early postpartum)
Methadone
Dolophine
Approved
B
L3
Morphine
Morphine
Approved
B
L3
Propoxyphene
Darvocet N,
Approved
C
L2
Propacet, Darvon 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
Approved
-
L1
Domperidone (used for nausea Motilum & vomiting, stimulates
lactation) [more] 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
Ceftazidime
Ceftazidime, Fortaz, Approved
B
L1
Taxidime Ceftriaxone
Rocephin
Approved
B
L2
Ciprofloxacin [more]
Cipro
Approved
C
L3
Clindamycin
Cleocin
Approved
B
L3
Erythromycin
E-Mycin, Ery-tab,
Approved
B
L1
ERYC, Ilosone
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
Sulfisoxazole
Gantrisin, Azo-
Approved
C
L2
Approved
D
L2
Approved
B
L1
Approved
C
L3
Gantrisin Tetracycline
Achromycin, Sumycin, Terramycin
Ticarcillin
Ticarcillin, Ticar, Timentin
Trimethoprim/sulfamethoxazol Proloprim, Trimpex e Anticoagulants Bishydroxycoumarin
[contents] -
Approved
-
NR
Coumadin,
Approved
D
L2
(dicumarol) Warfarin
Panwarfin 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 acid
Depakene, Depakote Approved
D
L2
Antifungals
[contents]
Fluconazole [more]
Diflucan
Approved
C
L2
Ketoconazole
Nizoral Shampoo,
Approved
C
L2
Nizoral Antihistamines [more]
[contents]
Dexbrompheniramine maleate -
Approved
-
NR
with d-isoephedrine 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 Approved
C
L2
Alpha Arthritis meds (see also: pain meds) Gold salts
Ridaura,
[contents] Approved
C
L5
Myochrysine, Solganal Asthma meds (see also: steroids) Dyphylline
Dilor, Lufyllin,
[contents] Approved
C
L3
Dyphylline Terbutaline
Bricanyl, Brethine
Approved
B
L2
Theophylline
Aminophylline,
Approved
C
L3
Quibron, Theo-Dur Contraceptives, Hormones [more] Estradiol
[contents]
Estratab, Permarin, Approved
X
Menest
L3 (may interfere with milk production)
Clogestone
-
Approved
-
NR
Contraceptive pill with
Preven, Seasonale, Approved
X
L3 (may
estrogen/progesterone
Norinyl, Norlestin,
interfere with
Ortho-Novum, Ovral,
milk
Lunelle injection,
production)
Ortho-Evra patch, etc. Levonorgestrel
Norplant, Mirena,
Approved
X
L2
Approved
D
L1
Plan B Medroxyprogesterone
Provera, Depo-
Provera, Cycrin
L4 (if used first 3 days postpartum)
Norethynodrel
Enovid
Approved
X
L2
Progesterone
Crinone, Prometrium Approved
-
L3
Cough meds [more]
[contents]
Codeine
Tylenol #3, #4
Approved
C
L3
Noscapine
-
Approved
-
NR
Decongestants [more] Pseudoephedrine
[contents] Sudafed, Halofed,
Approved
C
Novafed, Actifed
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
Diarrhea meds Loperamide
L3 [contents]
Imodium, Pepto
Approved
B
L2
Diarrhea Control, Maalox Antidiarrheal Caplets, Kaopectate II Caplets, Immodium Advanced ** Note: Pepto-Bismol & Kaopectate (bismuth subsalicylate is the active ingredient in both) are not recommended for routine use by nursing moms, due to the association of salicylates with Reyes syndrome in children. [more] Diuretics
[contents]
Acetazolamide
Dazamide, Diamox
Approved
C
L2
Bendroflumethiazide
Naturetin
Approved
D
L4 (may inhibit lactation)
Chlorothiazide
Hydrodiuril
Approved
D
L3
Chlorthalidone
Hygroton
Approved
D
L3
Hydrochlorothiazide
Hydrodiuril, Esidrix, Approved
D
L2
D
L2
Oretic Spironolactone
Aldactone
Approved
Galactagogues (milk supply) [more] Domperidone
Motilum
[contents] Approved
-
Heart, Blood Pressure meds
L1 [contents]
(Antiarrhythmics, Antihypertensives, Cardiac stimulants) Antiarrhythmics Disopyramide
Norpace, Napamide Approved
C
L2
Flecainide
Tambocor
Approved
C
L3
Mexiletine
Mexitil
Approved
B
L2
Procainamide
Pronestyl, Procan
Approved
C
L3
Quinidine
Quinaglute, Quinidex Approved
C
L2
Capoten
D
L3 (if used after
Antihypertensives Captopril
Approved
30 days) Diltiazem/Diltiazem HCL
Cardizem Sr,
Approved
C
L3
Dilacor-XR, Diltiazem, Cardizem CD Enalapril/Enalapril Maleate
Vasotec
Approved C (1st trim.)
