Twitter Delicious Facebook Digg Stumbleupon Favorites More

Sunday, March 27, 2011

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI


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**
Risiko Menyusui**
Notes
Acetaminophen  (Tylenol)
Approved
B
L1

Aspirin
Caution
C (1st, 2nd trim.)
D (3rd trim.)
L3
Azapropazone  (Rheumox)
Approved

-
L2

Butalbital (Fioricet, Fiorinal, Bancap, Two-dyne)
NR
D
L3
Butorphanol  (Stadol)
Approved
B (1st, 2nd trim.)
D (3rd trim.)
L3

Celecoxib (Celebrex))
NR
C
L2

Codeine (in Tylenol #3, #4)
Approved
C
L3
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
Hydromorphone (Dilaudid)
NR
C
L3
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
Methadone (Dolophine)
Approved
B
L3
Morphine (Duramorph, Infumorph, Epimorph, MS Contin)
Approved
B
L3
Nalbuphine (Nubain)
NR
B
L2

Naproxen (Anaprox, Naprosyn, Naproxen, Aleve)
Approved
B
L3;
L4 for chronic use
Nefopam (Acupan)
Approved
-
NR

Oxycodone (Tylox, Percodan,Oxycontin, Roxicet, Endocet, Roxiprin, Percocet)
NR
B
L3
Pentosan polysulfate (Elmiron)
NR
B
L2

Piroxicam (Feldene)
Approved
B
L2

Propoxyphene (Darvocet N, Propacet, Darvon)
Approved
C
L2
Rofecoxib (Vioxx)
Secobarbital (Seconal)
Approved
D
L3
Tolmetin (Tolectin)
Approved
C
L3

Tramadol HCL (Ultram, Ultracet)
NR
C
L3
Valdecoxib  (Bextra)
*  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**
Risiko Menyusui**
Azapropazone (apazone) Rheumox
Approved
-
L2
Dipyrone (banned in the US & UK) -
Approved
-
NR
Flufenamic acid -
Approved
-
NR
Ibuprofen Advil, Nuprin, Motrin, Pediaprofin
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
Mefenamic acid Ponstan, Ponstel
Approved
-
NR
Naproxen Anaprox, Naprosyn, Naproxen, Aleve
Approved
B
L3
L4 (for chronic use)
Phenylbutazone Butazolidine
Approved
-
NR
Piroxicam Feldene
Approved
B
L2
Suprofen Profenal
Approved
-
NR
Tolmetin Tolectin
Approved
C
L3
    Steroid
Methylprednisolone
high dosage methylprednisolone]
Solu-Medrol, Depo-Medrol, Medrol
Approved
C
L2
Prednisolone -
Approved
C
L2
Prednisone Deltasone, Meticorten, Orasone
Approved
C
L2
Obat Asma
Dyphylline Dilor, Lufyllin, Dyphylline
Approved
C
L3
Terbutaline Bricanyl, Brethine
Approved
B
L2
Theophylline Aminophylline, Quibron, Theo-Dur
Approved
C
L3
     Analgetik Narkotik  [more]
Butorphanol Stadol
Approved
B (1st, 2nd trim.)
D (3rd trim.)
L3
Codeine Tylenol #3, #4
Approved
C
L3
Fentanyl Sublimaze
Approved
B
L2
Meperidine Demerol
Approved
B
L2
L3 (if used early postpartum)
Methadone Dolophine
Approved
B
L3
Morphine Morphine
Approved
B
L3
Propoxyphene Darvocet 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**
Risiko Menyusui**
Notes
     Local anesthetics
Articaine (Septocaine)
NR
-
NR
Bupivacaine (Marcaine)
NR
C
L2

