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

Iodixanol

January 24, 2016 (Very Low Risk)

X-ray contrast medium with 49% Iodine.

At latest update no published data were found on excretion into breast milk. Because a high molecular weight a significant passage into the breast milk is unlikely. It is used in young infants and neonates.

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 one of them is their data no or minimal excretion in milk.

Given the low lipid solubility of the iodinated contrast, less than 1% of the dose administered to the mother just passing milk.
Due to their low oral bioavailability, intestinal absorption is less than 1% of the dose that he may take the infant.
The maximum dose just getting the baby is less than 0.01% of the maternal dose, which represents less than 1% of the dose administered to a nursing practice that is a radiological contrast examination.

Most radiology scientific societies agree that after a radiological iodinated contrast examination is not necessary to wait any time to resume nursing.

Alternatives

We do not have alternatives for Iodixanol 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.

Writings

  • أيوديكسانول (Arabic)
  • Йодиксанол (Cyrillic)
  • 碘克沙醇 (Chinese)
  • イオジキサノール (Japanese)
  • C35H44I6N6O15 (Molecular formula)

Drug trade names

References

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  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. 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
  9. Nielsen ST, Matheson I, Rasmussen JN, Skinnemoen K, Andrew E, Hafsahl G. Excretion of iohexol and metrizoate in human breast milk. Acta Radiol. 1987Abstract
  10. Texier F, Roque d'Orbcastel O, Etling N. [Stable iodine level in human milk after pulmonary angiography]. Presse Med. 1983Abstract
  11. FitzJohn TP, Williams DG, Laker MF, Owen JP. Intravenous urography during lactation. Br J Radiol. 1982Abstract
  12. Ilett KF, Hackett LP, Paterson JW, McCormick CC. Excretion of metrizamide in milk. Br J Radiol. 1981Abstract
  13. HOLMDAHL KH. Cholecystography during lactation. Acta radiol. 1956Abstract