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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 [  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 Medications' and Mothers' Milk by Thomas Hale, PhD (2004 edition).
|
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| 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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| Links for additional information |
- Finding good information about medication use during lactation
- Is this safe when breastfeeding? has information on various medications, medical procedures, etc.
- Herbs and Breastfeeding
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Page last modified:
03/30/2010
Written: 10/4/99