Question

I am a breastfeeding mother and i want to know if it is safe to use Technetium 99m exametazime? Is Technetium 99m exametazime safe for nursing mother and child? Does Technetium 99m exametazime extracts into breast milk? Does Technetium 99m exametazime has any long term or short term side effects on infants? Can Technetium 99m exametazime influence milk supply or can Technetium 99m exametazime decrease milk supply in lactating mothers?

Technetium 99m exametazime lactation summary

Technetium 99m exametazime usage has low risk in breastfeeding
  • DrLact safety Score for Technetium 99m exametazime is 3 out of 8 which is considered Low Risk as per our analyses.
  • A safety Score of 3 indicates that usage of Technetium 99m exametazime may cause some minor side effects in breastfed baby.
  • Our study of different scientific research indicates that Technetium 99m exametazime may cause moderate to no side effects in lactating mother.
  • Most of scientific studies and research papers declaring usage of Technetium 99m exametazime low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • While using Technetium 99m exametazime We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About Technetium 99m exametazime usage in lactation

Metastable Technetium 99 (99mTc) is a radioactive isotope that emits gamma radiation. Its radioactive decay half-life is 6.0 hours. After radioactive labelling with a sodium pertechnetate (Tc 99m) solution, the technetium (Tc 99m) test solution obtained is used in single photon emission computed tomography (SPECT) for the diagnosis of brain conditions, hidden foci of infection and extension of inflammatory bowel disease by leukocyte labelling. 0.1% of the administered dose is excreted in breast milk (Leide 2016, Liepe 2016). Breastfeeding interruption or close contact avoidance times are calculated so that the infant is not exposed to more than 1 millisievert (1 mSv = 0.1 rem) of radiation (ICRP 2008, Howe 2008, Stabin 2000). An adult receives between 5 and 10 mSv annually from environmental radiation. The main regulatory agencies which manage radioactive substances and experts consider that breastfeeding can occur immediately after a diagnostic test with Tc 99m exametazime (ARSAC 2016, ICRP 2008, Marshall 1996). Some agencies (ARSAC 2016, ICRP 2008) consider it more prudent to discontinue breastfeeding for about 4 hours, expressing breast milk and instead offering milk previously expressed and stored in a refrigerator prior to testing.Milk expressed after feeding can be frozen and used after 10 radioactive half lives: 10 x 6.0 = 60 hours = 3 days (Hale 2017, p.2019). Close contact with the infant need not be avoided (Mountford 1999).

Alternate Drugs for Radioactive Isotope, Radioisotope, Radionuclide, Diagnostic Radiopharmaceuticals. ATC V09

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