for everyone

Kadang-kadang kondisi sedang menyusui membuat kita ragu-ragu untuk mengkonsumsi obat,

takut obat bakal berpengaruh terhadap ASI dan atau bayi. Padahal banyak obat yang boleh

dikonsumsi untuk ibu-ibu yang hamil dan menyusui mulai dari tingkat L1 (safest) sampai L4.

Sebaiknya obat hanya dikonsumsi pada kondisi terpaksa, alias tidak ada pilihan lain, jika masih

bisa home therapy, sebaiknya obat tidak dikonsumsi. Salah satu obat paling aman untuk ibu

hamil dan atau menyusui adalah acetaminophen atau parasetamol.

Berikut ini linknya: http://www.kellymom.com/health/meds/aap-approved-meds.html

Lactation Risk Categories Pregnancy Risk Categories

L1 (Paling Aman)

L2 (Aman)

L3 (Cukup Aman)

L4 (Kemungkinan Barbahaya)

L5 (Kontra Indikasi)

A (studi terkontrol menunjukkan tanpa resiko)

B (tidak ada bukti risiko pada manusia)

C (risiko tidak dapat dikesampingkan)

D (bukti positif resiko)

X (dikontraindikasikan untuk Ibu Hamil)

Generic name Trade Name AAP approved?*

Pregnancy

Risk

Category**

Lactation

Risk

Category**

Analgesics (Pain-killers) [more]

Acetaminophen Tylenol Approved/diseujui 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

Ibuprofen

Advil, 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

Naproxen

Anaprox,

Naprosyn,

Naproxen, Aleve Approved B

L3 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

trim.)

L3

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,

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

Ceftazidime Ceftazidime,

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

L1 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-

Gantrisin Approved C L2

Tetracycline

Achromycin,

Sumycin,

Terramycin Approved D L2

Ticarcillin Ticarcillin,

Ticar, Timentin Approved B L1

Trimethoprim/sulfamethoxazole Proloprim,

Trimpex Approved C L3

Anticoagulants [contents]

Bishydroxycoumarin

(dicumarol) - Approved - NR

Warfarin Coumadin,

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 acid Depakene,

Depakote Approved D L2

Antifungals [contents]

Fluconazole [more] Diflucan Approved C L2

Ketoconazole

Nizoral

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 salts

Ridaura,

Myochrysine,

Solganal Approved C L5

Asthma meds (see also: steroids) [contents]

Dyphylline Dilor, Lufyllin,

Dyphylline Approved C L3

Terbutaline Bricanyl,

Brethine Approved B L2

Theophylline

Aminophylline,

Quibron, Theo-

Dur Approved C L3

Contraceptives, Hormones [more] [contents]

Estradiol

Estratab,

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,

Mirena, Plan B Approved X L2

Medroxyprogesterone Provera, Depo-

Provera, Cycrin Approved D

L1 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] [contents]

Pseudoephedrine

Sudafed,

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 D

L4 (may

inhibit

lactation)

Chlorothiazide Hydrodiuril Approved D L3

Chlorthalidone Hygroton Approved D L3

Hydrochlorothiazide Hydrodiuril,

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

Quinidine Quinaglute,

Quinidex Approved 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

Labetalol Trandate,

Normodyne Approved C L2

Methyldopa Aldomet Approved C L2

Metoprolol Toprol XL,

Lopressor Approved B L3

Minoxidil

Loniten,

Minodyl,

Rogaine Approved C

L2 (topically)

L3 (orally)

Nadolol Corgard,

Nadolol Approved C L4

Nifedipine Adalat, Approved C L2

Procardia

Oxprenolol

Apsolox, Slow-

Trasicor,

Trasicor Approved - NR

Propranolol Inderol Approved C L2

Sotalol Betapace Approved B L3

Timolol Blocadren Approved C L2

Verapamil Calan, Isoptin,

Covera-HS Approved C L2

Cardiac stimulants

Digoxin Lanoxin,

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]

Chloroquine Aralen, 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 hydrate Aquachloral,

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

Prednisone

Deltasone,

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

Ethambutol Ethambutol,

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 A

L3 (do not

overdose)

Folic acid - Approved

A (1st, 2nd

trim.)

C (3rd

trim.)

L1

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

Riboflavin/B2 - Disetujui A L1

Miscellaneous [contents]

Acitretin (Anti-psoriasis) Soriatane Disetujui - NR

Alcohol/Ethanol [more] - Disetujui D L3

Allopurinol Zyloprim,

Lopurin Disetujui

C L2

Antimony - Disetujui

- NR

Atropine (Anticholinergic,

drying agent)

Belladonna,

Atropine Disetujui

C L3

Azapropazone/apazone

(Antirheumatic) Rheumox Disetujui

- L2

Baclofen (muscle relaxant) Lioresal, Atrofen Disetujui

C L2

Barbiturate - Disetujui

- NR

Caffeine [more] Vivarin, NoDoz,

Coffee Disetujui

B L2

Carbetocin (Antihemorrhagic) Duratocin Disetujui

- NR

Chloroform - Disetujui

- NR

Cisplatin (Anti-cancer) Platinol Disetujui

D L4

Dapsone (Antileprosy) Avlosulfon,

DDS Disetujui

C L4

Hydroxychloroquine

(Antirheumatic, lupus) Plaquenil Disetujui

C L2

Iodides - Disetujui

- NR

Iodine - Disetujui

- NR

Iodine (povidone-iodine, eg, in a

vaginal douche) - Disetujui

- NR

Ivermectin (Antiparasitic) Mectizan Disetujui

C L3

Nalidixic acid (Urinary Anti-

infective) NegGram Disetujui

B L4

Norsteroids - Disetujui

- NR

Pyridostigmine (Muscle

stimulant)

Mestinon,

Regonol Disetujui

C L2

Scopolamine (Motion sickness) Transderm

Scope Disetujui

C L3

Sulfapyridine Dagenan Disetujui

- NR

Timolol (glaucoma med) Blocadren Disetujui

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 (Paling Aman)

L2 (Aman)

L3 (Cukup Aman)

L4 (Kemungkinan Barbahaya)

L5 (Kontra Indikasi)

A (studi terkontrol menunjukkan tanpa resiko)

B (tidak ada bukti risiko pada manusia)

C (risiko tidak dapat dikesampingkan)

D (bukti positif resiko)

X (dikontraindikasikan untuk Ibu Hamil)

NR: Not Reviewed. This drug has