Is Amidotrizoate compatible with breastfeeding? Do we have alternatives for Amidotrizoate?

Amidotrizoate

January 24, 2016 (Very Low Risk)

The X-ray contrast media that contain Amidotryzoic acid, Meglumine and Sodium have a content of Iodine from 47% to 62%.
Amidotryzoate excretion into breast milk is nil (Fitzjohn, 1982) or in clinically non-significant amount (Texier, 1983: <0.1% of maternal dose) and there have been no problems in infants whose mothers were on this medication.

The various Iodinated contrast media for imaging examinations (X-rays, CT scans) are considered compatible with breastfeeding since they are rapidly eliminated with little or no release of iodine, not metabolized and virtually not absorbed when taken by mouth. They are structurally very similar to each other, and some of them have shown no or minimal excretion in the breast milk.

Given a low lipoid solubility of the iodinated contrast media, less than 1% of the dose administered to the mother has been found to in the milk.
Due to their low oral bioavailability, intestinal absorption is less than 1% of the dose that would be swallowed by the infant.
The maximum that is finally got by the baby is less than 0.01% of the maternal dose, which represents less than 1% of the dose administered to an infant who undergoes a radiological contrast examination.

Most Scientific Societies of Radiology have agreed that after a radiological iodinated contrast examination is not necessary a temporary weaning of the baby.

American Academy of Pediatrics classifies it as usually compatible with breastfeeding medication.
WHO List of Essential Medicines 2002 states it is compatible with breastfeeding.

Alternatives

We do not have alternatives for Amidotrizoate since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Amidotrizoic Acid
  • Diatrizoate
  • Meglumine Amidotrizoate
  • Sodium Amidotrizoate

Writings

  • C11H9I3N2O4,C7H17NO5 (Molecular formula)

Drug trade names

References

  1. American College of Radiology Committee on Drugs and Contrast Media. ACR Manual on Contrast Media v10.1 2015Abstract Full text (link to original source) Full text (in our servers)
  2. Cova MA, Stacul F, Quaranta R, Guastalla P, Salvatori G, Banderali G, Fonda C, David V, Gregori M, Zuppa AA, Davanzo R. Radiological contrast media in the breastfeeding woman: a position paper of the Italian Society of Radiology (SIRM), the Italian Society of Paediatrics (SIP), the Italian Society of Neonatology (SIN) and the Task Force on Breastfeeding, Ministry of Health, Italy. Eur Radiol. 2014Abstract
  3. Quintana Rodríguez I. Uso de contrastes radiológicos en la mujer lactante y en niños.. CbSERAM nº 8/14 – Agosto 2014Abstract Full text (link to original source) Full text (in our servers)
  4. Tremblay E, Thérasse E, Thomassin-Naggara I, Trop I. Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation. Radiographics. 2012Abstract Full text (link to original source) Full text (in our servers)
  5. Wang PI, Chong ST, Kielar AZ, Kelly AM, Knoepp UD, Mazza MB, Goodsitt MM. Imaging of pregnant and lactating patients: part 1, evidence-based review and recommendations. AJR Am J Roentgenol. 2012Abstract Full text (link to original source) Full text (in our servers)
  6. Chen MM, Coakley FV, Kaimal A, Laros RK Jr. Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation. Obstet Gynecol. 2008Abstract
  7. Newman J. Breastfeeding and radiologic procedures. Can Fam Physician. 2007Abstract Full text (link to original source) Full text (in our servers)
  8. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  9. Webb JA, Thomsen HS, Morcos SK; Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol. 2005Abstract
  10. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  11. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  12. Nielsen ST, Matheson I, Rasmussen JN, Skinnemoen K, Andrew E, Hafsahl G. Excretion of iohexol and metrizoate in human breast milk. Acta Radiol. 1987Abstract
  13. Texier F, Roque d'Orbcastel O, Etling N. [Stable iodine level in human milk after pulmonary angiography]. Presse Med. 1983Abstract
  14. FitzJohn TP, Williams DG, Laker MF, Owen JP. Intravenous urography during lactation. Br J Radiol. 1982Abstract
  15. Ilett KF, Hackett LP, Paterson JW, McCormick CC. Excretion of metrizamide in milk. Br J Radiol. 1981Abstract
  16. HOLMDAHL KH. Cholecystography during lactation. Acta radiol. 1956Abstract