Selasa, 29 Maret 2011

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

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

daftar obat

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**

RisikoMenyusui**

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.)
D (3rd trim.)

L3

Celecoxib (Celebrex))

NR

C

L2

Codeine (in Tylenol #3, #4)

Approved

C

L3

3

Colchicine

Approved

D

L4

Diclofenac (Cataflam, Voltaren)

NR

B

L2

Fentanyl (Sublimaze)

Approved

B

L2

Flurbiprofen (Ansaid, Froben, Ocufen)

NR

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

L2

Hydrocodone (Lortab, Vicodin)

NR

B

L3

4

Hydromorphone(Dilaudid)

NR

C

L3

5

Ibuprofen (Advil, Nuprin, Motrin, Pediaprofen)

Approved

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

L1

Indomethacin(Indocin)

Approved

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

L3

Ketorolac (Toradol, Acular)

Approved

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

L2

Meperidine (Demerol)

Approved

B

L2;
L3 early postpartum

6

Methadone (Dolophine)

Approved

B

L3

7

Morphine (Duramorph, Infumorph, Epimorph, MS Contin)

Approved

B

L3

8

Nalbuphine (Nubain)

NR

B

L2

Naproxen (Anaprox, Naprosyn, Naproxen, Aleve)

Approved

B

L3;
L4 for chronic use

9

Nefopam (Acupan)

Approved

-

NR

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

NR

B

L3

10

Pentosan polysulfate(Elmiron)

NR

B

L2

Piroxicam (Feldene)

Approved

B

L2

Propoxyphene(Darvocet N, Propacet, Darvon)

Approved

C

L2

11

Rofecoxib (Vioxx)

Withdrawn from the market

12

Secobarbital (Seconal)

Approved

D

L3

13

Tolmetin (Tolectin)

Approved

C

L3

Tramadol HCL (Ultram, Ultracet)

NR

C

L3

14

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Withdrawn from the market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.

** 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 Kehamilan**

RisikoMenyusui**

Azapropazone (apazone)Rheumox

Approved

-

L2

Dipyrone (banned in the US & UK)-

Approved

-

NR

Flufenamic acid-

Approved

-

NR

IbuprofenAdvil, Nuprin, Motrin, Pediaprofin

Approved

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

L1

IndomethacinIndocin

Approved

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

L3

KetorolacToradol, Acular

Approved

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

L2

Mefenamic acidPonstan, Ponstel

Approved

-

NR

NaproxenAnaprox, Naprosyn, Naproxen, Aleve

Approved

B

L3
L4 (for chronic use)

PhenylbutazoneButazolidine

Approved

-

NR

PiroxicamFeldene

Approved

B

L2

SuprofenProfenal

Approved

-

NR

TolmetinTolectin

Approved

C

L3

Steroid

[contents]

Methylprednisolone
[ high dosage methylprednisolone]
Solu-Medrol, Depo-Medrol, Medrol

Approved

C

L2

Prednisolone-

Approved

C

L2

PrednisoneDeltasone, Meticorten, Orasone

Approved

C

L2

Obat Asma

[contents]

DyphyllineDilor, Lufyllin, Dyphylline

Approved

C

L3

TerbutalineBricanyl, Brethine

Approved

B

L2

TheophyllineAminophylline, Quibron, Theo-Dur

Approved

C

L3

Analgetik Narkotik [more]
ButorphanolStadol

Approved

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

L3

CodeineTylenol #3, #4

Approved

C

L3

FentanylSublimaze

Approved

B

L2

MeperidineDemerol

Approved

B

L2
L3 (if used early postpartum)

MethadoneDolophine

Approved

B

L3

MorphineMorphine

Approved

B

L3

PropoxypheneDarvocet N, Propacet, Darvon

Approved

C

L2

Obat Batuk
Nama Obat

AAP approved?*

Risiko Menyusui**

Codeine

yes

L3 (moderately safe)

Dextromethorphan

not reviewed

L1 (safest)

Guaifenesin

not reviewed

L2 (safer)

Dekongestan (Obat Pilek)
Nama Obat

AAP 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)
Nama Obat

AAP
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 Acetonide (Nasacort)

not reviewed

L3 (moderately safe)

Antihistamin (Anti Alergi)
Nama Obat

AAP
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 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 (2002 edition)

Obat Anestesi
Nama Obat

AAP approved?*

Kategori Risiko Kehamilan**

RisikoMenyusui**

Notes

Local anesthetics
Articaine (Septocaine)

NR

-

NR

more

Bupivacaine (Marcaine)

NR

C

L2

Lidocaine (Xylocaine)

Approved

C

L2

Mepivacaine (Carbocaine, Polocaine)

NR

C

L3

more

Procaine HCL (Novocaine)

NR

C

L3

General anesthetics
Halothane (Fluothane)

Approved

C

L2

more

Isoflurane (Forane)

NR

-

NR

1

Ketamine

NR

-

NR

more

Methohexital (Brevital)

Approved

B

L3

Nitrous oxide

NR

-

L3

Sevoflurane (Ultane)

NR

B

L3

Thiopental (Pentothal)

