Sodium Iodide I 123 use while Breastfeeding

Sodium Iodide I 123 Levels and Effects while Breastfeeding

Summary of Use during Lactation

Elective diagnostic nuclear medicine procedures should be delayed until the patient is no longer breastfeeding.[1] Information in this record refers to the use of sodium iodide I 123 as a diagnostic agent. The United States Nuclear Regulatory Commission states that breastfeeding need not be interrupted after administration of sodium iodide I 123 in doses up to 20 MBq (0.5 mCi) to a nursing mother.[2] However, to follow the principle of keeping exposure "as low as reasonably achievable", some experts recommend nursing the infant just before administration of the radiopharmaceutical and interrupting breastfeeding for 3 to 6 hours after the dose, then expressing the milk completely once and discarding it. If the mother has expressed and saved milk prior to the examination, she can feed it to the infant during the period of nursing interruption.[3][4][5] Mothers who receive a dose less than 400 MBq for a thyroid scan need not refrain from close contact with their infants.[6]

Mothers concerned about the level of radioactivity in their milk could ask to have it tested at a nuclear medicine facility at their hospital and when the radioactivity is at background levels they may safely resume breastfeeding. A method for measuring milk radioactivity and determining the time when a mother can safely resume breastfeeding has been published.[7]

Drug Levels

I 123 is a gamma emitter with a principal photon energy of 159 keV and a physical half-life of 13.2 hours.[2] Iodide is actively secreted into breastmilk and actively taken up by the mother's and infant's thyroid glands. The effective half-life of I 123 is 5.8 hours.[3][7]

Effects in Breastfed Infants

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

Possible Effects on Lactation

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

Alternate Drugs to Consider

(Hyperthyroidism Diagnosis) Sodium Pertechnetate Tc 99m

References

1. Parker JA, Daube-Witherspoon ME, Graham LS, Royal HD, Todd-Pokropek AE, Yester MV. Procedure guideline for general imaging: 3.0. Society of Nuclear Medicine. 2004. http://interactive.snm.org/docs/General_Imaging_v3.0.pdf

2. Howe DB, Beardsley M, Bakhsh S. Appendix U. Model procedure for release of patients or human research subjects administered radioactive materials. In, NUREG-1556. Consolidated guidance about materials licenses. Program-specific guidance about medical use licenses. Final report. U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards. 2008;9, Rev. 2. http://www.nrc.gov/reading-rm/doc-collections/nuregs/staff/sr1556/v9/r2/

3. Mountford PJ, Coakley AJ. A review of the secretion of radioactivity in human breast milk: data, quantitative analysis and recommendations. Nucl Med Commun. 1989;10:15-27. PMID: 2645546

4. Early PJ, Sodee DB. Principles and practice of nuclear medicine. 2nd ed. St. Louis. Mosby-Year Book, Inc. 1995:1380-1.

5. Administration of Radioactive Substances Advisory Committee. Notes for guidance on the clinical administration of radiopharmaceuticals and use of sealed radioactive sources. 2006;25-7. http://www.arsac.org.uk

6. Mountford PJ, O'Doherty MJ . Exposure of critical groups to nuclear medicine patients. Appl Radiat Isot. 1999;50:89-111. PMID: 10028630

7. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000;41:863-73. PMID: 10809203

Sodium Iodide I 123 Identification

Substance Name

Sodium Iodide I 123

CAS Registry Number

76924-93-1

Drug Class

Administrative Information

LactMed Record Number

666

Information from the National Library of Medicine's LactMed Database.

Last Revision Date

2013-09-07

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Disclaimer: This information is not intended as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. Use of this website signifies your agreement to the Terms of Use and Online Privacy Policy.

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