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Kelompok Analgetik, NSAIDS, Obat Batuk dan Pilek, Anti Alergi dan Asma, Anestesi Obat untuk Penghilang

Rasa Sakit (Pain Killer) Nama Obat Acetaminophen (Tylenol) Aspirin Azapropazone (Rheumox) Butalbital (Fioricet, Fiorinal, Bancap, Twodyne) Butorphanol (Stadol) Celecoxib (Celebrex)) Codeine (in Tylenol #3, #4) Colchicine Diclofenac (Cataflam, Voltaren) Fentanyl (Sublimaze) Flurbiprofen (Ansaid, Froben, Ocufen) Hydrocodone (Lortab, Vicodin) Hydromorphone (Dilaudid) Ibuprofen (Advil, Nuprin, Motrin, Pediaprofen) AAP approved?* Approved Caution Approved Kategori Risiko Kehamilan** B C (1st, 2nd trim.) D (3rd trim.) Risiko Notes Menyusui** L1 L3 L2 2 1

NR Approved NR Approved Approved NR Approved NR NR NR Approved

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

L3 L3 L2 L3 L4 L2 L2 L2 L3 L3 L1

4 5

Indomethacin (Indocin) Ketorolac (Toradol, Acular) Meperidine (Demerol)

Approved Approved

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

L3 L2 L2; L3 early 6 postpartum L3 L3 L2 L3; 9 L4 for chronic use NR L3 L2 L2 L2 11 12 L3 L3 L3 14 more 13 10 7 8

Approved

Methadone (Dolophine) Approved Morphine (Duramorph, Infumorph, Epimorph, MS Contin) Nalbuphine (Nubain) Naproxen (Anaprox, Naprosyn, Naproxen, Aleve) Nefopam (Acupan) Oxycodone (Tylox, Percodan,Oxycontin, Roxicet, Endocet, Roxiprin, Percocet) Pentosan polysulfate (Elmiron) Piroxicam (Feldene) Propoxyphene (Darvocet N, Propacet, Darvon) Rofecoxib (Vioxx) Secobarbital (Seconal) Tolmetin (Tolectin) Tramadol HCL (Ultram, Ultracet) Valdecoxib (Bextra) Approved NR Approved Approved NR NR Approved Approved

Withdrawn from the market Approved Approved NR D C C Withdrawn from the market

* 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 (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 Reyes 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 babys 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 Kategori Nama Dagang AAP Risiko Risiko approved?* Kehamilan** Menyusui** Approved Approved NR L2

Azapropazone Rheumox (apazone) Dipyrone (banned in the US & UK) Flufenamic acid -

Approved

NR

Ibuprofen

Advil, Nuprin, Approved Motrin, Pediaprofin

B (1st, 2nd L1 trim.) D (3rd trim.) B (1st, 2nd L3 trim.) D (3rd trim.) B (1st, 2nd L2 trim.) D (3rd trim.) B B C NR L3 L4 (for chronic use) NR L2 NR L3 [contents]

Indomethacin

Indocin

Approved

Ketorolac Mefenamic acid Naproxen Phenylbutazone Piroxicam Suprofen Tolmetin Steroid

Toradol, Acular Ponstan, Ponstel Anaprox, Naprosyn, Naproxen, Aleve Butazolidine Feldene Profenal Tolectin

Approved Approved Approved Approved Approved Approved Approved

Methylprednisolone Solu-Medrol, [ high dosage Depo-Medrol, methylprednisolone] Medrol Prednisolone Prednisone Deltasone, Meticorten, Orasone

Approved Approved Approved

C C C L2 L2

L2

Obat Asma Dyphylline Terbutaline Theophylline Dilor, Lufyllin, Dyphylline Bricanyl, Brethine Approved Approved C B C

[contents] L3 L2 L3

Aminophylline, Approved Quibron, Theo-Dur

Analgetik Narkotik [more] Butorphanol Codeine Fentanyl Stadol Tylenol #3, #4 Sublimaze B (1st, 2nd Approved trim.) D (3rd trim.) Approved Approved C B L3 L2 L2 L3 (if used early postpartum) L3 L3 L2 L3