Lidocaine (Xylocaine)
Approved
C
L2

Mepivacaine (Carbocaine, Polocaine)
NR
C
L3
Procaine HCL (Novocaine)
NR
C
L3

     General anesthetics
Halothane (Fluothane)
Approved
C
L2
Isoflurane (Forane)
NR
-
NR
Ketamine
NR
-
NR
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
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
Naloxone (Narcan)
NR
C
NR
Steroids
Decadron (Dexamethasone)
NR
C
NR
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**
Risiko Menyusui**
Antasida
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
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 [more] Cipro
Approved
C
L3
Clindamycin Cleocin
Approved
B
L3
Erythromycin E-Mycin, Ery-tab, ERYC, Ilosone
Approved
B
L1
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/sulfamethoxazole Proloprim, Trimpex
Approved
C
L3
Antikoagulan
Bishydroxycoumarin (dicumarol) -
Approved
-
NR
Warfarin Coumadin, Panwarfin
Approved
D
L2
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
Valproic acid Depakene, Depakote
Approved
D
L2
Anti Jamur
Fluconazole [more] Diflucan
Approved
C
L2
Ketoconazole Nizoral Shampoo, Nizoral
Approved
C
L2
Antivirus
Acyclovir [more] Zovirax
Approved
C
L2
Interferon-alpha [more] Alferon N, Interferon Alpha
Approved
C
L2
Arthritis meds (see also: pain meds)
Gold salts Ridaura, Myochrysine, Solganal
Approved
C
L5
Kontrasepsi, Hormon
Estradiol Estratab, Permarin, Menest
Approved
X
L3 (may interfere with milk production)
Clogestone -
Approved
-
NR
Contraceptive pill with estrogen/progesterone Preven, Seasonale, Norinyl, Norlestin, Ortho-Novum, Ovral, Lunelle injection, Ortho-Evra patch, etc.
Approved
X
L3 (may interfere with milk production)
Levonorgestrel Norplant, Mirena, Plan B
Approved
X
L2
Medroxyprogesterone Provera, Depo-Provera, Cycrin
Approved
D
L1
L4 (if used first 3 days postpartum)
Norethynodrel Enovid
Approved
X
L2
Progesterone Crinone, Prometrium
Approved
-
L3
Obat Diabetes
Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk category = L1.
Tolbutamide Oramide, Orinase
Approved
D
L3
Obat Diare
Loperamide Imodium, 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)
Acetazolamide Dazamide, Diamox
Approved
C
L2
Bendroflumethiazide Naturetin
Approved
D
L4 (may inhibit lactation)
Chlorothiazide Hydrodiuril
Approved
D
L3
Chlorthalidone Hygroton
Approved
D
L3
Hydrochlorothiazide (HCT) Hydrodiuril, Esidrix, Oretic
Approved
D
L2
Spironolactone Aldactone
Approved
D
L2
Anti Muntah  [more]
Domperidone Motilum
Approved
-
L1
Anti Hipertensi, Obat Jantung
     Anti aritmia
Disopyramide Norpace, Napamide
Approved
C
L2
Flecainide Tambocor
Approved
C
L3
Mexiletine Mexitil
Approved
B
L2
Procainamide Pronestyl, Procan
Approved
C
L3
Quinidine Quinaglute, Quinidex
Approved
C
L2
   Anti Hipertensi
Captopril Capoten
Approved
D
L3 (if used after 30 days)
Diltiazem/Diltiazem HCL Cardizem Sr, Dilacor-XR, Diltiazem, Cardizem CD
Approved
C
L3
Enalapril/Enalapril Maleate Vasotec
Approved
C (1st trim.)
D (2nd, 3rd trim.)
L2
Hydralazine Apresoline
Approved
C
L2
Labetalol Trandate, Normodyne
Approved
C
L2
Methyldopa Aldomet
Approved
C
L2
Metoprolol Toprol XL, Lopressor
Approved
B
L3
Minoxidil Loniten, Minodyl, Rogaine
Approved
C
L2 (topically)
L3 (orally)
Nadolol Corgard, Nadolol
Approved
C
L4
Nifedipine Adalat, Procardia
Approved
C
L2
Oxprenolol Apsolox, Slow-Trasicor, Trasicor
Approved
-
NR
Propranolol Inderol
Approved
C
L2
Sotalol Betapace
Approved
B
L3
Timolol Blocadren
Approved
C
L2
Verapamil Calan, Isoptin, Covera-HS
Approved
C
L2
     Cardiac stimulants
Digoxin Lanoxin, Lanoxicaps
Approved
C
L2
Laksan (Pelancar BAB) [more]
Cascara/Cascara Sagrada -
Approved
C
L3
Danthron -
Approved
-
NR
Magnesium sulfate Epsom salt
Approved
B
L1
Senna -
Approved
-
L3
Obat malaria
Chloroquine Aralen, Novo-chloroquine
Approved
C
L3
Hydroxychloroquine Plaquenil
Approved
C
L2
Pyrimethamine Daraprim
Approved
C
L4
Quinine Quinamm
Approved
D
L2
Medical Testing [more]
Diatrizoate -
Approved
-
NR
Fluorescein -
Approved
C
L3
Gadopentetic (Gadolinium) -
Approved
C
L2
Iohexol Omnipaque
Approved
B
L2
Iopanoic acid Telepaque
Approved
D
L2
Metrizamide Amipaque
Approved
B
L2
Metrizoate Isopaque
Approved
B
L2
Obat Migren [more]
Sumatriptan Imitrex
Approved
C
L3
Obat Sedativ [more]
Chloral hydrate Aquachloral, Noctec
Approved
C
L3
Methyprylon (withdrawn from use in US & Canada) -
Approved
-
NR
Bromide -
Approved
D
L5
Secobarbital Seconal
Approved
D
L3
Obat Tidur
Zolpidem/Zolpidem Tartrate Ambien
Approved
B
L3
Obat Anti Tiroid  [more]
Carbimazole -
Approved
D
L3
Methimazole (active metabolite of carbimazole) Tapazole
Approved
D
L3
Propylthiouracil PTU
Approved
D
L2
Thiouracil -
Approved
-
NR
Levothyroxine Synthroid, Levothroid, Thyroid, Levo-T, Levoxyl
Approved
A
L1
Obat TBC
Cycloserine Seromycin
Approved
C
L3
Ethambutol Ethambutol, Myambutol
Approved
B
L2
Isoniazid INH, Laniazid
Approved
C
L3
Rifampin Rifadin, Rimactane
Approved
C
L2
VITAMIN [more]
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, vitamin Calciferol, 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
Acitretin (Anti-psoriasis) Soriatane
Approved
-
NR
Alcohol/Ethanol [more] -
Approved
D
L3
Allopurinol Zyloprim, 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
Sulfapyridine Dagenan
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: kaahil.wordpress.com

0 comments:

Post a Comment