Approved

C

L3

Other medications often used during anesthesia
Sedatives
Diazepam (Valium)

Concern

D

L3; L4 for chronic use

Midazolam (Versed)

Concern

D

L3

Propofol (Diprivan)

NR

B

L2

more

Triazolam (Halcion)

NR

X

L3

Narcotic Analgesics
Alfentanil (Alfenta)

NR

C

L2

Fentanyl (Sublimaze)

Approved

B

L2

Hydromorphone (Dilaudid)

NR

C

L3

Morphine

Approved

B

L3

Reversal Medication
Flumazenil (Romazicon)

NR

C

NR

2

Naloxone (Narcan)

NR

C

NR

3

Steroids
Decadron (Dexamethasone)

NR

C

NR

more

Stimulants
Epinephrine (Adrenaline)

NR

C

L1

Anti-nausea
Promethazine (Phenergan)

NR

C

L2

* 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 (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. 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?*

Kategori Risiko Kehamilan**

RisikoMenyusui**

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]

AmoxicillinLarotid, Amoxil

Approved

B

L1

AztreonamAzactam

Approved

B

L2

CefadroxilUltracef, Duricef

Approved

B

L1

CefazolinAncef, Kefzol

Approved

B

L1

CefotaximeClaforan

Approved

B

L2

CefoxitinMefoxin

Approved

B

L1

CefprozilCefzil

Approved

C

L1

CeftazidimeCeftazidime, Fortaz, Taxidime

Approved

B

L1

CeftriaxoneRocephin

Approved

B

L2

Ciprofloxacin [more]Cipro

Approved

C

L3

ClindamycinCleocin

Approved

B

L3

ErythromycinE-Mycin, Ery-tab, ERYC, Ilosone

Approved

B

L1
L3 early postnatal

Fleroxacin-

Approved

-

NR

GentamicinGaramycin

Approved

C

L2

KanamycinKebecil, Kantrex

Approved

D

L2

MoxalactamMoxam

Approved

-

NR

NitrofurantoinMacrobid

Approved

B

L2

OfloxacinFloxin

Approved

C

L2

Penicillin-

Approved

B

L1

StreptomycinStreptomycin

Approved

D

L3

Sulbactam-

Approved

-

NR

SulfisoxazoleGantrisin, Azo-Gantrisin

Approved

C

L2

TetracyclineAchromycin, Sumycin, Terramycin

Approved

D

L2

TicarcillinTicarcillin, Ticar, Timentin

Approved

B

L1

Trimethoprim/sulfamethoxazoleProloprim, Trimpex

Approved

C

L3

Antikoagulan

[contents]

Bishydroxycoumarin (dicumarol)-

Approved

-

NR

WarfarinCoumadin, Panwarfin

Approved

D

L2

Antikonvulsan (Anti kejang)

[contents]

CarbamazepineTegretol, Epitol

Approved

C

L2

EthosuximideZarontin

Approved

C

L4

Magnesium sulfateEpsom salt

Approved

B

L1

PhenytoinDilantin

Approved

D

L2

Valproic acidDepakene, Depakote

Approved

D

L2

Anti Jamur

[contents]

Fluconazole [more]Diflucan

Approved

C

L2

KetoconazoleNizoral 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 saltsRidaura, Myochrysine, Solganal

Approved

C

L5

Kontrasepsi, Hormon

[contents]

EstradiolEstratab, Permarin, Menest

Approved

X

L3 (may interfere with milk production)

Clogestone-

Approved

-

NR

Contraceptive pill with estrogen/progesteronePreven, Seasonale, Norinyl, Norlestin, Ortho-Novum, Ovral, Lunelle injection, Ortho-Evra patch, etc.

Approved

X

L3 (may interfere with milk production)

LevonorgestrelNorplant, Mirena, Plan B

Approved

X

L2

MedroxyprogesteroneProvera, Depo-Provera, Cycrin

Approved

D

L1
L4 (if used first 3 days postpartum)

NorethynodrelEnovid

Approved

X

L2

ProgesteroneCrinone, Prometrium

Approved

-

L3

Obat Diabetes

[contents]

Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk category = L1.
TolbutamideOramide, Orinase

Approved

D

L3

Obat Diare

[contents]

LoperamideImodium, Pepto Diarrhea Control, Maalox Antidiarrheal Caplets, Kaopectate II Caplets, Immodium Advanced

Approved

B

L2

** 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]

AcetazolamideDazamide, Diamox

Approved

C

L2

BendroflumethiazideNaturetin

Approved

D

L4 (may inhibit lactation)

ChlorothiazideHydrodiuril

Approved

D

L3

ChlorthalidoneHygroton

Approved

D

L3

Hydrochlorothiazide (HCT)Hydrodiuril, Esidrix, Oretic

Approved

D

L2

SpironolactoneAldactone

Approved

D

L2

Anti Muntah [more]

[contents]

DomperidoneMotilum

Approved

-

L1

Anti Hipertensi, Obat Jantung

[contents]

