sebagai dokter

8/2/2019 Sebagai dokter

1/10

Sebagai dokter, kita kadang menerima pasien ibu hamil atau menyusui. Pasien seperti ini

membutuhkan terapi yang beda dari yang lainnya karena ditakutkan ada pengaruh obat

terhadap bayi yang dikandung. Dan sudah terbukti dari sejarah pengobatan, bahwa begitu

banyak obat yang memberikan efek negatif bagi bayi.

Berikut ini adalah daftar obat-obat yang Aman untuk digunakan pada ibu hamil danmenyusui. Baris kuning menunjukkan obat-obatan yang paling sering dipakai di Indonesia.

Sebagai keterangan,

untuk kategori Pregnancy Risk Category :

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)

untuk kategori Lactation Risk Category :

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

(Perhatian : Karena tabelnya terpotong, disediakan tempat untuk melihat gambar tabel lebih

jelas, bisa didownload di sini, File gambarnya tampak kecil, tapi bisa dizoom supaya

tulisannya kelihatan)

Generic name Trade NameAAP

approved?*

Pregnancy

Risk

Category**

Lactation

Risk

Category**

Analgesics (Pain-killers) [more]

Acetaminophen (Parasetamol) Tylenol Approved B L1

Colchicine Colchicine Approved D L4

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

Azapropazone (apazone) Rheumox Approved - L2

Ibuprofen

Advil, Nuprin,

Motrin,

PediaprofinApproved

B (1st, 2nd

trim.)

D (3rd

trim.)

L1

Indomethacin Indocin Approved

B (1st, 2nd

trim.)

D (3rd

trim.)

L3

KetorolacToradol,

Acular Approved

B (1st, 2nd

trim.)D (3rd

L2
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2/10

trim.)

Mefenamic acidPonstan,

PonstelApproved - NR

Naproxen

Anaprox,

Naprosyn,Naproxen,

Aleve

Approved B

L3

L4 (forchronic

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 (3rdtrim.)

L3

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

Propoxyphene

Darvocet 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]

AmoxicillinLarotid,

AmoxilApproved B L1

Aztreonam Azactam Approved B L2

Cefadroxil Ultracef,Duricef

Approved B L1
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3/10

Cefazolin Ancef, Kefzol Approved B L1

Cefotaxime Claforan Approved B L2

Cefoxitin Mefoxin Approved B L1

Cefprozil Cefzil Approved C L1

CeftazidimeCeftazidime,Fortaz,

TaxidimeApproved B L1

Ceftriaxone Rocephin Approved B L2

Ciprofloxacin [more] Cipro Approved C L3

Clindamycin Cleocin Approved B L3

Erythromycin

E-Mycin, Ery-

tab, ERYC,

IlosoneApproved B

L1L3 early

postnatal

Fleroxacin - Approved - NR

Gentamicin Garamycin Approved C L2

KanamycinKebecil,

KantrexApproved 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-

GantrisinApproved C L2

Tetracycline

Achromycin,

Sumycin,

Terramycin

Approved D L2

TicarcillinTicarcillin,

Ticar, TimentinApproved B L1

Trimethoprim/sulfamethoxazoleProloprim,

TrimpexApproved C L3

Anticoagulants [contents]Bishydroxycoumarin

(dicumarol)- Approved - NR

WarfarinCoumadin,

PanwarfinApproved D L2

Anticonvulsants [contents]

CarbamazepineTegretol,

EpitolApproved C L2

Ethosuximide Zarontin Approved C L4

Magnesium sulfate Epsom salt Approved B L1

Phenytoin Dilantin Approved D L2
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4/10

Valproic acidDepakene,

DepakoteApproved D L2

Antifungals [contents]

Fluconazole [more] Diflucan Approved C L2

KetoconazoleNizoralShampoo,

NizoralApproved 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

AlphaApproved C L2

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

Gold salts

Ridaura,

Myochrysine,

SolganalApproved C L5

Asthma meds (see also:steroids) [contents]

DyphyllineDilor, Lufyllin,

DyphyllineApproved C L3

TerbutalineBricanyl,

BrethineApproved B L2

Theophylline

Aminophylline,

Quibron, Theo-

Dur

Approved C L3

Contraceptives, Hormones [more] [contents]

Estradiol Estratab,Permarin,

MenestApproved X

L3 (may

interferewith milk

production)

Clogestone - Approved - NR

Contraceptive pill with

estrogen/progesterone

Preven,

Seasonale,

Norinyl,

Norlestin,

Ortho-Novum,

Ovral, Lunelle

injection,Ortho-Evra

Approved X

L3 (may

interfere

with milk

production)
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5/10

patch, etc.

