Friday, July 17, 2009

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

dari sumber URL : http://www.kellymom.com/health/meds/aap-approved-meds.html

daftar obat

Kelompok Analgetik, NSAIDS, Obat Batuk dan Pilek,

Anti Alergi dan Asma, Anestesi

Obat untuk Penghilang Rasa Sakit (Pain Killer)
Nama Obat

AAP approved?*

Kategori Risiko Kehamilan**

Risiko Menyusui**

Notes

Acetaminophen (Tylenol)

Approved

B

L1

Aspirin

Caution

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

L3

1

Azapropazone (Rheumox)

Approved

-

L2

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

NR

D

L3

2

Butorphanol (Stadol)

Approved

B (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)

NR

B (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)

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

Meperidine (Demerol)

Approved

B

L2;
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

B

L3;
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Withdrawn from the market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Withdrawn from the market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.

** 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

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

Steroid

[contents]

Methylprednisolone
[ high dosage methylprednisolone]
Solu-Medrol, Depo-Medrol, Medrol

Approved

C

L2

Prednisolone -

Approved

C

L2

Prednisone Deltasone, Meticorten, Orasone

Approved

C

L2

Obat Asma

[contents]

Dyphylline Dilor, Lufyllin, Dyphylline

Approved

C

L3

Terbutaline Bricanyl, Brethine

Approved

B

L2

Theophylline Aminophylline, Quibron, Theo-Dur

Approved

C

L3

Analgetik Narkotik [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

Obat Batuk
Nama Obat

AAP approved?*

Risiko Menyusui**

Codeine

yes

L3 (moderately safe)

Dextromethorphan

not reviewed

L1 (safest)

Guaifenesin

not reviewed

L2 (safer)

Dekongestan (Obat Pilek)
Nama Obat

AAP approved?*

Risiko Menyusui**

Phenylephrine

not reviewed

L3 (moderately safe)

Pseudoephedrine (Sudafed, Actifed)

yes

L3 (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 Obat

AAP
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 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)

* 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 Obat

AAP 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.

** 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 Kehamilan**

Risiko Menyusui**

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

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

Antikoagulan

[contents]

Bishydroxycoumarin (dicumarol) -

Approved

-

NR

Warfarin Coumadin, 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 acid Depakene, Depakote

Approved

D

L2

Anti Jamur

[contents]

Fluconazole [more] Diflucan

Approved

C

L2

Ketoconazole Nizoral 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 salts Ridaura, Myochrysine, Solganal

Approved

C

L5

Kontrasepsi, Hormon

[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

Obat Diabetes

[contents]

Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk category = L1.
Tolbutamide Oramide, 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]

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 (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
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

Anti Hipertensi
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, Procardia

Approved

C

L2

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

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]

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

Obat Migren [more]

[contents]

Sumatriptan Imitrex

Approved

C

L3

Obat Sedativ [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

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, Levoxyl

Approved

A

L1

Obat TBC

[contents]

Cycloserine Seromycin

Approved

C

L3

Ethambutol Ethambutol, Myambutol

Approved

B

L2

Isoniazid INH, Laniazid

Approved

C

L3

Rifampin Rifadin, 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, 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 -

Approved

A

L1

Lain-lain

[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.

** 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


Sumber: dari sini

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