DRUGSAFETY – ANALGETIK

DAFTAR OBAT AMAN DAN BERBAHAYA 
UNTUK IBU HAMIL DAN MENYUSUI
ANALGETIK

Nama Obat
Risiko Kehamilan
Risiko Menyusui
Acetaminophen (Tylenol)
B
L1
Aspirin
C (1st, 2nd trim.)
D (3rd trim.)
L3
Azapropazone (Rheumox)
-
L2
Butalbital (Fioricet, Fiorinal, Bancap, Two-dyne)
D
L3
Butorphanol  (Stadol)
B (1st, 2nd trim.)
D (3rd trim.)
L3
Celecoxib (Celebrex))
C
L2
Codeine (in Tylenol #3, #4)
C
L3
Colchicine
D
L4
Diclofenac (Cataflam, Voltaren)
B
L2
Fentanyl  (Sublimaze)
B
L2
Flurbiprofen (Ansaid, Froben, Ocufen)
B (1st, 2nd trim.)
C (3rd trim.)
L2
Hydrocodone (Lortab, Vicodin)
B
L3
Hydromorphone(Dilaudid)
C
L3
Ibuprofen (Advil, Nuprin, Motrin, Pediaprofen)
B (1st, 2nd trim.)
D (3rd trim.)
L1
Indomethacin (Indocin)
B (1st, 2nd trim.)
D (3rd trim.)
L3
Ketorolac (Toradol, Acular)
B (1st, 2nd trim.)
D (3rd trim.)
L2
Meperidine (Demerol)
B
L2;
L3 early postpartum
Methadone (Dolophine)
B
L3
Morphine (Duramorph, Infumorph, Epimorph, MS Contin)
B
L3
Nalbuphine (Nubain)
B
L2
Naproxen (Anaprox, Naprosyn, Naproxen, Aleve)
B
L3;
L4 for chronic use
Nefopam (Acupan)
-
NR
Oxycodone (Tylox, Percodan,Oxycontin, Roxicet, Endocet, Roxiprin, Percocet)
B
L3
Pentosan polysulfate(Elmiron)
B
L2
Piroxicam (Feldene)
B
L2
Propoxyphene(Darvocet N, Propacet, Darvon)
C
L2
Secobarbital (Seconal)
D
L3
Tolmetin (Tolectin)
C
L3
Tramadol HCL(Ultram, Ultracet)
C
L3
Butorphanol
B (1st, 2nd trim.)
D (3rd trim.)
L3
Codeine
C
L3
Fentanyl
B
L2
Meperidine
B
L2
L3 (if used early postpartum)
Methadone
B
L3
Morphine
B
L3
Propoxyphene
C
L2
** 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 o
2.     f Reye’s syndrome and internal bleeding.
3.     Fioricet (Fiorinal, Bancap, Two-dyne) contains acetaminaphen or asprin, caffeine, and butalbital. Per Hale, baby should be observed for sedation.
4.     Hale suggests weakened or premature infants be observed for sedation and apnea.
5.     Hale suggests newborns be observed for sedation, apnea, constipation.
6.     Per Hale, use of frequent, higher dose may result in infant sedation.
7.     Per Hale, Meperidine use during labor or early postpartum has been associated with sedation, poor sucking reflex, and neurobehavioral delay in infants.
8.     Per Hale, observe infant for sedation, respiratory depression, addiction, withdrawal syndrome.
9.     Per Hale, higher doses may result in infant sedation.
10. 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.
11. Roxicet, Endocet, Roxiprin, Percocet also contain acetaminophen. Per Hale, observe infant for sedation.
12. Per Hale, observe infant for sedation.
13. Per Hale, observe infant for GI cramping, distress, diarrhea.
14. Per Hale, observe infant for sedation.
15. Per Hale, observe infant for sedation.



Title : DRUGSAFETY – ANALGETIK
Description : DAFTAR OBAT AMAN DAN BERBAHAYA  UNTUK IBU HAMIL DAN MENYUSUI ANALGETIK Nama Obat Risiko Kehamilan Risiko Menyusui...