LevonorgestrelNorplant,

Mirena, Plan BApproved X L2

Medroxyprogesterone

Provera, Depo-

Provera,Cycrin

Approved D

L1

L4 (if usedfirst 3 days

postpartum)

Norethynodrel Enovid Approved X L2

ProgesteroneCrinone,

PrometriumApproved - L3

Cough meds [more] [contents]

Codeine Tylenol #3, #4 Approved C L3

Noscapine - Approved - NR

Decongestants [more] [contents]

Pseudoephedrine

Sudafed,

Halofed,

Novafed,

Actifed

Approved C

L3 (foracute 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.

TolbutamideOramide,

OrinaseApproved 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]

AcetazolamideDazamide,

DiamoxApproved C L2

Bendroflumethiazide Naturetin Approved D

L4 (may

inhibit

lactation)

Chlorothiazide Hydrodiuril Approved D L3
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6/10

Chlorthalidone Hygroton Approved D L3

HydrochlorothiazideHydrodiuril,

Esidrix, OreticApproved 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

DisopyramideNorpace,

NapamideApproved C L2

Flecainide Tambocor Approved C L3

Mexiletine Mexitil Approved B L2

Procainamide Pronestyl,Procan Approved C L3

QuinidineQuinaglute,

QuinidexApproved C L2

Antihypertensives

Captopril Capoten Approved D

L3 (if used

after 30

days)

Diltiazem/Diltiazem HCL

Cardizem Sr,

Dilacor-XR,

Diltiazem,Cardizem CD

Approved C L3

Enalapril/Enalapril Maleate Vasotec Approved

C (1st

trim.)

D (2nd, 3rd

trim.)

L2

Hydralazine Apresoline Approved C L2

LabetalolTrandate,

NormodyneApproved C L2

Methyldopa Aldomet Approved C L2

Metoprolol Toprol XL,Lopressor

Approved B L3

Minoxidil

Loniten,

Minodyl,

Rogaine

Approved C

L2(topically)

L3 (orally)

NadololCorgard,

NadololApproved C L4

NifedipineAdalat,

ProcardiaApproved C L2

Oxprenolol

Apsolox, Slow-

Trasicor,Trasicor

Approved - NR
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7/10

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,

LanoxicapsApproved 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-

chloroquineApproved 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 L2Iohexol 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,

MedrolApproved C L2
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8/10

Prednisolone - Approved C L2

Prednisone

Deltasone,

Meticorten,

OrasoneApproved 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,

MyambutolApproved B L2

Isoniazid INH, Laniazid Approved C L3

RifampinRifadin,

RimactaneApproved 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, vitaminCalciferol,

Delta-dApproved A

L3 (do not

overdose)

Folic acid - Approved

A (1st, 2nd

trim.)

C (3rdtrim.)

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

AllopurinolZyloprim,

LopurinApproved C L2

Antimony - Approved - NR

Atropine (Anticholinergic, Belladonna, Approved C L3
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9/10

drying agent) Atropine

Azapropazone/apazone

(Antirheumatic)Rheumox Approved - L2

Baclofen (muscle relaxant)Lioresal,

Atrofen

Approved C L2

Barbiturate - Approved - NR

Caffeine [more]Vivarin,

NoDoz, CoffeeApproved B L2

Carbetocin (Antihemorrhagic) Duratocin Approved - NR

Chloroform - Approved - NR

Cisplatin (Anti-cancer) Platinol Approved D L4

Dapsone (Antileprosy)Avlosulfon,

DDSApproved 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 (Musclestimulant)

Mestinon,Regonol

Approved C L2

Scopolamine (Motion sickness)Transderm

ScopeApproved C L3

Sulfapyridine Dagenan Approved - NR

Timolol (glaucoma med) Blocadren Approved D L3

* Per the AAP Policy StatementThe Transfer of Drugs and Other Chemicals Into

Human Milk, revised September 2001.

Approved: (Table 6)Maternal Medication Usually Compatible WithBreastfeeding

Caution: (Table 5)Drugs That Have Been Associated With Significant Effectson 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.** PerMedications' and Mothers' Milkby Thomas Hale, PhD (2004 edition).

Lactation Risk Categories Pregnancy Risk Categories

L1 (safest) L2 (safer) A (controlled studies show no risk) B (no evidence of risk in humans)
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10/10

L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

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

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