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Selected List of Medications approved by the AAP for use in breastfeeding mothers (AAP list revised 8/04)

The information contained here is a partial list of medications that are approved by the AAP for use in breastfeeding mothers. Medications are categorized by use. The generic name is listed first, followed by trade name(s).

This list is for general information only. I urge you to get as much information as you can before using any medications during lactation, since most medications do pass into your milk. Double check the information given here with the original references before using it to make any decisions.

Many other medications (not included on the AAP list) are generally considered safe for use while breastfeeding. I used Thomas Hale's book, Medications and Mothers' Milk, to categorize medications according to use, and to add trade names and risk categories. See the bottom of this page for a list of references and sources of additional information.

I've tried to proofread this thoroughly, but there may still be some typos. Always double check with the original source.

Table of Contents

 

Generic name Trade Name AAP approved?* Pregnancy Risk Category** Lactation Risk Category**
Analgesics (Pain-killers) [more]
Acetaminophen Tylenol Approved B L1
Colchicine Colchicine Approved D L4
Nefopam Acupan Approved - NR
     Non-steroidal anti-inflammatory analgesics (NSAIDs) [more]
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
     Narcotic analgesics [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
Anesthesia, Anesthetics [more] [contents]
Halothane Fluothane Approved C L2
Lidocaine Xylocaine Approved C L2
Methohexital Brevital Approved B L3
Thiopental Pentothal Approved C L3
Antacids, GI meds [contents]
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
Antibiotics [contents]
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
Anticoagulants [contents]
Bishydroxycoumarin (dicumarol) - Approved - NR
Warfarin Coumadin, Panwarfin Approved D L2
Anticonvulsants [contents]
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
Antifungals [contents]
Fluconazole [more] Diflucan Approved C L2
Ketoconazole Nizoral Shampoo, Nizoral Approved C L2
Antihistamines [more] [contents]
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
Antivirals [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 salts Ridaura, Myochrysine, Solganal Approved C L5
Asthma meds (see also: steroids) [contents]
Dyphylline Dilor, Lufyllin, Dyphylline Approved C L3
Terbutaline Bricanyl, Brethine Approved B L2
Theophylline Aminophylline, Quibron, Theo-Dur Approved C L3
Contraceptives, Hormones [more] [contents]
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
Cough meds [more] [contents]
Codeine Tylenol #3, #4 Approved C L3
Noscapine - Approved - NR
Decongestants [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 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
Galactagogues (milk supply) [more] [contents]
Domperidone Motilum Approved - L1
Heart, Blood Pressure meds
(Antiarrhythmics, Antihypertensives, Cardiac stimulants)		 [contents]
     Antiarrhythmics
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
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
Laxatives [more] [contents]
Cascara/Cascara Sagrada - Approved C L3
Danthron - Approved - NR
Magnesium sulfate Epsom salt Approved B L1
Senna - Approved - L3
Malaria meds [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
Migraine meds (see also: pain meds) [more] [contents]
Sumatriptan Imitrex Approved C L3
Sedatives [more] [contents]
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
Sleep Aids [contents]
Zolpidem/Zolpidem Tartrate Ambien Approved B L3
Steroids [contents]
Methylprednisolone
[PDF high dosage methylprednisolone]		 Solu-Medrol, Depo-Medrol, Medrol Approved C L2
Prednisolone - Approved C L2
Prednisone Deltasone, Meticorten, Orasone Approved C L2
Thyroid meds [more] [contents]
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
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 - 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
Miscellaneous [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
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.

 

References

Table 6: Maternal Medication Usually Compatible With Breast-Feeding, from the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.

Hale, Thomas. Medications and Mothers' Milk, 12th Edition. Hale Publishing, 2006. Dr. Hale's website is located at http://neonatal.ttuhsc.edu/lact/index.html.

 

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Page last modified: 09/08/2006
Written: 10/4/99

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