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 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 (CataIlam,
Voltaren)
NR B L2
Fentanyl (Sublimaze) Approved B L2
Flurbiprofen (Ansaid,
Froben, OcuIen)
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, PediaproIen)
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,
InIumorph, Epimorph, MS
Contin)
Approved B L3 8
Nalbuphine (Nubain) NR B L2
Naproxen (Anaprox,
Naprosyn, Naproxen,
Aleve)
Approved B
L3;
L4 Ior 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Rofecoxib (Vioxx) Withdrawn Irom the market 12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Valdecoxib (Bextra) Withdrawn Irom the market more
* Per the AAP Policy Statement The TransIer oI Drugs and Other Chemicals Into Human
Milk, revised September 2001.
O Approved (Table 6) Maternal Medication Usually Compatible With BreastIeeding
O Caution (Table 5) Drugs That Have Been Associated With SigniIicant EIIects on
Some Nursing InIants and Should Be Given to Nursing Mothers With Caution
O 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
O L1 (saIest)
O L2 (saIer)
O L3 (moderately saIe)
O L4 (possibly hazardous)
O L5 (contraindicated)
O A (controlled studies show no risk)
O B (no evidence oI risk in humans)
O C (risk cannot be ruled out)
O D (positive evidence oI risk)
O (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 oI Reye`s
syndrome and internal bleeding.
2. Fioricet (Fiorinal, Bancap, Two-dyne) contains acetaminaphen or asprin, caIIeine, and
butalbital. Per Hale, baby should be observed Ior sedation.
3. Hale suggests weakened or premature inIants be observed Ior sedation and apnea.
4. Hale suggests newborns be observed Ior sedation, apnea, constipation.
5. Per Hale, use oI Irequent, higher dose may result in inIant sedation.
6. Per Hale, Meperidine use during labor or early postpartum has been associated with
sedation, poor sucking reIlex, and neurobehavioral delay in inIants.
7. Per Hale, observe inIant Ior sedation, respiratory depression, addiction, withdrawal
syndrome.
8. Per Hale, higher doses may result in inIant sedation.
9. Per Hale, should be used with caution due to its long halI-liIe and its eIIect on baby`s
cardiovascular system, kidneys and GI tract; short-term, inIrequent or occasional use is
not necessarily incompatible with breastIeeding.
10.Roxicet, Endocet, Roxiprin, Percocet also contain acetaminophen. Per Hale, observe
inIant Ior sedation.
11.Per Hale, observe inIant Ior sedation.
12.Per Hale, observe inIant Ior GI cramping, distress, diarrhea.
13.Per Hale, observe inIant Ior sedation.
14.Per Hale, observe inIant Ior 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

FluIenamic acid - Approved - NR
IbuproIen
Advil, Nuprin, Motrin,
PediaproIin
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
MeIenamic acid Ponstan, Ponstel Approved - NR
Naproxen
Anaprox, Naprosyn,
Naproxen, Aleve
Approved B
L3
L4 (Ior chronic
use)
Phenylbutazone Butazolidine Approved - NR
Piroxicam Feldene Approved B L2
SuproIen ProIenal Approved - NR
Tolmetin Tolectin Approved C L3
Steroid |contents|
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 |contents|
Dyphylline
Dilor, LuIyllin,
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 (iI 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 saIe)
Dextromethorphan not reviewed L1 (saIest)
GuaiIenesin not reviewed L2 (saIer)
Dekongestan (Obat Pilek)
Nama Obat
AAP
approved?`
Risiko Menyusui``
Phenylephrine not reviewed L3 (moderately saIe)
Pseudoephedrine
(SudaIed, ActiIed)
yes
L3 (moderately saIe) Ior acute use
L4 (possibly hazardous) Ior chronic use due to
potential Ior decreasing milk supply
* Per the AAP Policy Statement The TransIer oI 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 (saIer)
Cromlyn sodium
(Nasalcrom)
not reviewed L1 (saIest)
Fluticasone (Flonase) not reviewed L3 (moderately saIe)
Mometasone
(Nasonex)
not reviewed L3 (moderately saIe)
Phenylephrine (in
some Iorms oI Sinex
and Neo-Synephrine)
not reviewed L3 (moderately saIe)
Triamcinolone
Acetonide (Nasacort)
not reviewed L3 (moderately saIe)
Antihistamin (Anti Alergi)
Nama Obat
AAP
approved?`
Risiko Menyusui``
Brompheniramine not reviewed L3 (moderately saIe)

