DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU

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DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU

HAMIL DAN MENYUSUI

Disusun kembali oleh dr.Abu Hana

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

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.)

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Celecoxib (Celebrex)) NR C L2

Ibuprofen (Advil, Nuprin,

Motrin, Pediaprofen) Approved

B (1st, 2nd trim.)

D (3rd trim.) L1

Indomethacin (Indocin) Approved B (1st, 2nd trim.)

Ketorolac (Toradol,

Acular) Approved

B (1st, 2nd trim.)

Meperidine (Demerol) Approved B

L2; L3 early postpartum

6

Methadone (Dolophine) Approved B L3 7

Morphine (Duramorph, Infumorph, Epimorph, MS Contin) L4 for chronic

use

9

Nefopam (Acupan) Approved - NR

Oxycodone (Tylox, Percodan,Oxycontin, Roxicet, Endocet, Roxiprin, Percocet)

Rofecoxib (Vioxx) Withdrawn from the market 12

Secobarbital (Seconal) Approved D L3 13

Tolmetin (Tolectin) Approved C L3

Tramadol HCL (Ultram,

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Valdecoxib (Bextra) Withdrawn from the market more * Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.

 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 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

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Kehamilan**

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

L3

Ketorolac Toradol, Acular Approved

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

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

L3

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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

approved?* Risiko Menyusui**

Codeine yes L3 (moderately safe)

Dextromethorphan not reviewed L1 (safest)

Guaifenesin not reviewed L2 (safer)

Dekongestan (Obat Pilek)

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)

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

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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 Medications’ and Mothers’ Milk by Thomas Hale, PhD (2002 edition)

Menyusui** Notes

Local anesthetics

Halothane (Fluothane) Approved C L2 more

Isoflurane (Forane) NR - NR 1

Ketamine NR - NR more

Methohexital (Brevital) Approved B L3

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Sevoflurane (Ultane) NR B L3

Thiopental (Pentothal) Approved C L3

Other medications often used during anesthesia

Sedatives

Decadron (Dexamethasone) NR C NR more

Stimulants

Epinephrine (Adrenaline) NR C L1

Anti-nausea

Promethazine (Phenergan) NR C L2

 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.

 L2 (safer)

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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?*

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

Gentamicin Garamycin Approved C L2

Kanamycin Kebecil, Kantrex Approved D L2

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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

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]

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production)

Clogestone - Approved - NR

Contraceptive pill with estrogen/progesterone 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

** 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)

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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

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

Nadolol Corgard,

Nadolol Approved C L4

Nifedipine Adalat,

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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

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Thiouracil - Approved - NR

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

D, vitamin Calciferol,

Delta-d Approved A

Lain-lain [contents]

Acitretin (Anti-psoriasis) Soriatane Approved - NR

Alcohol/Ethanol [more] - Approved D L3

Allopurinol Zyloprim,

Lopurin Approved C L2

(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

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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

Scopolamine (Motion sickness) Transderm

Scope Approved C L3

Sulfapyridine Dagenan Approved - NR

Timolol (glaucoma med) Blocadren Approved D L3

 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.

 L2 (safer)

NR: Not Reviewed. This drug has not yet been reviewed by Hale

Keamanan obat pada kehamilan

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Pada umumnya para ibu hamil akan memberitahu dokter saat berobat bahwa dirinya hamil sekian bulan. Demikian pula jika berobat saat menyusui (ASI bayinya. Informasi tersebut diberikan si ibu dengan harapan dokter akan memberikan obat yang aman bagi janin yang dikandungnya. Itupun tak jarang si ibu masih mananyakan kepada dokter apakah obat yang dgunakan benar-benar aman. Hal ini sangat wajar dan kita patut menghargainya.

Di sisi lain, ketika seorang ibu hamil sakit adakalanya enggan ke dokter lantaran takut menggunakan obat. Alhasil keluhannya makin bertambah dan akhirnya datang juga ke dokter untuk berobat.

