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**
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
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)
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
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)
Morphine B L3
