Recommendations made
pediatrician - Dr. Victоr Аbdоw
Rоckville, МD, USА.
Is it allowed to take Tc 99m hexamethylpropylene amine oxime during lactation? |
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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). |
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Types of risk
VERY LOW RISK
It is allowed while breastfeeding. It is not dangerous for a baby. It is moderately safe. more...
LOW RISK PROBABLE
Possible presence in breast milk is allowed. Follow the doctor's recommendation. more...
HIGH RISK PROBABLE
An unsafe drug, it is necessary to assess the risks while taking. Use safer analogs. more...
VERY HIGH RISK
It is not recommended. You need to stop breastfeeding or choose a safe analog. more...
Scientific literature
The level of risk for breastfeeding is confirmed in these scientific publications:- http://www.ncbi.nlm.nih.gov/pubmed/26732471
- https://www.gov.uk/government/publications/arsac-notes-for-guidance
- https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/492127/ARSAC_NfG_2016.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/26857567
- http://www.ncbi.nlm.nih.gov/pubmed/19154964
- http://www.bmap.ucla.edu/docs/ICRP_106_RadiationDosetoPatientsfromRadiopharmaceuticals_vol38_2008.pdf
- https://scp.nrc.gov/narmtoolbox/nureg1556vol9_rev2_012408.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/10809203
- http://jnm.snmjournals.org/content/41/5/863.full.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/10028630
- http://www.ncbi.nlm.nih.gov/pubmed/8929318