Lactation
Risk Categories
|
Pregnancy
Risk Categories
|
|
|
Generic
name
|
Trade
Name/ nama dagang
|
AAP
approved?
|
||||||||
Acetaminophen/PCT
|
Tylenol
|
Approved/diseujui
|
B
|
L1
|
||||||
Colchicine
|
Colchicine
|
Approved
|
D
|
L4
|
||||||
Nefopam
|
Acupan
|
Approved
|
-
|
NR
|
||||||
Non-steroidal
anti-inflammatory analgesics (NSAIDs)
|
||||||||||
Azapropazone (apazone)
|
Rheumox
|
Approved
|
-
|
L2
|
||||||
Dipyrone (dilarang di AS &
Inggris)
|
-
|
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
|
||||||
Narcotic
analgesics
|
||||||||||
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
|
||||||
Halothane
|
Fluothane
|
Approved
|
C
|
L2
|
||||||
Lidocaine
|
Xylocaine
|
Approved
|
C
|
L2
|
||||||
Methohexital
|
Brevital
|
Approved
|
B
|
L3
|
||||||
Thiopental
|
Pentothal
|
Approved
|
C
|
L3
|
||||||
Cimetidine (Antacid)
|
Tagamet
|
Approved
|
B
|
L2
|
||||||
Cisapride (GI tract stimulant)
|
Propulsid
|
Approved
|
C
|
L2
|
||||||
Domperidone (used for nausea &
vomiting, stimulates lactation)
|
Motilum
|
Approved
|
-
|
L1
|
||||||
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
|
||||||
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
|
||||||
Bishydroxycoumarin (dicumarol)
|
-
|
Approved
|
-
|
NR
|
||||||
Warfarin
|
Coumadin, Panwarfin
|
Approved
|
D
|
L2
|
||||||
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
|
||||||
Fluconazole
|
Diflucan
|
Approved
|
C
|
L2
|
||||||
Ketoconazole
|
Nizoral Shampoo, Nizoral
|
Approved
|
C
|
L2
|
||||||
Dexbrompheniramine maleate with
d-isoephedrine
|
-
|
Approved
|
-
|
NR
|
||||||
Fexofenadine
|
Allegra
|
Approved
|
C
|
L2
|
||||||
Loratadine
|
Claritin
|
Approved
|
B
|
L1
|
||||||
Terfenadine
|
Seldane
|
Approved
|
-
|
NR
|
||||||
Triprolidine
|
Actidil, Actifed
|
Approved
|
C
|
L1
|
||||||
Acyclovir
|
Zovirax
|
Approved
|
C
|
L2
|
||||||
Interferon-alpha
|
Alferon N, Interferon Alpha
|
Approved
|
C
|
L2
|
||||||
Gold salts
|
Ridaura, Myochrysine, Solganal
|
Approved
|
C
|
L5
|
||||||
Dyphylline
|
Dilor, Lufyllin, Dyphylline
|
Approved
|
C
|
L3
|
||||||
Terbutaline
|
Bricanyl, Brethine
|
Approved
|
B
|
L2
|
||||||
Theophylline
|
Aminophylline, Quibron, Theo-Dur
|
Approved
|
C
|
L3
|
||||||
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
|
||||||
Codeine
|
Tylenol #3, #4
|
Approved
|
C
|
L3
|
||||||
Noscapine
|
-
|
Approved
|
-
|
NR
|
||||||
Pseudoephedrine
|
Sudafed, Halofed, Novafed, Actifed
|
Approved
|
C
|
L3 (for acute use)
L4 (for chronic use) |
||||||
Note: Insulin has not been
reviewed by the AAP. Pregnancy risk category = B; Lactation risk category =
L1.
Catatan:
Insulin belum dikaji oleh AAP. Kategori risiko kehamilan = B; Risiko laktasi
kategori L1.
|
||||||||||
Tolbutamide
|
Oramide, Orinase
|
Approved
|
D
|
L3
|
||||||
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.
