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
L1 (Paling Aman)
L2 (Aman)
L3 (Cukup Aman)
L4 (Kemungkinan Barbahaya)
L5 (Kontra Indikasi)

Pregnancy Risk Categories

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?*
Analgesics (Pain-killers) [more]
Acetaminophen
Tylenol
Approved/diseujui
Colchicine
Colchicine
Approved
Nefopam
Acupan
Approved
Non-steroidal anti-inflammatory analgesics (NSAIDs) [more]
Azapropazone (apazone)
Rheumox
Approved
Dipyrone (banned in the US &
Approved
UK)
Flufenamic acid
Approved
Ibuprofen

Advil, Nuprin,
Motrin,
Pediaprofin

Approved

Indomethacin

Indocin

Approved

Ketorolac

Toradol, Acular

Approved

Mefenamic acid

Ponstan, Ponstel

Approved

Pregnancy Lactation
Risk
Risk
Category** Category**
B
D
-

L1
L4
NR

L2

NR

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

NR
L1

L3

L2
NR

Naproxen
Phenylbutazone
Piroxicam
Suprofen
Tolmetin
Narcotic analgesics [more]

Anaprox,
Naprosyn,
Naproxen, Aleve
Butazolidine
Feldene
Profenal
Tolectin

Approved

Approved
Approved
Approved
Approved

B
C

L3
L4 (for
chronic use)
NR
L2
NR
L3

Butorphanol

Stadol

Approved

Codeine
Fentanyl

Tylenol #3, #4
Sublimaze

Approved
Approved

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

Meperidine

Demerol

Approved

Methadone
Morphine

Dolophine
Morphine
Darvocet N,
Propacet,
Darvon

Approved
Approved

B
B

L3
L2
L2
L3 (if used
early
postpartum)
L3
L3

Approved

L2

Propoxyphene

Approved
Approved
Approved
Approved

C
C
B
C

Approved
Approved

B
C

[contents]
L2
L2
L3
L3
[contents]
L2
L2

Approved

L1

B
B
B
B
B

[contents]
L1
L2
L1
L1
L2

Anesthesia, Anesthetics [more]

Halothane
Fluothane
Lidocaine
Xylocaine
Methohexital
Brevital
Thiopental
Pentothal
Antacids, GI meds
Cimetidine (Antacid)
Tagamet
Cisapride (GI tract stimulant)
Propulsid
Domperidone (used for nausea
& vomiting, stimulates lactation) Motilum
[more]
Antibiotics
Amoxicillin
Larotid, Amoxil
Aztreonam
Azactam
Cefadroxil
Ultracef, Duricef
Cefazolin
Ancef, Kefzol
Cefotaxime
Claforan

L3

Approved
Approved
Approved
Approved
Approved

Cefoxitin
Cefprozil

Mefoxin
Cefzil
Ceftazidime,
Ceftazidime
Fortaz, Taxidime
Ceftriaxone
Rocephin
Ciprofloxacin [more]
Cipro
Clindamycin
Cleocin
E-Mycin, EryErythromycin
tab, ERYC,
Ilosone
Fleroxacin
Gentamicin
Garamycin
Kanamycin
Kebecil, Kantrex
Moxalactam
Moxam
Nitrofurantoin
Macrobid
Ofloxacin
Floxin
Penicillin
Streptomycin
Streptomycin
Sulbactam
Gantrisin, AzoSulfisoxazole
Gantrisin
Achromycin,
Tetracycline
Sumycin,
Terramycin
Ticarcillin,
Ticarcillin
Ticar, Timentin
Proloprim,
Trimethoprim/sulfamethoxazole
Trimpex
Anticoagulants
Bishydroxycoumarin
(dicumarol)
Coumadin,
Warfarin
Panwarfin
Anticonvulsants
Carbamazepine
Tegretol, Epitol
Ethosuximide
Zarontin
Magnesium sulfate
Epsom salt
Phenytoin
Dilantin
Depakene,
Valproic acid
Depakote

Approved
Approved

B
C

L1
L1

Approved

L1

Approved
Approved
Approved

B
C
B

Approved

Approved
Approved
Approved
Approved
Approved
Approved
Approved
Approved
Approved

C
D
B
C
B
D
-

L2
L3
L3
L1
L3 early
postnatal
NR
L2
L2
NR
L2
L2
L1
L3
NR

Approved

L2

Approved

L2

Approved

L1

Approved

L3
[contents]

Approved

NR

Approved

L2

Approved
Approved
Approved
Approved

C
C
B
D

[contents]
L2
L4
L1
L2

Approved

L2

Antifungals
Fluconazole [more]
Ketoconazole
Antihistamines [more]
Dexbrompheniramine maleate
with d-isoephedrine
Fexofenadine
Loratadine
Terfenadine
Triprolidine
Antivirals
Acyclovir [more]

