Techneium Tc 99m Bicisate use while Breastfeeding

Techneium Tc 99m Bicisate 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 technetium Tc 99m bicisate (Tc 99m ethylcysteinate dimer; Tc 99m ECD) as a diagnostic agent. The International Commission on Radiological Protection states that breastfeeding need not be interrupted after administration of Tc 99m ECD.[2] 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 need not refrain from close contact with their infants after usual clinical doses.[6] However, reducing close contact with the child to the least possible time for 6 hours following injection of the radiopharmaceutical, will ensure that the exposure is "as low as reasonably achievable".

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

Tc 99m is a gamma emitter with a principal photon energy of 140.5 keV and a physical half-life of 6.024 hours.[8] The elimination half-life of Tc 99m ECD is about 50 minutes in patients with normal renal function, but may be prolonged in renal impairment.

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.

References

1. Parker JA, Daube-Witherspoon ME, Graham LS et al. Procedure guideline for general imaging: 3.0. Society of Nuclear Medicine. 2004. http://interactive.snm.org/docs/General_Imaging_v3.0.pdf

2. ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Annex D. Ann ICRP. 2008;38:163-84. PMID: 19154964

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

8. 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/

Techneium Tc 99m Bicisate Identification

Substance Name

Techneium Tc 99m Bicisate

CAS Registry Number

121281-41-2

Drug Class

Administrative Information

LactMed Record Number

813

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.

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