Codeine (in Robitussin AC): Category C, 3rd trimester risk
Lactation - limited human data, probably compatible
Nausea:
Hydroxyzine (Vistaril): Category C, Human data suggest low risk
Pyridoxine (Vitamin B6): Category A, Compatible
Lactation - compatible, but excessively high doses inhibit lactation
Metoclopramide (Reglan): Category B, Compatible
Lactation - unknown effects, limited human data, potential toxicity due to dopaminergic blocking mechanism
Promethazine (Phenergan): Category C, Compatible
Lactation - no human data, probably compatible
Ondansetron (Zofran): Category B, Limited human data, animal data suggest low risk.
Lactation - no human data, probably compatible
Doxylamine: Category A, Compatible
Lactation - no human data, probably compatible
Trimethobenzamide (Tigan): Category C, human data suggest low risk
Lactation - no human data, probably compatible
Upper respiratory infection and allergy:***No Risk***
Saline Nasal spray: saline is ok in pregnancy and lactation
Vick's vapor-rub: not ingested and therefore is ok in pregnancy and lactation
Steam inhalation: ok in pregnancy and lactation
Vaseline: applied nasally or on lips, with no risk.
***Nasal sprays***
NasalCrom™: Category B, compatible
Lactation - no data, probably compatible
Afrin™: Category C, insufficient evidence. Small studies show normal use ok, but heavy use (against label) results in fetal brady most likely from vasoconstrictor activity.
Lactation - compatible
Flonase™: Category C, no other data found by me
Lactation - unknown, no other data found by me
Nasocort™: Category C, no other data found by me regarding nasal administration, but other routes are classified as having risk.
Lactation - no human data, probably compatible
***Anti-Tussives***
Dextromethorphan (in Robitussin DM): Category C, Compatible
Lactation - compatible
Codeine (in Robitussin AC): Category C, 3rd trimester risk
Lactation - limited human data, probably compatible
Pseudoephedrine (Sudafed™): Category C, limited human data and no relevant animal data, not recommended before 18weeks given association with omphalocele
Lactation - limited human data, probably compatible, compatible per AAP, but known to sometimes reduce or halt lactation
Phenylephrine: Category C, human data suggest risk
Lactation - no human data, probably compatible, but known to sometimes reduce or halt lactation
***Mucolytics***
Guaifenesin (in Robitussin DM, AC): Category C, Compatible, Surveillance studies show no increased risks of birth defects
Lactation - no human data, probably compatible
***Name brands***
Nyquil Cold and Flu™ and Nyquil Cough™ (Acetaminophen, Dextromethorphan, Doxylamine): Compatible, as above for each ingredient
Lactation - Compatible as above for each ingredient
nB. Nyquil D™ has pseudoephedrine, and Nyquil Sinus™ has phenylephrine and therefore not recommended for pregnancy but compatible for lactation
Tylenol Cold™ and Tylenol Allergy™: Contains phenylephrine and therefore not recommended for pregnancy but compatible for lactation
GERD:
Ranitidine (Zantac): Category B, Compatible
Lactation - limited human data, probably compatible, cimetidine compatible per AAP
Pantoprazole (Protonix): Category B, no human data, animal data suggest low risk
Lactation - limited human data with potential toxicity
Omeprazole (Prilosec): Category C, Human data suggest low risk
Lactation - limited human data with potential toxicity
Anti-infectives:
Fluconazole (Diflucan): Category C, human data suggest risk at >=400mg/day 1st trimester especially
Lactation - Compatible
Cephalexin (Keflex): Category B
Lactation - safe
Ciprofloxacin: Category C, Human data suggest risk
Lactation - limited human data, probably compatible, compatible per AAP
Macrobid/Nitrofurantoin: Category B, Risk in 3rd trimester of hemolytic anemia possibly from immature erythrocyte enzymes - glutathione.
Lactation - Limited human data, probably compatible
TMP-SMX/Bactrim/Septra: Category C, human data suggest risk.
Lactation - Compatible