Meperidine

Demerol

Approved

Methadone Morphine Propoxyphene

Dolophine Morphine Darvocet N, Propacet, Darvon

Approved Approved Approved

B B C

Obat Batuk Nama Obat Codeine Dextromethorphan Guaifenesin AAP approved?* yes Risiko Menyusui** L3 (moderately safe)

not L1 (safest) reviewed not L2 (safer) reviewed AAP approved?*

Dekongestan (Obat Pilek) Nama Obat Phenylephrine Pseudoephedrine (Sudafed, Actifed) Risiko Menyusui**

not L3 (moderately safe) reviewed 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 Beclomethasone (Vanceril, Beclovent, Beconase, Vancenase) Cromlyn sodium (Nasalcrom) Fluticasone (Flonase) Mometasone (Nasonex) Phenylephrine (in some forms of Sinex and Neo-Synephrine) Triamcinolone Acetonide (Nasacort) AAP approved?* not L2 (safer) reviewed not L1 (safest) reviewed not L3 (moderately safe) reviewed not L3 (moderately safe) reviewed not L3 (moderately safe) reviewed not L3 (moderately safe) reviewed AAP approved?* Risiko Menyusui**

Antihistamin (Anti Alergi) Nama Obat Brompheniramine Chlorpheniramine (Chlor-Trimeton) CTM Cetirizine (Zyrtec) Dexbrompheniramine maleate with d-isoephedrine Diphenhydramine (Benadryl) Risiko Menyusui**

not L3 (moderately safe) reviewed not L3 (moderately safe) reviewed not L2 (safer) reviewed yes not reviewed

not L2 (safer) reviewed

Doxylamine Fexofenadine (Allegra) Loratadine (Claritin)

not L4 (possibly hazardous) reviewed yes yes L3 (moderately safe) L2 (safer)

Terfenadine not reviewed yes (Seldane) Triprolidine (Actidil, L1 (safest) yes Actifed) * 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 Local anesthetics Articaine (Septocaine) Bupivacaine (Marcaine) Lidocaine (Xylocaine) Mepivacaine (Carbocaine, Polocaine) Procaine HCL (Novocaine) General anesthetics Halothane (Fluothane) Isoflurane (Forane) Ketamine Methohexital (Brevital) Nitrous oxide Sevoflurane (Ultane) Thiopental (Pentothal) Approved NR NR Approved NR NR Approved C B B C L2 NR NR L3 L3 L3 L3 more 1 more NR NR Approved NR NR C C C C NR L2 L2 L3 L3 more more AAP Kategori Risiko Risiko Notes approved?* Kehamilan** Menyusui**

Other medications often used during anesthesia Sedatives Diazepam (Valium) Concern D Midazolam (Versed) Propofol (Diprivan) Triazolam (Halcion) Narcotic Analgesics Alfentanil (Alfenta) Fentanyl (Sublimaze) Hydromorphone (Dilaudid) Morphine Reversal Medication Flumazenil (Romazicon) Naloxone (Narcan) Steroids Decadron (Dexamethasone) Stimulants Epinephrine (Adrenaline) Anti-nausea Promethazine (Phenergan) NR C NR C NR C NR NR C C NR Approved NR Approved C B C B Concern NR NR D B X

L3; L4 for chronic use L3 L2 L3 L2 L2 L3 L3 NR NR NR L1 L2 3 more 2 more

* 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 Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May Be of Concern 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 (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 Antasida Cimetidine (Antacid) Cisapride (GI tract stimulant)

Nama Dagang

Kategori AAP Risiko Risiko approved?* Kehamilan** Menyusui** [contents]

Tagamet Propulsid

Approved Approved Approved

B C L2 L1

L2

Domperidone (used for nausea & vomiting, stimulates Motilum lactation) [more] Antibiotika Amoxicillin Aztreonam Cefadroxil Cefazolin Cefotaxime Cefoxitin Cefprozil Ceftazidime Ceftriaxone Ciprofloxacin [more] Clindamycin Larotid, Amoxil Azactam Ultracef, Duricef Ancef, Kefzol Claforan Mefoxin Cefzil

[contents] Approved Approved Approved Approved Approved Approved Approved B B B B B B C B B C B L2 L1 L1 L2 L1 L1 L1 L2 L3 L3 L1

Ceftazidime, Fortaz, Approved Taxidime Rocephin Cipro Cleocin Approved Approved Approved

