DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL

DAN MENYUSUI

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.

Lactation Risk Categories

L1 (safest)

L2 (safer)

L3 (moderately safe)

L4 (possibly hazardous)

L5 (contraindicated)

Antikonvulsan, Obat Tidur, Sedatif, dan Migren

Nama Obat R.Hamil R.Menyusui

Sumatriptan C L3

Chloral hydrate C L3

Methyprylon - NR

Bromide D L5

Secobarbital D L3

Zolpidem B L3

Bishydroxycoumarin - NR

Warfarin D L2

Carbamazepine C L2

Ethosuximide C L4

Magnesium sulfate B L1

Phenytoin D L2

Valproic acid D L2

Obat TBC dan Malaria

Nama Obat Risiko Kehamilan Risiko Menyusui

Obat TB

Cycloserine C L3

Ethambutol B L2

Isoniazid C L3

Rifampin C L2

Obat malaria

Chloroquine C L3

Hydroxychloroquine C L2

Pyrimethamine C L4

Quinine D L2

Anti Hipertensi, Anti Aritmia, dan Diuretik

Nama Generik Risiko Kehamilan** RisikoMenyusui**

Acetazolamide C L2

Bendroflumethiazide D L4 (may inhibit lactation)

Chlorothiazide D L3

Chlorthalidone D L3

Hydrochlorothiazide (HCT) D L2

Spironolactone D L2

Disopyramide C L2

Flecainide C L3

Mexiletine B L2

Procainamide C L3

Quinidine C L2

Captopril D L3 (if used after 30 days)

Diltiazem/Diltiazem HCL C L3

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

L2

Hydralazine C L2

Labetalol C L2

Methyldopa C L2

Metoprolol B L3

Minoxidil C L2(topically) L3 (orally)

Nadolol C L4

Nifedipine C L2

Oxprenolol - NR

Propranolol C L2

Sotalol B L3

Timolol C L2

Verapamil C L2

Digoxin C L2

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding* Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.

Anti Jamur dan Anti Virus

Nama Generik Risiko Kehamilan RisikoMenyusui

Antijamur

Fluconazole C L2

Ketoconazole C L2

Antivirus

Acyclovir C L2

Interferon-alpha C L2

Antibiotik

Nama Generik Risiko Kehamilan Risiko Menyusui

Amoxicillin B L1

Aztreonam B L2

Cefadroxil B L1

Cefazolin B L1

Cefotaxime B L2

Cefoxitin B L1

Cefprozil C L1

Ceftazidime B L1

Ceftriaxone B L2

Ciprofloxacin C L3

Clindamycin B L3

Erythromycin B L1 L3 early postnatal

Fleroxacin - NR

Gentamicin C L2

Kanamycin D L2

Moxalactam - NR

Nitrofurantoin B L2

Ofloxacin C L2

Penicillin B L1

Streptomycin D L3

Sulbactam - NR

Sulfisoxazole C L2

Tetracycline D L2

Ticarcillin B L1

Trimethoprim/sulfamethoxazole C L3

Antasida, Laksan (Pelancar BAB) dan Obat Diare

Nama Generik Risiko Kehamilan Risiko Menyusui

Cimetidine (Antacid) B L2

Cisapride (GI tract stimulant) C L2

Domperidone (used for nausea & vomiting, stimulates lactation)

- L1

Cascara/Cascara Sagrada C L3

Danthron - NR

Magnesium sulfate B L1

Senna - L3

Loperamide B L2

Antihistamin

Nama Obat AAP approved?*

Risiko Menyusui**

Brompheniramine not reviewed

L3 (moderately safe)

Chlorpheniramine (Chlor-Trimeton) CTM

not reviewed

L3 (moderately safe)

Cetirizine (Zyrtec) not reviewed

L2 (safer)

Dexbrompheniramine maleate with 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)

Obat Asma, Obat Batuk, dan Spray Hidung

Nama Generik Kategori Risiko Kehamilan**

RisikoMenyusui**

Dyphylline C L3

Terbutaline B L2

Theophylline C L3

Nama Obat Risiko Menyusui**

Codeine L3 (moderately safe)

Dextromethorphan L1 (safest)

Guaifenesin L2 (safer)

Phenylephrine L3 (moderately safe)

Pseudoephedrine (Sudafed, Actifed)

L3 (moderately safe) for acute use L4 (possibly hazardous) for chronic use due to potential for decreasing milk supply

Beclomethasone (Vanceril, Beclovent, Beconase, Vancenase)

L2 (safer)

Cromlyn sodium (Nasalcrom) L1 (safest)

Fluticasone (Flonase) L3 (moderately safe)

Mometasone (Nasonex) L3 (moderately safe)

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

L3 (moderately safe)

Triamcinolone Acetonide (Nasacort)

L3 (moderately safe)

NSAIDs dan Steroid

Nama Generik Kategori Risiko Kehamilan** RisikoMenyusui**

Azapropazone (apazone) - L2

Dipyrone - NR

Flufenamic acid - NR

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

L1

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

L3

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

L2

Mefenamic acid - NR

Naproxen B L3 L4

Phenylbutazone - NR

Piroxicam B L2

Suprofen - NR

Tolmetin C L3

Methylprednisolone C L2

Prednisolone C L2

Prednisone C L2

ANALGETIK

Nama Obat Risiko Kehamilan Risiko Menyusui

Acetaminophen (Tylenol) B L1

Aspirin C (1st, 2nd trim.)

D (3rd trim.) L3

Azapropazone (Rheumox) - L2

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

D L3

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

D (3rd trim.) L3

Celecoxib (Celebrex)) C L2

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

Colchicine D L4

Diclofenac (Cataflam, Voltaren) B L2

Fentanyl (Sublimaze) B L2

Flurbiprofen (Ansaid, Froben, Ocufen) B (1st, 2nd trim.)

C (3rd trim.) L2

Hydrocodone (Lortab, Vicodin) B L3

Hydromorphone(Dilaudid) C L3

Ibuprofen (Advil, Nuprin, Motrin, Pediaprofen)

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

L1

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

D (3rd trim.) L3

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

D (3rd trim.) L2

Meperidine (Demerol) B L2;

L3 early postpartum

Methadone (Dolophine) B L3

Morphine (Duramorph, Infumorph, Epimorph, MS Contin)

B L3

Nalbuphine (Nubain) B L2

Naproxen (Anaprox, Naprosyn, Naproxen, Aleve)

B L3;

L4 for chronic use

Nefopam (Acupan) - NR

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

B L3

Pentosan polysulfate(Elmiron) B L2

Piroxicam (Feldene) B L2

Propoxyphene(Darvocet N, Propacet, Darvon)

C L2

Secobarbital (Seconal) D L3

Tolmetin (Tolectin) C L3

Tramadol HCL(Ultram, Ultracet) C L3

Butorphanol B (1st, 2nd trim.)

D (3rd trim.) L3

Codeine C L3

Fentanyl B L2

Meperidine B L2

L3 (if used early postpartum)

Methadone B L3

Morphine B L3

Propoxyphene C L2