Diatrizoate use while Breastfeeding

Drugs containing Diatrizoate: Gastrografin, Hypaque, MD-Gastroview, MD-76, Cystografin, Angiografin, Urografin 325, Cystografin-Dilute, Hypaque Meglumine, Urovison, Show all 30 »Cardiografin, Hypaque-M, Reno-30, Sinografin, Reno-Dip, MD-76 R, Urografin 150, Urografin 370, Reno-60, Reno-M-60, Reno-M-30, Hypaque Sodium, Hypaque-76, Renovist, Reno-M-DIP, Renovist II, Hypaque Cysto, Renografin-76, Renografin-60, Renocal-76

Diatrizoate Levels and Effects while Breastfeeding

Summary of Use during Lactation

Limited information indicates that maternal doses of diatrizoate up to 38 g (containing 18.5 grams of iodine) produce low levels in milk. In addition, because diatrizoate is poorly absorbed orally, it is not likely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants. Guidelines developed by several professional organizations state that breastfeeding need not be disrupted after a nursing mother receives a iodine-containing contrast medium.[1][2][3]

Drug Levels

Maternal Levels. One woman who was 7 weeks postpartum received 50 mL of an iodinated contrast medium containing 38 grams of sodium and meglumine salts of diatrizoate by rapid intravenous injection for urography (intravenous pyelogram; IVP). The total dose of iodine in this dose was 18.5 grams. Milk samples were expressed at 6, 9, 13 and 16.5 hours after the dose. Diatrizoate was undetectable (<2 mg/L) in any of the milk samples.[4]

A woman received 300 mL of sodium and meglumine salts of diatrizoate by intravenous injection for pulmonary angiography for a suspected pulmonary embolism 48 hours after delivery by cesarean section. This dose contained a total of 93 grams of iodine. All milk produced for the next 5 days (collection method not stated) was saved for analysis. The total amount of iodine excreted into milk during the first 24 hours after the dose was 31 mg or 0.03% of the dose administered. On the second and third days after administration, 0.008% (7.6 mg) and 0.0005% (0.5 mg), respectively, of the iodine dose was excreted in milk. By day 5, the concentration of iodine in milk was 119 mcg/L, compared to the mean of 70 mcg/L in 200 samples of normal breastmilk in the same laboratory.[5]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Iohexol

References

1. American College of Radiology Committee on Drugs and Contrast Media. Administration of contrast media to breast-feeding mothers. In, ACR manual on contrast media. 2012;Version 8:79-80.

2. Webb JA, Thomsen HS, Morcos SK, Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol. 2005;15:1234-40. PMID: 15609057

3. Chen MM, Coakley FV, Kaimal A, Laros RK Jr. Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation. Obstet Gynecol. 2008;112:333-40. PMID: 18669732

4. FitzJohn TP, Williams DG, Laker MF, Owen JP. Intravenous urography during lactation. Br J Radiol. 1982;55:603-5. PMID: 7116094

5. Texier F, Roque D'Orbcastel O, Etling N. [Stable iodine level in human milk after pulmonary angiography]. Presse Med (Paris). 1983;19:769. Letter. PMID: 6220321

Diatrizoate Identification

Substance Name

Diatrizoate

CAS Registry Number

117-96-4

Drug Class

Contrast Agents

Diagnostic Agents

Administrative Information

LactMed Record Number

528

Last Revision Date

20130907

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