Erythromycin Fleroxacin Gentamicin Kanamycin Moxalactam Nitrofurantoin Ofloxacin Penicillin Streptomycin Sulbactam

E-Mycin, Ery-tab, ERYC, Ilosone Garamycin Kebecil, Kantrex Moxam Macrobid Floxin -

Approved Approved Approved Approved Approved Approved Approved Approved

B C D B C B D C D B C

L1 L3 early postnatal NR L2 L2 NR L2 L2 L1 L3 NR L2 L2 L1 L3 [contents]

Streptomycin Approved Approved Approved Approved Approved Approved

Gantrisin, Sulfisoxazole AzoGantrisin Achromycin, Tetracycline Sumycin, Terramycin Ticarcillin, Ticarcillin Ticar, Timentin Trimethoprim/sulfamethoxazol Proloprim, e Trimpex Antikoagulan Bishydroxycoumarin (dicumarol) Warfarin Antikonvulsan (Anti kejang) Carbamazepine Ethosuximide Tegretol, Epitol Zarontin Coumadin, Panwarfin

Approved Approved

D L2

NR

[contents] Approved Approved C C L4 L2

Magnesium sulfate Phenytoin Valproic acid Anti Jamur Fluconazole [more] Ketoconazole Antivirus Acyclovir [more] Interferon-alpha [more]

Epsom salt Dilantin Depakene, Depakote Diflucan Nizoral Shampoo, Nizoral Zovirax Alferon N, Interferon Alpha

Approved Approved Approved

B D D

L1 L2 L2 [contents]

Approved Approved

C C L2

L2

[contents] Approved Approved C C L2 [contents] C L5 [contents] Estratab, Permarin, Menest Preven, Seasonale, Norinyl, Norlestin, OrthoNovum, Ovral, Lunelle injection, Ortho-Evra patch, etc. L3 (may interfere with milk production) NR L2

Arthritis meds (see also: pain meds) Gold salts Kontrasepsi, Hormon Ridaura, Myochrysine, Approved Solganal

Estradiol

Approved

Clogestone

Approved

Contraceptive pill with estrogen/progesterone

Approved

L3 (may interfere with milk production)

Levonorgestrel

Norplant, Mirena, Plan Approved B Provera, DepoProvera, Cycrin Enovid Crinone, Prometrium Approved

L2 L1 L4 (if used first 3 days postpartum) L2 L3 [contents]

Medroxyprogesterone

Norethynodrel Progesterone Obat Diabetes

Approved Approved

X -

Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk category = L1. Oramide, Tolbutamide Approved D L3 Orinase Obat Diare [contents] Imodium, Pepto Diarrhea Control, Maalox Loperamide Antidiarrheal Approved B L2 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] Diuretik (Peluruh Kencing) Acetazolamide Bendroflumethiazide Chlorothiazide Dazamide, Diamox Naturetin Hydrodiuril Approved Approved Approved C D D [contents] L2 L4 (may inhibit lactation) L3

Chlorthalidone Hydrochlorothiazide (HCT) Spironolactone Anti Muntah [more] Domperidone Anti aritmia Disopyramide Flecainide Mexiletine Procainamide Quinidine Anti Hipertensi Captopril

Hygroton Hydrodiuril, Esidrix, Oretic Aldactone

Approved Approved Approved

D D D

L3 L2 L2 [contents]

Motilum

Approved

L1 [contents]

Anti Hipertensi, Obat Jantung Norpace, Napamide Tambocor Mexitil Pronestyl, Procan Quinaglute, Quinidex Approved Approved Approved Approved Approved C C B C C

L2 L3 L2 L3 L2

Capoten

Approved

L3 (if used after 30 days) L3

Diltiazem/Diltiazem HCL

Cardizem Sr, Dilacor-XR, Approved Diltiazem, Cardizem CD Vasotec Apresoline Trandate, Normodyne Aldomet Toprol XL, Lopressor

Enalapril/Enalapril Maleate Hydralazine Labetalol Methyldopa Metoprolol

C (1st trim.) Approved D (2nd, 3rd L2 trim.) Approved Approved Approved Approved C C C B L2 L2 L2 L3

Minoxidil Nadolol Nifedipine Oxprenolol Propranolol Sotalol Timolol Verapamil Cardiac stimulants Digoxin

