Lactation Risk Categories   Pregnancy Risk Categories  L1 (Paling Aman)

L2 (Aman)

L3 (Cukup Aman)

L4 (Kemungkinan Barbahaya)

L5 (Kontra Indikasi)

A (studi terkontrol menunjukkan tanpa resiko)

B (tidak ada bukti risiko pada manusia)

C (risiko tidak dapat dikesampingkan)

D (bukti positif resiko)

X (dikontraindikasikan untuk Ibu Hamil)

Generic name Trade Name AAP approved?*

Pregnancy Risk

Category**

Lactation Risk

Category**Analgesics (Pain-killers) [more]Acetaminophen Tylenol Approved/diseujui B L1Colchicine Colchicine Approved D L4Nefopam Acupan Approved - NR     Non-steroidal anti-inflammatory analgesics (NSAIDs) [more]Azapropazone (apazone) Rheumox Approved - L2Dipyrone (banned in the US & UK) - Approved - NR

Flufenamic acid - Approved - NR

IbuprofenAdvil, 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 BL3

L4 (for chronic use)

Phenylbutazone Butazolidine Approved - NRPiroxicam Feldene Approved B L2

Suprofen Profenal Approved - NRTolmetin Tolectin Approved C L3     Narcotic analgesics [more]

Butorphanol Stadol Approved

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

L3

Codeine Tylenol #3, #4 Approved C L3Fentanyl Sublimaze Approved B L2

Meperidine Demerol Approved B

L2L3 (if used

early postpartum)

Methadone Dolophine Approved B L3Morphine Morphine Approved B L3

PropoxypheneDarvocet N, Propacet, Darvon

Approved C L2

Anesthesia, Anesthetics [more] [contents]Halothane Fluothane Approved C L2Lidocaine Xylocaine Approved C L2Methohexital Brevital Approved B L3Thiopental Pentothal Approved C L3Antacids, GI meds [contents]Cimetidine (Antacid) Tagamet Approved B L2Cisapride (GI tract stimulant) Propulsid Approved C L2Domperidone (used for nausea & vomiting, stimulates lactation) [more]

Motilum Approved - L1

Antibiotics [contents]

Amoxicillin Larotid, Amoxil Approved B L1

Aztreonam Azactam Approved B L2

Cefadroxil Ultracef, Duricef Approved B L1

Cefazolin Ancef, Kefzol Approved B L1Cefotaxime Claforan Approved B L2Cefoxitin Mefoxin Approved B L1Cefprozil Cefzil Approved C L1Ceftazidime Ceftazidime,

Fortaz, Approved B L1

TaxidimeCeftriaxone Rocephin Approved B L2Ciprofloxacin [more] Cipro Approved C L3Clindamycin Cleocin Approved B L3

ErythromycinE-Mycin, Ery-tab, ERYC, Ilosone

Approved BL1

L3 early postnatal

Fleroxacin - Approved - NRGentamicin Garamycin Approved C L2

Kanamycin Kebecil, Kantrex Approved D L2

Moxalactam Moxam Approved - NRNitrofurantoin Macrobid Approved B L2Ofloxacin Floxin Approved C L2Penicillin - Approved B L1Streptomycin Streptomycin Approved D L3Sulbactam - Approved - NR

Sulfisoxazole Gantrisin, Azo-Gantrisin Approved C L2

TetracyclineAchromycin, Sumycin, Terramycin

Approved D L2

Ticarcillin Ticarcillin, Ticar, Timentin Approved B L1

Trimethoprim/sulfamethoxazole Proloprim, Trimpex Approved C L3

Anticoagulants [contents]Bishydroxycoumarin (dicumarol) - Approved - NR

Warfarin Coumadin, Panwarfin Approved D L2

Anticonvulsants [contents]Carbamazepine Tegretol, Epitol Approved C L2Ethosuximide Zarontin Approved C L4Magnesium sulfate Epsom salt Approved B L1Phenytoin Dilantin Approved D L2

Valproic acid Depakene, Depakote Approved D L2

Antifungals [contents]Fluconazole [more] Diflucan Approved C L2

KetoconazoleNizoral Shampoo, Nizoral

Approved C L2

Antihistamines [more] [contents]Dexbrompheniramine maleate with d-isoephedrine - Approved - NR

Fexofenadine Allegra Approved C L2Loratadine Claritin Approved B L1Terfenadine Seldane Approved - NRTriprolidine Actidil, Actifed Approved C L1Antivirals [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

Asthma meds (see also: steroids) [contents]

Dyphylline Dilor, Lufyllin, Dyphylline Approved C L3

Terbutaline Bricanyl, Brethine Approved B L2

TheophyllineAminophylline, Quibron, Theo-Dur

Approved C L3

Contraceptives, Hormones [more] [contents]

EstradiolEstratab, 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, Approved X L2

Mirena, Plan B

Medroxyprogesterone Provera, Depo-Provera, Cycrin Approved D

L1L4 (if used first 3 days postpartum)

Norethynodrel Enovid Approved X L2

Progesterone Crinone, Prometrium Approved - L3

Cough meds [more] [contents]Codeine Tylenol #3, #4 Approved C L3Noscapine - Approved - NRDecongestants [more] [contents]

Pseudoephedrine

Sudafed, Halofed, Novafed, Actifed

Approved C

L3 (for acute use)

L4 (for chronic use)

Diabetes meds [contents]Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk category = L1.

