1.

Obat-obat Golongan Antibiotik untuk Kehamilan dan ibu menyusui

Daftar Obat Golongan Antibiotik dengan Indeks keamanan A - B pada Ibu Hamil dan
menyusui:

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)

Antibiotika
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 Cipro Approved C L3
Clindamycin Cleocin Approved B L3
L1
Erythromycin E-Mycin, Ery-tab, ERYC, Ilosone Approved B L3 early
postnatal
Fleroxacin - Approved - NR
 Gentamicin Garamycin Approved C L2
Kanamycin Kebecil, Kantrex Approved D L2
Moxalactam Moxam Approved - NR
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
Tetracycline Achromycin, Sumycin, Terramycin Approved D L2
Ticarcillin Ticarcillin, Ticar, Timentin Approved B L1
Trimethoprim/sulfameth
Proloprim, Trimpex Approved C L3
oxazole

2. Obat-obat Golongan Analgesik (opioid dan nonopioid), Antipiretik dan NSAID untuk
Kehamilan dan ibu menyusui

Obat untuk Penghilang Rasa Sakit (Pain Killer)

AAP Kategori Risiko Risiko
Nama Obat Notes
approved?* Kehamilan** Menyusui**
Acetaminophen (Tylenol) Approved B L1
C (1st, 2nd trim.)
Aspirin Caution L3 1
D (3rd trim.)
Approved
Azapropazone (Rheumox) - L2

Butalbital (Fioricet,
Fiorinal, Bancap, Two- NR D L3 2
dyne)
 B (1st, 2nd trim.)
Butorphanol (Stadol) Approved L3
D (3rd trim.)
Celecoxib (Celebrex)) NR C L2
Codeine (in Tylenol #3, #4) Approved C L3 3
Colchicine Approved D L4
Diclofenac (Cataflam,
NR B L2
Voltaren)
Fentanyl (Sublimaze) Approved B L2
Flurbiprofen (Ansaid, B (1st, 2nd trim.)
NR L2
Froben, Ocufen) C (3rd trim.)
Hydrocodone (Lortab,
NR B L3 4
Vicodin)
Hydromorphone
NR C L3 5
(Dilaudid)
Ibuprofen (Advil, Nuprin, B (1st, 2nd trim.)
Approved L1
Motrin, Pediaprofen) D (3rd trim.)
B (1st, 2nd trim.)
Indomethacin (Indocin) Approved L3
D (3rd trim.)
Ketorolac (Toradol, B (1st, 2nd trim.)
Approved L2
Acular) D (3rd trim.)
L2;
Meperidine (Demerol) Approved B L3 early 6
postpartum
Methadone (Dolophine) Approved B L3 7
Morphine (Duramorph,
Infumorph, Epimorph, MS Approved B L3 8
Contin)
Nalbuphine (Nubain) NR B L2
Naproxen (Anaprox, L3;
Approved B 9
Naprosyn, Naproxen, L4 for chronic
Aleve) use
Nefopam (Acupan) Approved - NR
Oxycodone (Tylox,
Percodan,Oxycontin,
NR B L3 10
Roxicet, Endocet, Roxiprin,
Percocet)
Pentosan polysulfate
NR B L2
(Elmiron)
Piroxicam (Feldene) Approved B L2
Propoxyphene (Darvocet
Approved C L2 11
N, Propacet, Darvon)
Rofecoxib (Vioxx) Withdrawn from the market 12
Secobarbital (Seconal) Approved D L3 13
Tolmetin (Tolectin) Approved C L3
Tramadol HCL (Ultram,
NR C L3 14
Ultracet)
Valdecoxib (Bextra) Withdrawn from the market
* 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) A (controlled studies show no risk)
L2 (safer) B (no evidence of risk in humans)
L3 (moderately safe) C (risk cannot be ruled out)
 L4 (possibly hazardous) D (positive evidence of risk)
L5 (contraindicated) X (contraindicated in pregnancy)

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

Non-steroidal anti-inflammatory analgesics (NSAIDs)

Kategori
Nama Generik Nama Dagang AAP Risiko Risiko
approved?* Kehamilan** Menyusui**
Azapropazone (apazone) Rheumox Approved - L2
Dipyrone (banned in the
- Approved - NR
US & UK)