Seorang dokter tentu sangat paham bahwa saat memberikan(meresepkan) obat bagi wanita hamil akan dipilihkan obat yang aman, baik dalam hal jenis obat (berdasarkan indeks keamanan obat), dosis maupun lamanya penggunaan. Selain itu akan dipertimbangkan pula aspek-aspek lain berdasarkan penyakitnya, misalnya: resiko penularan kepada anggota keluarga lain, dan pertimbangan lain terkait kondisi janin maupun si ibu sendiri.

Pun manakala seorang dokter dihadapkan pada 2 pilihan sulit yang menyangkut life saving, aspek manfaat akan dikedepankan dibanding resiko yang bakal dihadapi baik bagi janin maupun ibunya.

Sebagai contoh, seorang ibu hamil yang kebetulan menderita asma, justru seyogyanya segera berobat agar tidak mengalami sesak berkepanjangan yang justru tidak baik bagi janin karena beresiko terjadinya hipoksia (kekurangan oksigen) yang akan mempengaruhi pasokan oksigen bagi janin.

INDEKS KEAMANAN OBAT PADA KEHAMILAN

Hingga kini kita di Indonesia masih menggunakan kriteria keamanan obat bagi ibu hamil yang dilansir oleh FDA (Food and Drug Administration) sebagai pedoman dalam memberikan obat pada ibu hamil.

Pada posting ini penulis hanya menampilkan garis-garis besar batasan keamanan obat bagi ibu hamil yang tersusun dalam 5 kategori (kategori A, B, C, D dan X) beserta contoh-contohnya agar diketahui khalayak dengan harapan dapat memberikan informasi yang bermanfaat.

Kategori-kategori tersebut dibuat berdasarkan ada tidaknya (besar kecilnya) resiko terhadap sistem reproduksi, efek samping dan manfaat yag diharapkan.

Obat Kategori A: adalah golongan obat yang pada studi (terkontrol) pada kehamilan tidak menunjukkan resiko bagi janin pada trimester 1 dan trimester berikutnya. Obat dalam kategori ini amat kecil kemungkinannya bagi keselamatan janin.

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yang menunjukkan adanya efek samping, kecuali adanya penurunan fertilitas pada kehamilan trimester pertama, sedangkan pada trimester berikutnya tidak didapatkan bukti adanya resiko.

Obat Kategori C: adalah golongan obat yang pada studi terhadap sistem reproduksi binatang percobaan menunjukkan adanya efek samping bagi janin. Sedangkan pada wanita hamil belum ada study terkontrol. Obat golongan ini hanya dapat dipergunakan jika manfaatnya lebih besar ketimbang resiko yang mungkin terjadi pada janin.

Obat Kategoti D: adalah golongan obat yang menunjukkan adanya resiko bagi janin. Pada keadaan khusus obat ini digunakan jika manfaatnya kemungkinan lebih besar dibanding resikonya. Penggunaan obat golongan ini terutama untuk mengatasi keadaan yang mengancam jiwa atau jika tidak ada obat lain yang lebih aman.

Obat Kategori X: adalah golongan obat yang pada studi terhadap binatang percobaan maupun pada manusia menunjukkan bukti adanya resiko bagi janin. Obat golongan ini tidak boleh dipergunakan (kontra indikasi) untuk wanita hamil, atau kemungkinan dalam keadaan hamil.

CONTOH OBAT KATEGORI A (nama generik): Ascorbic acid (vitamin C) *masuk kategori C jika dosisnya melebihi US RDA*, Doxylamine, Ergocalciferol *masuk kategori D jika

dosisnya melebihi US RDA*, Folic acid *masuk kategori C jika dosisnya melebihi 0,8 mg per hari*, Hydroxocobalamine *masuk kategori C jika dosisnya melebihi US RDA*, Liothyronine, Nystatin vaginal sup *masuk kategori C jika digunakan per oral dan topikal*, Pantothenic acid *masuk kategori C jika dosisnya melebihi US RDA*, Potassium chloride, Potassium citrate, Potassium gluconate, Pyridoxine (vitamin B6), Riboflavin *masuk kategori C jika dosisnya melebihi US RDA*, Thiamine (vitamin B1) *masuk kategori C jika dosisnya melebihi US RDA*, Thyroglobulin, Thyroid hormones, Vitamin D *masuk kategori D jika dosisnya melebihi US RDA*, Vitamin E *masuk kategori C jika dosisnya melebihi US RDA*.