Loniten, Minodyl, Rogaine Corgard, Nadolol Adalat, Procardia Apsolox, SlowTrasicor, Trasicor Inderol Betapace Blocadren Calan, Isoptin, Covera-HS Lanoxin, Lanoxicaps Epsom salt Aralen, Novochloroquine Plaquenil Daraprim Quinamm

Approved Approved Approved Approved Approved Approved Approved Approved

C C C C B C C

L2 (topically) L3 (orally) L4 L2 NR L2 L3 L2 L2

Approved

L2 [contents]

Laksan (Pelancar BAB) [more] Cascara/Cascara Sagrada Danthron Magnesium sulfate Senna Obat malaria Chloroquine Hydroxychloroquine Pyrimethamine Quinine Approved Approved Approved Approved C C C D Approved Approved Approved Approved C B -

L3 NR L1 L3 [contents] L3 L2 L4 L2

Medical Testing [more] Diatrizoate Fluorescein Gadopentetic (Gadolinium) Iohexol Iopanoic acid Metrizamide Metrizoate Obat Migren [more] Sumatriptan Obat Sedativ [more] Chloral hydrate Aquachloral, Approved Noctec Approved Approved Approved C D D Imitrex Approved C Omnipaque Telepaque Amipaque Isopaque Approved Approved Approved Approved Approved Approved Approved C C B D B B

[contents] NR L3 L2 L2 L2 L2 L2 [contents] L3 [contents] L3 NR L5 L3 [contents] Ambien Approved B L3 [contents] Approved Approved Approved Approved Approved D D D A L3 L2 NR L1 L3

Methyprylon (withdrawn from use in US & Canada) Bromide Secobarbital Obat Tidur Zolpidem/Zolpidem Tartrate Obat Anti Tiroid [more] Carbimazole Methimazole (active metabolite Tapazole of carbimazole) Propylthiouracil Thiouracil Levothyroxine PTU Synthroid, Levothroid, Thyroid, Levo-T, Seconal

Levoxyl Obat TBC Cycloserine Ethambutol Isoniazid Rifampin VITAMIN [more] B-1 (thiamin) B-12 (Cyanocobalamin) Approved Approved A L1 L2; L4 in high doses (may inhibit lactation) L3 (do not overdose) Seromycin Ethambutol, Myambutol INH, Laniazid Rifadin, Rimactane Approved Approved Approved Approved C B C C L2 L3 L2 [contents] NR [contents] L3

B-6 (pyridoxine)

Approved

D, vitamin

Calciferol, Delta-d -

Approved

Folic acid K-1, vitamin (Phytonadione) Riboflavin/B2 Lain-lain Acitretin (Anti-psoriasis) Alcohol/Ethanol [more] Allopurinol Antimony Atropine (Anticholinergic, drying agent)

Approved Approved Approved

A (1st, 2nd L1 trim.) C (3rd trim.) C A L1 L1 [contents]

Soriatane Zyloprim, Lopurin Belladonna, Atropine

Approved Approved Approved Approved Approved

D C C L3 L2 NR L3

NR

Azapropazone/apazone (Antirheumatic) Baclofen (muscle relaxant) Barbiturate Caffeine [more]

Rheumox Lioresal, Atrofen Vivarin, NoDoz, Coffee Platinol Avlosulfon, DDS Plaquenil -

Approved Approved Approved Approved Approved Approved Approved Approved Approved Approved Approved Approved Approved Approved Approved Approved Approved Approved Approved

C B D C C C B C C D

L2 L2 NR L2 NR NR L4 L4 L2 NR NR NR L3 L4 NR L2 L3 NR L3

Carbetocin (Antihemorrhagic) Duratocin Chloroform Cisplatin (Anti-cancer) Dapsone (Antileprosy) Hydroxychloroquine (Antirheumatic, lupus) Iodides Iodine

Iodine (povidone-iodine, eg, in a vaginal douche) Ivermectin (Antiparasitic) Nalidixic acid (Urinary Antiinfective) Norsteroids Pyridostigmine (Muscle stimulant) Mectizan NegGram -

Mestinon, Regonol Transderm Scopolamine (Motion sickness) Scope Sulfapyridine Timolol (glaucoma med) Dagenan Blocadren

* 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 (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