Chlorpheniramine
(Chlor-Trimeton)
CTM
not reviewed L3 (moderately saIe)
Cetirizine (Zyrtec) not reviewed L2 (saIer)

Dexbrompheniramine
maleate
with d-isoephedrine
yes not reviewed

Diphenhydramine
(Benadryl)
not reviewed L2 (saIer)
Doxylamine not reviewed L4 (possibly hazardous)

FexoIenadine
(Allegra)
yes L3 (moderately saIe)
Loratadine (Claritin) yes L2 (saIer)

TerIenadine
(Seldane)
yes not reviewed

Triprolidine (Actidil,
ActiIed)
yes L1 (saIest)

* Per the AAP Policy Statement The TransIer oI 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 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
IsoIlurane (Forane) NR - NR 1
Ketamine NR - NR more
Methohexital (Brevital) Approved B L3
Nitrous oxide NR - L3
SevoIlurane (Ultane) NR B L3
Thiopental (Pentothal) Approved C L3
Other medications often used during anesthesia
Sedatives
Diazepam (Valium) Concern D L3; L4 Ior
chronic use

Midazolam (Versed) Concern D L3
PropoIol (Diprivan) NR B L2 more
Triazolam (Halcion) NR L3
Narcotic Analgesics
AlIentanil (AlIenta) 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 TransIer oI Drugs and Other Chemicals Into Human
Milk, revised September 2001.
O Approved (Table 6) Maternal Medication Usually Compatible With BreastIeeding
O Concern (Table 4) Drugs Ior Which the EIIect on Nursing InIants Is Unknown but
May Be oI Concern
O Caution (Table 5) Drugs That Have Been Associated With SigniIicant EIIects on
Some Nursing InIants and Should Be Given to Nursing Mothers With Caution
O 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
O L1 (saIest)
O L2 (saIer)
O L3 (moderately saIe)
O L4 (possibly hazardous)
O L5 (contraindicated)
O A (controlled studies show no risk)
O B (no evidence oI risk in humans)
O C (risk cannot be ruled out)
O D (positive evidence oI risk)
O (contraindicated in pregnancy)
NR Not Reviewed. This drug has not yet been reviewed by Hale.