Diflucan
Nizoral
Shampoo,
Nizoral

Clogestone

Contraceptive pill with

estrogen/progesterone

Approved

L2
[contents]

Approved

NR

Allegra
Claritin
Seldane
Actidil, Actifed

Approved
Approved
Approved
Approved

C
B
C

Approved

L2
L1
NR
L1
[contents]
L2

Approved

L2

Zovirax
Alferon N,
Interferon-alpha [more]
Interferon Alpha
Arthritis meds (see also: pain meds)
Ridaura,
Gold salts
Myochrysine,
Solganal
Asthma meds (see also: steroids)
Dilor, Lufyllin,
Dyphylline
Dyphylline
Bricanyl,
Terbutaline
Brethine
Aminophylline,
Theophylline
Quibron, TheoDur
Contraceptives, Hormones [more]
Estradiol

Approved

[contents]
L2

Estratab,
Permarin,
Menest
Preven,
Seasonale,
Norinyl,
Norlestin, OrthoNovum, Ovral,
Lunelle
injection, OrthoEvra patch, etc.

[contents]
Approved

L5
[contents]

Approved

L3

Approved

L2

Approved

L3

Approved

Approved

[contents]
L3 (may
interfere
with milk
production)
NR

Approved

L3 (may
interfere
with milk
production)

Levonorgestrel

Medroxyprogesterone
Norethynodrel
Progesterone
Cough meds [more]
Codeine
Noscapine
Decongestants [more]

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

Approved

L2

Approved

Approved

L1
L4 (if used
first 3 days
postpartum)
L2

Approved

L3

[contents]
Tylenol #3, #4
Approved
C
L3
NR
Approved
[contents]
L3 (for
Sudafed,
acute use)
Pseudoephedrine
Halofed,
Approved
C
L4 (for
Novafed, Actifed
chronic use)
Diabetes meds
[contents]
Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk
category = L1.
Oramide,
Tolbutamide
Approved
D
L3
Orinase
Diarrhea meds
[contents]
Imodium, Pepto
Diarrhea
Control, Maalox
Antidiarrheal
Loperamide
Caplets,
Approved
B
L2
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]
Diuretics
[contents]
Dazamide,
Acetazolamide
Approved
C
L2
Diamox
L4 (may
Bendroflumethiazide
Naturetin
inhibit
Approved
D
lactation)
Chlorothiazide
Hydrodiuril
Approved
D
L3

Chlorthalidone

Hygroton
Approved
Hydrodiuril,
Hydrochlorothiazide
Approved
Esidrix, Oretic
Spironolactone
Aldactone
Approved
Galactagogues (milk supply) [more]
Domperidone
Motilum
Approved
Heart, Blood Pressure meds
(Antiarrhythmics, Antihypertensives, Cardiac stimulants)
Antiarrhythmics
Norpace,
Disopyramide
Approved
Napamide
Flecainide
Tambocor
Approved
Mexiletine
Mexitil
Approved
Pronestyl,
Procainamide
Approved
Procan
Quinaglute,
Quinidine
Approved
Quinidex
Antihypertensives

L3

L2

L2
[contents]
L1

Captopril

Capoten

Diltiazem/Diltiazem HCL

Cardizem Sr,
Dilacor-XR,
Diltiazem,
Cardizem CD

[contents]

L2

C
B

L3
L2

L3

L2

Approved

L3 (if used
after 30
days)

Approved

L3

Enalapril/Enalapril Maleate

Vasotec

Approved

Hydralazine

Apresoline
Trandate,
Normodyne
Aldomet
Toprol XL,
Lopressor
Loniten,
Minodyl,
Rogaine
Corgard,
Nadolol
Adalat,

Approved

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

Approved

L2

Approved

L2

Approved

L3

Approved

L2
(topically)
L3 (orally)

Approved

L4

Approved

L2

Labetalol
Methyldopa
Metoprolol
Minoxidil
Nadolol
Nifedipine

L2
L2

Oxprenolol
Propranolol
Sotalol
Timolol
Verapamil

Procardia
Apsolox, SlowTrasicor,
Trasicor
Inderol
Betapace
Blocadren
Calan, Isoptin,
Covera-HS

Approved

NR

Approved
Approved
Approved

C
B
C

L2
L3
L2

Approved

L2

Approved

L2

Approved
Approved
Approved
Approved

C
B
-

[contents]
L3
NR
L1
L3
[contents]

Approved

L3

Approved
Approved
Approved

C
C
D

Approved
Approved
Approved
Approved
Approved
Approved
Approved

C
C
B
D
B
B

Approved

L2
L4
L2
[contents]
NR
L3
L2
L2
L2
L2
L2
[contents]
L3
[contents]

