DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI ANALGETIK Nama Obat Acetaminophen (Tylenol)

Aspirin Risiko Kehamilan B C (1st, 2nd trim.) D (3rd trim.) Azapropazone (Rheumox) Butalbital (Fioricet, Fiorinal, Bancap, Two-dyne) Butorphanol (Stadol) B (1st, 2nd trim.) D (3rd trim.) 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) 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.) Ketorolac (Toradol, Acular) B (1st, 2nd trim.) D (3rd trim.) Meperidine (Demerol) B L2; L3 early postpartum Methadone (Dolophine) Morphine (Duramorph, Infumorph, B B L3 L3 L2 L3 L3 L3 L1 L2 L3 L4 L2 L2 L2 L3 D L3 L2 Risiko Menyusui L1 L3

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) Butorphanol D C C B (1st, 2nd trim.) D (3rd trim.) Codeine Fentanyl Meperidine C B B L3 L2 L2 L3 (if used early postpartum) Methadone Morphine Propoxyphene B B C L3 L3 L2 L3 L3 L3 L3 B B C L2 L2 L2 B NR L3 B B L2 L3; L4 for chronic use

Antibiotik Nama Generik Kategori Risiko Kehamilan Amoxicillin B L1 Risiko Menyusui

Aztreonam Cefadroxil Cefazolin Cefotaxime Cefoxitin Cefprozil Ceftazidime Ceftriaxone Ciprofloxacin Clindamycin Erythromycin

B B B B B C B B C B B

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

Fleroxacin Gentamicin Kanamycin Moxalactam Nitrofurantoin Ofloxacin Penicillin Streptomycin Sulbactam Sulfisoxazole Tetracycline Ticarcillin Trimethoprim/sulfamethoxazole C D B C NR L2 L2 L1 L3 B C B D NR L2 L2 L1 L3 C D NR L2 L2

** 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.

* 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).