CONTOH OBAT KATEGORI B (nama generik): Acetylcysteine, Acyclovir, Amiloride

*masuk kategori D jika digunakan untuk hipertensi yang diinduksi oleh kehamilan*, Ammonium chloride, Ammonium lactate *topical*, Amoxicillin, Amphotericin B, Ampicillin, Atazanavir, Azatadine, Azelaic acid, Benzylpenicillin, Bisacodyl, Budesonide *inhalasi, nasal*, Buspiron, Caffeine, Carbenicillin, Camitine, Cefaclor, Cefadroxil, Cefalexin, Cefalotin, Cefamandole, Cefapirin, Cefatrizine, Cefazolin, Cefdinir, Cefditoren, Cefepime, Cefixime, Cefmetazole,

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Clemastine, Clindamycin, Clotrimazole, Cloxacillin, Clozapine, Colestyramine, …. dll ….. dll

… buanyak

CONTOH OBAT KATEGORI C (nama generik): Acetazolamide, Acetylcholine chloride, Adenosine, Albendazole, Albumin, Alclometasone, Allopurinol, Aluminium hydrochloride, Aminophylline, Amitriptyline, Amlodipine, Antazoline, Astemizole, Atropin, Bacitracin, Beclometasone, Belladonna, Benzatropine mesilate, Benzocaine, Buclizine, Butoconazole, Calcitonin, Calcium acetate, Calcium ascorbate, Calcium carbonate, Calcium chloride, Calcium citrate, Calcium folinate, Calcium glucoheptonade, Calcium gluconate, Calcium lactate, Calcium phosphate, Calcium polystyrene sulfonate, Capreomycin, Captopril, Carbachol, Carbidopa, Carbinoxamine, Chloral hydrate, Chloramphenicol, Chloroquine, Chlorothiazide,

Chlorpromazine, Choline theophyllinate, Cidofovir, Cilastatin, Cinnarizine, Cyprofloxacin, Cisapride, Clarithromycin, Clinidium bromide, Clonidine, Co-trimoxazole, Codeine,

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Isosorbid dinitrate, Ketoconazole, Ketotifen fumarate, Magaldrate, Mefenamic acid, Methyl

prednisolone, …dll …dll …

CONTOH OBAT KATEGORI D (nama generik): Amikacin, Amobarbital, Atenolol, Carbamazepine, Carbimazole, Chlordizepoxide, Cilazapril, Clonazepam, Diazepam,

Doxycycline, Imipramine, Kanamycin, Lorazepam, Lynestrenol, Meprobamate, Methimazole,

Minocycline, Oxazepam, Oxytetracycline, Tamoxifen, Tetracycline, Uracil, Voriconazole… dll … dll.

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Ooopsss … banyak banget, mana namanya rumit pula. … hehehe, maaf

Obat-obat kategori A (yang paling aman pada kehamilan) dan obat kategori X (kontra indikasi pada kehamilan) sengaja ditulis lengkap agar dapat diketahui oleh khalayak. *padahal alasan

sebenarnya karena itemnya ga banyak* …sedangkan

obat kategori B, C dan D hanya ditulis sebagian kecil saja karena saking banyaknya item dan jenisnya.

PESAN-PESAN:

Bagi khalayak, penggunaan obat menyangkut jenis, dosis dan lamanya pemakaian seyogyanya atas petunjuk dokter.

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… apalagi jika tidak mencantumkan efek samping, peringatan hati-hati pada kondisi tertentu dan kontra-indikasi.

Obat hanya akan bermanfaat jika digunakan dengan tepat sesuai indikasi, dosis dan lamanya pengobatan berlandaskan pengetahuan yang dapat dipertanggung jawabkan.