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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
Sumatriptan
Chloral hydrate
Methyprylon
Bromide
Secobarbital
Zolpidem
Bishydroxycoumarin
Warfarin
Carbamazepine
Ethosuximide
Magnesium sulfate
Phenytoin
Valproic acid

R.Hamil
C
C
D
D
B
D
C
C
B
D
D

R.Menyusui
L3
L3
NR
L5
L3
L3
NR
L2
L2
L4
L1
L2
L2

Obat TBC dan Malaria


Nama Obat
Obat TB
Cycloserine
Ethambutol
Isoniazid
Rifampin
Obat malaria
Chloroquine
Hydroxychloroquine
Pyrimethamine
Quinine

Risiko Kehamilan

Risiko Menyusui

C
B
C
C

L3
L2
L3
L2

C
C
C
D

L3
L2
L4
L2

Risiko Kehamilan**
C

RisikoMenyusui**
L2

Anti Hipertensi, Anti Aritmia, dan Diuretik


Nama Generik
Acetazolamide

Bendroflumethiazide
Chlorothiazide
Chlorthalidone
Hydrochlorothiazide (HCT)
Spironolactone
Disopyramide
Flecainide
Mexiletine
Procainamide
Quinidine
Captopril
Diltiazem/Diltiazem HCL
Enalapril/Enalapril Maleate
Hydralazine
Labetalol
Methyldopa
Metoprolol
Minoxidil

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

Nadolol
Nifedipine
Oxprenolol
Propranolol
Sotalol
Timolol
Verapamil
Digoxin

C
C
C
B
C
C
C

L4 (may inhibit lactation)


L3
L3
L2
L2
L2
L3
L2
L3
L2
L3 (if used after 30 days)
L3
L2
L2
L2
L2
L3
L2(topically)
L3 (orally)
L4
L2
NR
L2
L3
L2
L2
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
Antijamur
Fluconazole
Ketoconazole
Antivirus
Acyclovir
Interferon-alpha

Risiko Kehamilan

RisikoMenyusui

C
C

L2
L2

C
C

L2
L2

Antibiotik
Nama Generik
Amoxicillin
Aztreonam
Cefadroxil
Cefazolin
Cefotaxime
Cefoxitin

Risiko Kehamilan
B
B
B
B
B
B

Risiko Menyusui
L1
L2
L1
L1
L2
L1

Cefprozil
Ceftazidime
Ceftriaxone
Ciprofloxacin
Clindamycin
Erythromycin

C
B
B
C
B
B

Fleroxacin
Gentamicin
Kanamycin
Moxalactam
Nitrofurantoin
Ofloxacin
Penicillin
Streptomycin
Sulbactam
Sulfisoxazole
Tetracycline
Ticarcillin
Trimethoprim/sulfamethoxazole

C
D
B
C
B
D
C
D
B
C

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

Antasida, Laksan (Pelancar BAB) dan Obat Diare


Nama Generik
Cimetidine (Antacid)
Cisapride (GI tract stimulant)
Domperidone (used for nausea &
vomiting, stimulates lactation)
Cascara/Cascara Sagrada
Danthron
Magnesium sulfate
Senna
Loperamide

Risiko Kehamilan

Risiko Menyusui

B
C
-

L2
L2
L1

C
B
B

L3
NR
L1
L3
L2

Antihistamin
Nama Obat
Brompheniramine
Chlorpheniramine
(Chlor-Trimeton) CTM
Cetirizine (Zyrtec)
Dexbrompheniramine
maleate
with d-isoephedrine
Diphenhydramine
(Benadryl)
Doxylamine
Fexofenadine (Allegra)

AAP
approved?*
not
reviewed
not
reviewed
not
reviewed
yes

not
reviewed
not
reviewed
yes

Risiko Menyusui**
L3 (moderately safe)
L3 (moderately safe)
L2 (safer)
not reviewed

L2 (safer)
L4 (possibly hazardous)
L3 (moderately safe)

Loratadine (Claritin)
Terfenadine (Seldane)
Triprolidine (Actidil,
Actifed)

yes
yes
yes

L2 (safer)
not reviewed
L1 (safest)

Obat Asma, Obat Batuk, dan Spray Hidung


Nama Generik
Dyphylline
Terbutaline
Theophylline
Nama Obat
Codeine
Dextromethorphan
Guaifenesin
Phenylephrine
Pseudoephedrine (Sudafed,
Actifed)
Beclomethasone (Vanceril,
Beclovent, Beconase, Vancenase)
Cromlyn sodium (Nasalcrom)
Fluticasone (Flonase)
Mometasone (Nasonex)
Phenylephrine (in some forms of
Sinex and Neo-Synephrine)
Triamcinolone Acetonide
(Nasacort)

Kategori Risiko
Kehamilan**
C
B
C

RisikoMenyusui**
L3
L2
L3
Risiko Menyusui**

L3 (moderately safe)
L1 (safest)
L2 (safer)
L3 (moderately safe)
L3 (moderately safe) for acute use
L4 (possibly hazardous) for chronic use due to potential for
decreasing milk supply
L2 (safer)
L1 (safest)
L3 (moderately safe)
L3 (moderately safe)
L3 (moderately safe)
L3 (moderately safe)

NSAIDs dan Steroid


Nama Generik
Azapropazone (apazone)
Dipyrone
Flufenamic acid
Ibuprofen

Mefenamic acid
Naproxen

Kategori Risiko Kehamilan**


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

Phenylbutazone
Piroxicam
Suprofen
Tolmetin
Methylprednisolone
Prednisolone
Prednisone

B
C
C
C
C

Indomethacin
Ketorolac

RisikoMenyusui**
L2
NR
NR
L1
L3
L2
NR
L3
L4
NR
L2
NR
L3
L2
L2
L2

ANALGETIK
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)
Indomethacin (Indocin)
Ketorolac (Toradol, Acular)

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

Risiko Menyusui
L1

L3

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

L3
L2

L3
L2
L3
L4
L2
L2
L2
L3
L3
L1
L3
L2

Meperidine (Demerol)

Methadone (Dolophine)
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)
Secobarbital (Seconal)
Tolmetin (Tolectin)
Tramadol HCL(Ultram, Ultracet)

L2;
L3 early postpartum
L3

L3

L2
L3;
L4 for chronic use
NR

L3

B
B

L2
L2

L2

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

L3
L3
L3

Butorphanol
Codeine
Fentanyl

Meperidine

Methadone

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

Morphine
Propoxyphene

B
C

L3
L2