1. IsoIlurane (Forane) is used Ior c-sections and directly in newborns. Induction oI and
recovery Irom isoIlurane anesthesia are rapid, so the majority oI the medication is out oI
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 Iorms oI Robitussin, Delsym and Benylin are considered compatible with
breastIeeding. 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 |contents|
Cimetidine (Antacid) Tagamet Approved B L2
Cisapride (GI tract stimulant) Propulsid Approved C L2
Domperidone (used Ior nausea
& vomiting, stimulates
lactation) |more|
Motilum Approved - L1
Antibiotika |contents|
Amoxicillin Larotid, Amoxil Approved B L1
Aztreonam Azactam Approved B L2
CeIadroxil UltraceI, DuriceI Approved B L1
CeIazolin AnceI, KeIzol Approved B L1
CeIotaxime ClaIoran Approved B L2
CeIoxitin MeIoxin Approved B L1
CeIprozil CeIzil Approved C L1
CeItazidime
CeItazidime,
Fortaz, Taxidime
Approved B L1
CeItriaxone Rocephin Approved B L2
CiproIloxacin |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
NitroIurantoin Macrobid Approved B L2
OIloxacin Floxin Approved C L2
Penicillin - Approved B L1
Streptomycin Streptomycin Approved D L3
Sulbactam - Approved - NR
SulIisoxazole
Gantrisin, Azo-
Gantrisin
Approved C L2
Tetracycline
Achromycin,
Sumycin,
Terramycin
Approved D L2
Ticarcillin
Ticarcillin,
Ticar, Timentin
Approved B L1
Trimethoprim/sulIamethoxazole
Proloprim,
Trimpex
Approved C L3
Antikoagulan |contents|
Bishydroxycoumarin
(dicumarol)
- Approved - NR
WarIarin
Coumadin,
PanwarIin
Approved D L2
Antikonvulsan (Anti kejang) |contents|
Carbamazepine Tegretol, Epitol Approved C L2
Ethosuximide Zarontin Approved C L4
Magnesium sulIate Epsom salt Approved B L1
Phenytoin Dilantin Approved D L2
Valproic acid
Depakene,
Depakote
Approved D L2
Anti 1amur |contents|
Fluconazole |more| DiIlucan Approved C L2
Ketoconazole
Nizoral
Shampoo,
Nizoral
Approved C L2
Antivirus |contents|
Acyclovir |more| Zovirax Approved C L2
InterIeron-alpha |more|
AlIeron N,
InterIeron Alpha
Approved C L2
Arthritis meds (see also: pain meds) |contents|
Gold salts
Ridaura,
Myochrysine,
Solganal
Approved C L5
Kontrasepsi, Hormon |contents|
Estradiol
Estratab,
Permarin,
Menest
Approved
L3 (may
interIere
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
L3 (may
interIere
with milk
production)
Levonorgestrel
Norplant,
Mirena, Plan B
Approved L2
Medroxyprogesterone
Provera, Depo-
Provera, Cycrin
Approved D
L1
L4 (iI used
Iirst 3 days
postpartum)
Norethynodrel Enovid Approved L2
Progesterone
Crinone,
Prometrium
Approved - L3
Obat Diabetes |contents|
ote. Insulin has not been reviewed by the AAP. Pregnancy risk category B, Lactation risk
category L1.
Tolbutamide
Oramide,
Orinase
Approved D L3
Obat Diare |contents|
Loperamide
Imodium, Pepto
Diarrhea
Control, Maalox
Antidiarrheal
Caplets,
Kaopectate II
Caplets,
Approved B L2
Immodium
Advanced
ote. 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|
Acetazolamide
Dazamide,
Diamox
Approved C L2
BendroIlumethiazide 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] |contents|
Domperidone Motilum Approved - L1
Anti Hipertensi, Obat 1antung |contents|
nti 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
nti Hipertensi
Captopril Capoten Approved D
L3 (iI used
aIter 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, Approved B L3
Lopressor
Minoxidil
Loniten,
Minodyl,
Rogaine
Approved C
L2
(topically)
L3 (orally)
Nadolol
Corgard,
Nadolol
Approved C L4
NiIedipine
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
ardiac stimulants
Digoxin
Lanoxin,
Lanoxicaps
Approved C L2
Laksan (Pelancar BAB) more] |contents|
Cascara/Cascara Sagrada - Approved C L3
Danthron - Approved - NR
Magnesium sulIate Epsom salt Approved B L1
Senna - Approved - L3
Obat malaria |contents|
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] |contents|
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] |contents|
Sumatriptan Imitrex Approved C L3
Obat Sedativ more] |contents|
Chloral hydrate
Aquachloral,
Noctec
Approved C L3
Methyprylon (withdrawn Irom
use in US & Canada)
- Approved - NR
Bromide - Approved D L5
Secobarbital Seconal Approved D L3
Obat Tidur |contents|
Zolpidem/Zolpidem Tartrate Ambien Approved B L3
Obat Anti Tiroid more] |contents|
Carbimazole - Approved D L3
Methimazole (active metabolite
oI 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 |contents|
Cycloserine Seromycin Approved C L3
Ethambutol
Ethambutol,
Myambutol
Approved B L2
Isoniazid INH, Laniazid Approved C L3
RiIampin
RiIadin,
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, vitamin
CalciIerol,
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
RiboIlavin/B
2
- Approved A L1
Lain-lain |contents|
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
BacloIen (muscle relaxant) Lioresal, AtroIen Approved C L2
Barbiturate - Approved - NR
CaIIeine |more|
Vivarin, NoDoz,
CoIIee
Approved B L2
Carbetocin (Antihemorrhagic) Duratocin Approved - NR
ChloroIorm - Approved - NR
Cisplatin (Anti-cancer) Platinol Approved D L4
Dapsone (Antileprosy)
AvlosulIon,
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-
inIective)
NegGram Approved B L4
Norsteroids - Approved - NR
Pyridostigmine (Muscle
stimulant)
Mestinon,
Regonol
Approved C L2
Scopolamine (Motion sickness)
Transderm
Scope
Approved C L3
SulIapyridine Dagenan Approved - NR
Timolol (glaucoma med) Blocadren Approved D L3
* Per the AAP Policy Statement The TransIer oI Drugs and Other Chemicals Into Human
Milk, revised September 2001.
O Approved (Table 6) Maternal Medication Usually Compatible With BreastIeeding
O Caution (Table 5) Drugs That Have Been Associated With SigniIicant EIIects on
Some Nursing InIants and Should Be Given to Nursing Mothers With Caution
O 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
O L1 (saIest)
O L2 (saIer)
O L3 (moderately saIe)
O L4 (possibly hazardous)
O A (controlled studies show no risk)
O B (no evidence oI risk in humans)
O C (risk cannot be ruled out)
O D (positive evidence oI risk)
O L5 (contraindicated) O (contraindicated in pregnancy)
NR Not Reviewed. This drug has not yet been reviewed by Hale