L2
D (2nd, 3rd trim.) Hydralazine
Apresoline
Approved
C
L2
Labetalol
Trandate,
Approved
C
L2
Approved
C
L2
Normodyne Methyldopa
Aldomet
Metoprolol
Toprol XL, Lopressor Approved
B
L3
Minoxidil
Loniten, Minodyl,
C
L2(topically)
Approved
Rogaine
L3 (orally)
Nadolol
Corgard, Nadolol
Approved
C
L4
Nifedipine
Adalat, Procardia
Approved
C
L2
Oxprenolol
Apsolox, Slow-
Approved
-
NR
Trasicor, Trasicor Propranolol
Inderol
Approved
C
L2
Sotalol
Betapace
Approved
B
L3
Timolol
Blocadren
Approved
C
L2
Verapamil
Calan, Isoptin,
Approved
C
L2
Lanoxin, Lanoxicaps Approved
C
L2
Covera-HS Cardiac stimulants Digoxin Laxatives [more]
[contents]
Cascara/Cascara Sagrada
-
Approved
C
L3
Danthron
-
Approved
-
NR
Magnesium sulfate
Epsom salt
Approved
B
L1
Senna
-
Approved
-
L3
Malaria meds Chloroquine
[contents] Aralen, Novo-
Approved
C
L3
chloroquine Hydroxychloroquine
Plaquenil
Approved
C
L2
Pyrimethamine
Daraprim
Approved
C
L4
Quinine
Quinamm
Approved
D
L2
Medical Testing [more] Diatrizoate
[contents] -
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] Sumatriptan
Imitrex
[contents] Approved
C
Sedatives [more]
L3 [contents]
Chloral hydrate
Aquachloral, Noctec Approved
C
L3
Methyprylon (withdrawn from
-
Approved
-
NR
Bromide
-
Approved
D
L5
Secobarbital
Seconal
Approved
D
L3
use in US & Canada)
Sleep Aids Zolpidem/Zolpidem Tartrate
[contents] Ambien
Approved
B
Steroids
[contents]
Methylprednisolone
Solu-Medrol, Depo- Approved
[
Medrol, Medrol
high dosage
L3
C
L2
methylprednisolone] Prednisolone
-
Approved
C
L2
Prednisone
Deltasone,
Approved
C
L2
Meticorten, Orasone Thyroid meds [more] Carbimazole
[contents] -
Methimazole (active metabolite Tapazole of carbimazole)
Approved
D
L3
Approved
D
L3
Propylthiouracil
PTU
Approved
D
L2
Thiouracil
-
Approved
-
NR
Levothyroxine
Synthroid,
Approved
A
L1
Levothroid, Thyroid, Levo-T, Levoxyl Tuberculosis meds
[contents]
Cycloserine
Seromycin
Approved
C
L3
Ethambutol
Ethambutol,
Approved
B
L2
Myambutol 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
A
L3 (do not overdose)
Folic acid
-
Approved A (1st, 2nd
L1
trim.) C (3rd trim.) 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,
Belladonna, Atropine Approved
C
L3
Rheumox
Approved
-
L2
Baclofen (muscle relaxant)
Lioresal, Atrofen
Approved
C
L2
Barbiturate
-
Approved
-
NR
Caffeine [more]
Vivarin, NoDoz,
Approved
B
L2
drying agent) Azapropazone/apazone (Antirheumatic)
Coffee Carbetocin (Antihemorrhagic)
Duratocin
Approved
-
NR
Chloroform
-
Approved
-
NR
Cisplatin (Anti-cancer)
Platinol
Approved
D
L4
Dapsone (Antileprosy)
Avlosulfon, DDS
Approved
C
L4
Hydroxychloroquine
Plaquenil
Approved
C
L2
Iodides
-
Approved
-
NR
Iodine
-
Approved
-
NR
Iodine (povidone-iodine, eg, in -
Approved
-
NR
(Antirheumatic, lupus)
a vaginal douche) Ivermectin (Antiparasitic)
Mectizan
Approved
C
L3
Nalidixic acid (Urinary Anti-
NegGram
Approved
B
L4
Norsteroids
-
Approved
-
NR
Pyridostigmine (Muscle
Mestinon, Regonol
Approved
C
L2
Scopolamine (Motion sickness) Transderm Scope
Approved
C
L3
Sulfapyridine
Dagenan
Approved
-
NR
Timolol (glaucoma med)
Blocadren
Approved
D
L3
infective)
stimulant)
* 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
L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)
Pregnancy Risk Categories
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.
References 1. Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001. 2. Hale, Thomas. Medications and Mothers’ Milk, 12th Edition. Hale Publishing, 2006. Dr. Hale’s website is located at http://neonatal.ttuhsc.edu/lact/index.html.
