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Iodohippurate Sodium I 131 use while Breastfeeding

Iodohippurate Sodium I 131 Levels and Effects while Breastfeeding

Summary of Use during Lactation

Information in this record refers to the use of iodohippurate sodium I 131 (ortho-iodohippurate sodium I 131; I-131 OIH) as a diagnostic agent. The United States Nuclear Regulatory Commission states that breastfeeding need not be interrupted after administration of I-131 OIH in doses up to 10 MBq (0.3 mCi) to a nursing mother.[1] However, some experts recommend nursing the infant just before administration of the radiopharmaceutical and interrupting breastfeeding for 12 to 30 hours after the dose.[2][3][4] 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.[2][5][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. When the radioactivity is at a safe level she may 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 131 is a beta and high-energy gamma emitter with a main gamma emission energy of 364 keV and a physical half-life of 8.04 days.[1] The effective half-life of I-131 OIH averages 4.5 to 6.3 hours (range 2.2 to 7.6 hours).[2][3][7] About 2.4% of an administered dose is excreted into breastmilk.[3]

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.

References

1. 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/

2. 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

3. Leide-Svegborn S, Ahlgren L, Johansson L et al. Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption. Eur J Nucl Med Mol Imaging. 2016;43:808-21. PMID: 26732471

4. Mattsson S, Johansson L, Leide Svegborn S et al. Radiation dose to patients from radiopharmaceuticals: A compendium of current information related to frequently used substances. Annex D. Recommendations on breast-feeding interruptions. Ann ICRP. 2015;44 (2 Suppl):319-21. PMID: 26069086

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

6. 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

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

Iodohippurate Sodium I 131 Identification

Substance Name

Iodohippurate Sodium I 131

CAS Registry Number

881-17-4

Drug Class

Radiopharmaceuticals

Iodine Radioisotopes

Administrative Information

LactMed Record Number

671

Last Revision Date

20160401

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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