Flufenamic acid - Approved - NR

B (1st, 2nd
Advil, Nuprin, Motrin,
Ibuprofen Approved trim.) L1
Pediaprofin
D (3rd trim.)
B (1st, 2nd
Indomethacin Indocin Approved trim.) L3
D (3rd trim.)
B (1st, 2nd
Ketorolac Toradol, Acular Approved trim.) L2
D (3rd trim.)
Mefenamic acid Ponstan, Ponstel Approved - NR
L3
Anaprox, Naprosyn,
Naproxen Approved B L4 (for chronic
Naproxen, Aleve
use)
Phenylbutazone Butazolidine Approved - NR
Piroxicam Feldene Approved B L2
Suprofen Profenal Approved - NR
Tolmetin Tolectin Approved C L3
Steroid
Methylprednisolone
Solu-Medrol, Depo-
[ high dosage Approved C L2
Medrol, Medrol
methylprednisolone]
Prednisolone - Approved C L2
Deltasone, Meticorten,
Prednisone Approved C L2
Orasone

Obat Asma
Dilor, Lufyllin,
Dyphylline Approved C L3
Dyphylline
Terbutaline Bricanyl, Brethine Approved B L2
Aminophylline,
Theophylline Approved C L3
Quibron, Theo-Dur

Analgetik Narkotik
B (1st, 2nd
Butorphanol Stadol Approved trim.) L3
D (3rd trim.)
Codeine Tylenol #3, #4 Approved C L3
Fentanyl Sublimaze Approved B L2
L2
Meperidine Demerol Approved B L3 (if used early
postpartum)
Methadone Dolophine Approved B L3
Morphine Morphine Approved B L3
Darvocet N, Propacet,
Propoxyphene Approved C L2
Darvon
Obat Batuk
AAP
Nama Obat Risiko Menyusui**
approved?*
Codeine yes L3 (moderately safe)
Dextromethorphan not reviewed L1 (safest)
Guaifenesin not reviewed L2 (safer)
Dekongestan (Obat Pilek)
AAP
Nama Obat Risiko Menyusui**
approved?*
Phenylephrine not reviewed L3 (moderately safe)
L3 (moderately safe) for acute use
Pseudoephedrine
yes L4 (possibly hazardous) for chronic use due to potential
(Sudafed, Actifed)
for decreasing milk supply
Nasal Sprays (Spray Hidung)
AAP
Nama Obat Risiko Menyusui**
approved?*
Beclomethasone
(Vanceril, Beclovent, not reviewed L2 (safer)
Beconase, Vancenase)
Cromlyn sodium
not reviewed L1 (safest)
(Nasalcrom)
Fluticasone (Flonase) not reviewed L3 (moderately safe)
Mometasone
not reviewed L3 (moderately safe)
(Nasonex)
Phenylephrine (in
some forms of Sinex not reviewed L3 (moderately safe)
and Neo-Synephrine)
Triamcinolone not reviewed L3 (moderately safe)
 Acetonide (Nasacort)
Antihistamin (Anti Alergi)
AAP
Nama Obat Risiko Menyusui**
approved?*
Brompheniramine not reviewed L3 (moderately safe)
Chlorpheniramine
(Chlor-Trimeton) not reviewed L3 (moderately safe)
CTM
Cetirizine (Zyrtec) not reviewed L2 (safer)
Dexbrompheniramine
maleate yes not reviewed
with d-isoephedrine
Diphenhydramine
not reviewed L2 (safer)
(Benadryl)
Doxylamine not reviewed L4 (possibly hazardous)
Fexofenadine
yes L3 (moderately safe)
(Allegra)
Loratadine (Claritin) yes L2 (safer)
Terfenadine
yes not reviewed
(Seldane)
Triprolidine (Actidil,
yes L1 (safest)
Actifed)

3. Obat-obat Golongan Antihipertensi, dan obat jantung untuk Kehamilan dan ibu menyusui

Kategori
Nama Generik Nama Dagang AAP Risiko Risiko
approved?* Kehamilan** Menyusui**
Anti Hipertensi, Obat Jantung
Anti aritmia
 Norpace,
Disopyramide Approved C L2
Napamide
Flecainide Tambocor Approved C L3
Mexiletine Mexitil Approved B L2
Pronestyl,
Procainamide Approved C L3
Procan
Quinaglute,
Quinidine Approved C L2
Quinidex
Anti Hipertensi
L3 (if used
Captopril Capoten Approved D after 30
days)
Cardizem Sr,
Dilacor-XR,
Diltiazem/Diltiazem HCL Approved C L3
Diltiazem,
Cardizem CD
C (1st trim.)
Enalapril/Enalapril Maleate Vasotec Approved D (2nd, 3rd L2
trim.)
Hydralazine Apresoline Approved C L2
Trandate,
Labetalol Approved C L2
Normodyne
Methyldopa Aldomet Approved C L2
Toprol XL,
Metoprolol Approved B L3
Lopressor
Loniten, L2
Minoxidil Minodyl, Approved C (topically)
Rogaine L3 (orally)
Corgard,
Nadolol Approved C L4
Nadolol
 Adalat,
Nifedipine Approved C L2
Procardia
Apsolox, Slow-
Oxprenolol Trasicor, Approved - NR
Trasicor
Propranolol Inderol Approved C L2
Sotalol Betapace Approved B L3
Timolol Blocadren Approved C L2
Calan, Isoptin,
Verapamil Approved C L2
Covera-HS
Cardiac stimulants
Lanoxin,
Digoxin Approved C L2
Lanoxicaps