Catatan: Pepto-Bismol &
Kaopectate (bismuth subsalicylate adalah bahan aktif dalam kedua) tidak
direkomendasikan untuk penggunaan rutin oleh ibu menyusui, karena asosiasi
salisilat dengan sindrom Reyes pada anak-anak.
|
||||||||||
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
|
Hydrodiuril, Esidrix, Oretic
|
Approved
|
D
|
L2
|
||||||
Spironolactone
|
Aldactone
|
Approved
|
D
|
L2
|
||||||
Domperidone
|
Motilum
|
Approved
|
-
|
L1
|
||||||
Antiarrhythmics/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
|
||||||
Antihypertensives/
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/ stimulasi jantung
|
||||||||||
Digoxin
|
Lanoxin, Lanoxicaps
|
Approved
|
C
|
L2
|
||||||
Cascara/Cascara Sagrada
|
-
|
Approved
|
C
|
L3
|
||||||
Danthron
|
-
|
Approved
|
-
|
NR
|
||||||
Magnesium sulfate
|
Epsom salt
|
Approved
|
B
|
L1
|
||||||
Senna
|
-
|
Approved
|
-
|
L3
|
||||||
Chloroquine
|
Aralen, Novo-chloroquine
|
Approved
|
C
|
L3
|
||||||
Hydroxychloroquine
|
Plaquenil
|
Approved
|
C
|
L2
|
||||||
Pyrimethamine
|
Daraprim
|
Approved
|
C
|
L4
|
||||||
Quinine
|
Quinamm
|
Approved
|
D
|
L2
|
||||||
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
|
||||||
Sumatriptan
|
Imitrex
|
Approved
|
C
|
L3
|
||||||
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
|
||||||
Zolpidem/Zolpidem Tartrate
|
Ambien
|
Approved
|
B
|
L3
|
||||||
Methylprednisolone
|
Solu-Medrol, Depo-Medrol, Medrol
|
Approved
|
C
|
L2
|
||||||
Prednisolone
|
-
|
Approved
|
C
|
L2
|
||||||
Prednisone
|
Deltasone, Meticorten, Orasone
|
Approved
|
C
|
L2
|
||||||
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
|
||||||
Cycloserine
|
Seromycin
|
Approved
|
C
|
L3
|
||||||
Ethambutol
|
Ethambutol, Myambutol
|
Approved
|
B
|
L2
|
||||||
Isoniazid
|
INH, Laniazid
|
Approved
|
C
|
L3
|
||||||
Rifampin
|
Rifadin, Rimactane
|
Approved
|
C
|
L2
|
||||||
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
|
-
|
Disetujui
|
A
|
L1
|
||||||
Acitretin (Anti-psoriasis)
|
Soriatane
|
Disetujui
|
-
|
NR
|
||||||
Alcohol/Ethanol
|
-
|
Disetujui
|
D
|
L3
|
||||||
Allopurinol
|
Zyloprim, Lopurin
|
|
C
|
L2
|
||||||
Antimony
|
-
|
|
-
|
NR
|
||||||
Atropine (Anticholinergic, drying
agent)
|
Belladonna, Atropine
|
|
C
|
L3
|
||||||
Azapropazone/apazone
(Antirheumatic)
|
Rheumox
|
|
-
|
L2
|
||||||
Baclofen (muscle relaxant)
|
Lioresal, Atrofen
|
|
C
|
L2
|
||||||
Barbiturate
|
-
|
|
-
|
NR
|
||||||
Caffeine
|
Vivarin, NoDoz, Coffee
|
|
B
|
L2
|
||||||
Carbetocin (Antihemorrhagic)
|
Duratocin
|
|
-
|
NR
|
||||||
Chloroform
|
-
|
|
-
|
NR
|
||||||
Cisplatin (Anti-cancer)
|
Platinol
|
|
D
|
L4
|
||||||
Dapsone (Antileprosy)
|
Avlosulfon, DDS
|
|
C
|
L4
|
||||||
Hydroxychloroquine (Antirheumatic,
lupus)
|
Plaquenil
|
|
C
|
L2
|
||||||
Iodides
|
-
|
|
-
|
NR
|
||||||
Iodine
|
-
|
|
-
|
NR
|
||||||
Iodine (povidone-iodine, eg, in a
vaginal douche)
|
-
|
|
-
|
NR
|
||||||
Ivermectin (Antiparasitic)
|
Mectizan
|
|
C
|
L3
|
||||||
Nalidixic acid (Urinary
Anti-infective)
|
NegGram
|
|
B
|
L4
|
||||||
Norsteroids
|
-
|
|
-
|
NR
|
||||||
Pyridostigmine (Muscle stimulant)
|
Mestinon, Regonol
|
|
C
|
L2
|
||||||
Scopolamine (Motion sickness)
|
Transderm Scope
|
|
C
|
L3
|
||||||
Sulfapyridine
|
Dagenan
|
|
-
|
NR
|
||||||
Timolol (glaucoma med)
|
Blocadren
|
|
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).
|
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