Approved

L3

Approved

NR

Approved

L5

Cardiac stimulants
Digoxin
Laxatives [more]
Cascara/Cascara Sagrada
Danthron
Magnesium sulfate
Senna
Malaria meds
Chloroquine

Lanoxin,
Lanoxicaps
Epsom salt
Aralen, Novochloroquine
Plaquenil
Daraprim
Quinamm

Hydroxychloroquine
Pyrimethamine
Quinine
Medical Testing [more]
Diatrizoate
Fluorescein
Gadopentetic (Gadolinium)
Iohexol
Omnipaque
Iopanoic acid
Telepaque
Metrizamide
Amipaque
Metrizoate
Isopaque
Migraine meds (see also: pain meds) [more]
Sumatriptan
Imitrex
Sedatives [more]
Aquachloral,
Chloral hydrate
Noctec
Methyprylon (withdrawn from
use in US & Canada)
Bromide
-

Secobarbital
Sleep Aids
Zolpidem/Zolpidem Tartrate
Steroids
Methylprednisolone
[
high dosage
methylprednisolone]
Prednisolone
Prednisone
Thyroid meds [more]
Carbimazole
Methimazole (active metabolite
of carbimazole)
Propylthiouracil
Thiouracil
Levothyroxine
Tuberculosis meds
Cycloserine
Ethambutol
Isoniazid
Rifampin

Seconal

Approved

Ambien

Approved

Approved

L2

Approved

L2

Approved

L2

Solu-Medrol,
Depo-Medrol,
Medrol
Deltasone,
Meticorten,
Orasone
-

Approved

[contents]
L3

Tapazole

Approved

L3

PTU
Synthroid,
Levothroid,
Thyroid, Levo-T,
Levoxyl

Approved
Approved

D
-

L2
NR

Approved

L1

Approved

[contents]
L3

Approved

L2

Approved

L3

Approved

L2

Seromycin
Ethambutol,
Myambutol
INH, Laniazid
Rifadin,
Rimactane

Vitamins [more]
B-1 (thiamin)
B-12 (Cyanocobalamin)

Approved
Approved

B-6 (pyridoxine)

Approved

D, vitamin

Calciferol,
Delta-d

Approved

Approved

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

Folic acid

L3
[contents]
L3
[contents]

[contents]
NR
L1
L2; L4 in
high doses
(may inhibit
lactation)
L3 (do not
overdose)
L1

K-1, vitamin (Phytonadione)

Riboflavin/B2
Miscellaneous
Acitretin (Anti-psoriasis)
Alcohol/Ethanol [more]

Soriatane
Zyloprim,
Lopurin

Disetujui
Disetujui

L1
L1
[contents]
NR
L3

Disetujui

L2

Antimony

Disetujui

NR

Atropine (Anticholinergic,
drying agent)
Azapropazone/apazone
(Antirheumatic)

Belladonna,
Atropine

Disetujui

L3

Rheumox

Disetujui

L2

Baclofen (muscle relaxant)

Lioresal, Atrofen

Disetujui

L2

Barbiturate

Disetujui

NR

Caffeine [more]

Vivarin, NoDoz,
Coffee

Disetujui

L2

Carbetocin (Antihemorrhagic)

Duratocin

Disetujui

NR

Chloroform

Disetujui

NR

Cisplatin (Anti-cancer)

Platinol

Disetujui

L4

Dapsone (Antileprosy)

Avlosulfon,
DDS

Disetujui

L4

Hydroxychloroquine
(Antirheumatic, lupus)

Plaquenil

Disetujui

L2

Iodides

Disetujui

NR

Iodine

Disetujui

NR

Iodine (povidone-iodine, eg, in a

vaginal douche)

Disetujui

NR

Ivermectin (Antiparasitic)

Mectizan

Disetujui

L3

Nalidixic acid (Urinary Antiinfective)

NegGram

Disetujui

L4

Norsteroids

Disetujui

NR

Disetujui

L2

Disetujui

L3

Allopurinol

Pyridostigmine (Muscle
stimulant)

Mestinon,
Regonol
Transderm
Scopolamine (Motion sickness)
Scope

Approved
Disetujui

C
A

Sulfapyridine

Dagenan

Disetujui

NR

Timolol (glaucoma med)

Blocadren

Disetujui

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)
A (studi terkontrol menunjukkan tanpa resiko)
L2 (Aman)
B (tidak ada bukti risiko pada manusia)
L3 (Cukup Aman)
C (risiko tidak dapat dikesampingkan)
L4 (Kemungkinan Barbahaya)
D (bukti positif resiko)
L5 (Kontra Indikasi)
X (dikontraindikasikan untuk Ibu Hamil)
NR: Not Reviewed. This drug has