Tolbutamide Oramide, Orinase Approved D L3

Diarrhea meds [contents]

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]Diuretics [contents]

Acetazolamide Dazamide, Diamox Approved C L2

Bendroflumethiazide Naturetin Approved DL4 (may inhibit

lactation)Chlorothiazide Hydrodiuril Approved D L3Chlorthalidone Hygroton Approved D L3

Hydrochlorothiazide Hydrodiuril, Esidrix, Oretic Approved D L2

Spironolactone Aldactone Approved D L2Galactagogues (milk supply) [more] [contents]Domperidone Motilum Approved - L1Heart, Blood Pressure meds (Antiarrhythmics, Antihypertensives, Cardiac stimulants) [contents]

     Antiarrhythmics

Disopyramide Norpace, Napamide Approved C L2

Flecainide Tambocor Approved C L3Mexiletine Mexitil Approved B L2

Procainamide Pronestyl, Procan Approved C L3

Quinidine Quinaglute, Quinidex Approved C L2

     Antihypertensives

Captopril Capoten Approved DL3 (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

MinoxidilLoniten, Minodyl, Rogaine

Approved CL2

(topically)L3 (orally)

Nadolol Corgard, Nadolol Approved C L4

Nifedipine Adalat, Procardia Approved C L2

Oxprenolol Apsolox, Slow- Approved - NR

Trasicor, Trasicor

Propranolol Inderol Approved C L2Sotalol Betapace Approved B L3Timolol Blocadren Approved C L2

Verapamil Calan, Isoptin, Covera-HS Approved C L2

     Cardiac stimulants

Digoxin Lanoxin, Lanoxicaps Approved C L2

Laxatives [more] [contents]Cascara/Cascara Sagrada - Approved C L3Danthron - Approved - NRMagnesium sulfate Epsom salt Approved B L1Senna - Approved - L3Malaria meds [contents]

Chloroquine Aralen, Novo-chloroquine Approved C L3

Hydroxychloroquine Plaquenil Approved C L2Pyrimethamine Daraprim Approved C L4Quinine Quinamm Approved D L2Medical Testing [more] [contents]Diatrizoate - Approved - NRFluorescein - Approved C L3Gadopentetic (Gadolinium) - Approved C L2Iohexol Omnipaque Approved B L2Iopanoic acid Telepaque Approved D L2Metrizamide Amipaque Approved B L2Metrizoate Isopaque Approved B L2Migraine meds (see also: pain meds) [more] [contents]Sumatriptan Imitrex Approved C L3Sedatives [more] [contents]

Chloral hydrate Aquachloral, Noctec Approved C L3

Methyprylon (withdrawn from use in US & Canada) - Approved - NR

Bromide - Approved D L5Secobarbital Seconal Approved D L3Sleep Aids [contents]

Zolpidem/Zolpidem Tartrate Ambien Approved B L3Steroids [contents]Methylprednisolone[  high dosage methylprednisolone]

Solu-Medrol, Depo-Medrol, Medrol

Approved C L2

Prednisolone - Approved C L2

PrednisoneDeltasone, Meticorten, Orasone

Approved C L2

Thyroid meds [more] [contents]Carbimazole - Approved D L3Methimazole (active metabolite of carbimazole) Tapazole Approved D L3

Propylthiouracil PTU Approved D L2Thiouracil - Approved - NR

Levothyroxine

Synthroid, Levothroid, Thyroid, Levo-T, Levoxyl

Approved A L1

Tuberculosis meds [contents]Cycloserine Seromycin Approved C L3

Ethambutol Ethambutol, Myambutol Approved B L2

Isoniazid INH, Laniazid Approved C L3

Rifampin Rifadin, Rimactane Approved C L2

Vitamins [more] [contents]B-1 (thiamin) - Approved - NRB-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 L1Riboflavin/B2  - Disetujui A L1Miscellaneous [contents]

Acitretin (Anti-psoriasis) Soriatane Disetujui - NRAlcohol/Ethanol [more] - Disetujui D L3

Allopurinol Zyloprim, Lopurin Disetujui

C L2

Antimony -Disetujui

- NR

Atropine (Anticholinergic, drying agent)

Belladonna, Atropine Disetujui

C L3

Azapropazone/apazone (Antirheumatic) Rheumox

Disetujui- L2

Baclofen (muscle relaxant) Lioresal, Atrofen Disetujui

C L2

Barbiturate -Disetujui

- NR

Caffeine [more] Vivarin, NoDoz, Coffee Disetujui

B L2

Carbetocin (Antihemorrhagic) DuratocinDisetujui

- NR

Chloroform -Disetujui

- NR

Cisplatin (Anti-cancer) PlatinolDisetujui

D L4

Dapsone (Antileprosy) Avlosulfon, DDS Disetujui

C L4

Hydroxychloroquine (Antirheumatic, lupus) Plaquenil

DisetujuiC L2

Iodides -Disetujui

- NR

Iodine -Disetujui

- NR

Iodine (povidone-iodine, eg, in a vaginal douche)

- - NR

Disetujui

Ivermectin (Antiparasitic) MectizanDisetujui

C L3

Nalidixic acid (Urinary Anti-infective) NegGram

DisetujuiB L4

Norsteroids -Disetujui

- NR

Pyridostigmine (Muscle stimulant)

Mestinon, Regonol Disetujui

C L2

Scopolamine (Motion sickness) Transderm Scope Disetujui

C L3

Sulfapyridine DagenanDisetujui

- NR

Timolol (glaucoma med) BlocadrenDisetujui

D L3

*  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 (Paling Aman)

L2 (Aman)

L3 (Cukup Aman)

L4 (Kemungkinan Barbahaya)

L5 (Kontra Indikasi)

A (studi terkontrol menunjukkan tanpa resiko)

B (tidak ada bukti risiko pada manusia)

C (risiko tidak dapat dikesampingkan)

D (bukti positif resiko)

X (dikontraindikasikan untuk Ibu Hamil) NR: Not Reviewed. This drug has