Anti aritmia
DisopyramideNorpace, Napamide

Approved

C

L2

FlecainideTambocor

Approved

C

L3

MexiletineMexitil

Approved

B

L2

ProcainamidePronestyl, Procan

Approved

C

L3

QuinidineQuinaglute, Quinidex

Approved

C

L2

Anti Hipertensi
CaptoprilCapoten

Approved

D

L3 (if used after 30 days)

Diltiazem/Diltiazem HCLCardizem Sr, Dilacor-XR, Diltiazem, Cardizem CD

Approved

C

L3

Enalapril/Enalapril MaleateVasotec

Approved

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

L2

HydralazineApresoline

Approved

C

L2

LabetalolTrandate, Normodyne

Approved

C

L2

MethyldopaAldomet

Approved

C

L2

MetoprololToprol XL, Lopressor

Approved

B

L3

MinoxidilLoniten, Minodyl, Rogaine

Approved

C

L2 (topically)
L3 (orally)

NadololCorgard, Nadolol

Approved

C

L4

NifedipineAdalat, Procardia

Approved

C

L2

OxprenololApsolox, Slow-Trasicor, Trasicor

Approved

-

NR

PropranololInderol

Approved

C

L2

SotalolBetapace

Approved

B

L3

TimololBlocadren

Approved

C

L2

VerapamilCalan, Isoptin, Covera-HS

Approved

C

L2

Cardiac stimulants
DigoxinLanoxin, Lanoxicaps

Approved

C

L2

Laksan (Pelancar BAB) [more]

[contents]

Cascara/Cascara Sagrada-

Approved

C

L3

Danthron-

Approved

-

NR

Magnesium sulfateEpsom salt

Approved

B

L1

Senna-

Approved

-

L3

Obat malaria

[contents]

ChloroquineAralen, Novo-chloroquine

Approved

C

L3

HydroxychloroquinePlaquenil

Approved

C

L2

PyrimethamineDaraprim

Approved

C

L4

QuinineQuinamm

Approved

D

L2

Medical Testing [more]

[contents]

Diatrizoate-

Approved

-

NR

Fluorescein-

Approved

C

L3

Gadopentetic (Gadolinium)-

Approved

C

L2

IohexolOmnipaque

Approved

B

L2

Iopanoic acidTelepaque

Approved

D

L2

MetrizamideAmipaque

Approved

B

L2

MetrizoateIsopaque

Approved

B

L2

Obat Migren [more]

[contents]

SumatriptanImitrex

Approved

C

L3

Obat Sedativ [more]

[contents]

Chloral hydrateAquachloral, Noctec

Approved

C

L3

Methyprylon (withdrawn from use in US & Canada)-

Approved

-

NR

Bromide-

Approved

D

L5

SecobarbitalSeconal

Approved

D

L3

Obat Tidur

[contents]

Zolpidem/Zolpidem TartrateAmbien

Approved

B

L3

Obat Anti Tiroid [more]

[contents]

Carbimazole-

Approved

D

L3

Methimazole (active metabolite of carbimazole)Tapazole

Approved

D

L3

PropylthiouracilPTU

Approved

D

L2

Thiouracil-

Approved

-

NR

LevothyroxineSynthroid, Levothroid, Thyroid, Levo-T, Levoxyl

Approved

A

L1

Obat TBC

[contents]

CycloserineSeromycin

Approved

C

L3

EthambutolEthambutol, Myambutol

Approved

B

L2

IsoniazidINH, Laniazid

Approved

C

L3

RifampinRifadin, Rimactane

Approved

C

L2

VITAMIN [more]

[contents]

B-1 (thiamin)-

Approved

-

NR

B-12 (Cyanocobalamin)-

Approved

A

L1

B-6 (pyridoxine)-

Approved

A

L2; L4 in high doses (may inhibit lactation)

D, vitaminCalciferol, Delta-d

Approved

A

L3 (do not overdose)

Folic acid-

Approved

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

L1

K-1, vitamin (Phytonadione)-

Approved

C

L1

Riboflavin/B2 -

Approved

A

L1

Lain-lain

[contents]

Acitretin (Anti-psoriasis)Soriatane

Approved

-

NR

Alcohol/Ethanol [more]-

Approved

D

L3

AllopurinolZyloprim, Lopurin

Approved

C

L2

Antimony-

Approved

-

NR

Atropine (Anticholinergic, drying agent)Belladonna, Atropine

Approved

C

L3

Azapropazone/apazone (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

Cisplatin (Anti-cancer)Platinol

Approved

D

L4

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

Norsteroids-

Approved

-

NR

Pyridostigmine (Muscle stimulant)Mestinon, Regonol

Approved

C

L2

Scopolamine (Motion sickness)Transderm Scope

Approved

C

L3

SulfapyridineDagenan

Approved

-

NR

Timolol (glaucoma med)Blocadren

Approved

D

L3

* 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 (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


Sumber :
http://kaahil.wordpress.com/2009/05/23/daftar-obat-aman-dan-berbahaya-untuk-ibu-hamil-dan-menyusui/

1 komentar:

  1. Thank you for providing valuable information over the generic medicines.
    It was really helpful.

    BalasHapus