4. Obat-obat Golongan Antikonvulsan untuk Kehamilan dan ibu menyusui

Kategori
Nama Generik Nama Dagang AAP Risiko Risiko
approved?* Kehamilan** Menyusui**
Antikonvulsan (Anti kejang)
Carbamazepine Tegretol, Epitol Approved C L2
Ethosuximide Zarontin Approved C L4
Magnesium sulfate Epsom salt Approved B L1
Phenytoin Dilantin Approved D L2
Depakene,
Valproic acid Approved D L2
Depakote
Anti Muntah
Domperidone Motilum Approved - L1
Obat Migren
Sumatriptan Imitrex Approved C L3
 Obat Sedativ
Aquachloral,
Chloral hydrate Approved C L3
Noctec
Methyprylon (withdrawn from
- Approved - NR
use in US & Canada)
Bromide - Approved D L5
Secobarbital Seconal Approved D L3
Obat Tidur
Zolpidem/Zolpidem Tartrate Ambien Approved B L3

5. Obat-obat yang bekerja di saluran Gastrointestinal pada Kehamilan dan ibu menyusui
Kategori
Nama Generik Nama Dagang AAP Risiko Risiko
approved?* Kehamilan** Menyusui**
Obat Diare
Imodium, Pepto
Diarrhea
Control, Maalox
Antidiarrheal
Loperamide Caplets, Approved B L2
Kaopectate II
Caplets,
Immodium
Advanced
Diuretik (Peluruh Kencing)
Dazamide,
Acetazolamide Approved C L2
Diamox
L4 (may
Bendroflumethiazide Naturetin Approved D inhibit
lactation)
Chlorothiazide Hydrodiuril Approved D L3
Chlorthalidone Hygroton Approved D L3
Hydrodiuril,
Hydrochlorothiazide (HCT) Approved D L2
Esidrix, Oretic
Spironolactone Aldactone Approved D L2
Laksan (Pelancar BAB)
Cascara/Cascara Sagrada - Approved C L3
Danthron - Approved - NR
Magnesium sulfate Epsom salt Approved B L1
Senna - Approved - L3
VITAMIN
B-1 (thiamin) - Approved - NR
B-12 (Cyanocobalamin) - Approved A L1
L2; L4 in
high doses
B-6 (pyridoxine) - Approved A
(may inhibit
lactation)
Calciferol, L3 (do not
D, vitamin Approved A
Delta-d overdose)
A (1st, 2nd
Folic acid - Approved trim.) L1
C (3rd trim.)
K-1, vitamin (Phytonadione) - Approved C L1
Riboflavin/B2 - Approved A L1
Kontrasepsi, Hormon
L3 (may
Estratab,
interfere
Estradiol Permarin, Approved X
with milk
Menest
production)
 Clogestone - Approved - NR
Preven,
Seasonale,
Norinyl, L3 (may
Contraceptive pill with Norlestin, Ortho- interfere
Approved X
estrogen/progesterone Novum, Ovral, with milk
Lunelle production)
injection, Ortho-
Evra patch, etc.
Norplant,
Levonorgestrel Approved X L2
Mirena, Plan B
L1
Provera, Depo- L4 (if used
Medroxyprogesterone Approved D
Provera, Cycrin first 3 days
postpartum)
Norethynodrel Enovid Approved X L2
Crinone,
Progesterone Approved - L3
Prometrium

Daftar Pustaka

1. Farmakologi Dan Terapi Edisi 5. 2009. Jakarta: Balai Penerbit FK UI

2. MIMS Indonesia Petunjuk Konsultasi Edisi 12. 2012. Jakarta: PT. Bhuana Ilmu Populer
(Kelompok Gramedia)
3. Selected List of Medications approved by the AAP for use in breastfeeding mothers (AAP list
revised 8/04). 2011, di unduh pada tanggal 31 Mei 2013 pukul 9.45 di
http://www.kellymom.com/health/meds/aap-approved-meds.html