Is Technetium 99m mertiatide (MAG3) compatible with breastfeeding? Do we have alternatives for Technetium 99m mertiatide (MAG3)?

Technetium 99m mertiatide (MAG3)

February 22, 2018 (Low Risk)

The metastable Technetium 99 (Tc 99m) is a radioactive isotope that emits gamma radiation. Its half-life of radioactive decay is 6.0 hours.
After radioactive labeling with a solution of pertechnetate (99mTc) of sodium, the obtained technetium (99mTc) -mertiatide solution is used in scintigraphy for the diagnosis of nephrourological disease.

0.07% of the administered dose is excreted in breast milk (Leide 2016, Liepe 2016).
Lactation times or avoiding close contact 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 regulating organisms of administration of radioactive substances and experts consider that it is possible to breastfeed immediately after a diagnostic test with Tc 99m mertiatide (ARSAC 2016, ICRP 2008, Howe 2008, Stabin 2000, Evans 1993).

Some organisms (ARSAC 2016, ICRP 2008) consider it more prudent to interrupt breastfeeding for about 4 hours, once extracting the milk and being able to offer, instead, milk previously extracted and stored in the refrigerator before the test.
The milk extracted after intake can be frozen and used once 10 radioactive half-lives have passed: 10 x 6.0 = 60 hours = 3 days (Hale 2017, page 2019).

It is not necessary to avoid close contact with the infant (Mountford 1999).


See below the information of this related product:

Alternatives

We do not have alternatives for Technetium 99m mertiatide (MAG3) .

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

  • Tc 99m mercaptoacetyltriglycine
  • Tc 99m mertiatide

Writings

  • Tc 99m MAG3 (Abbreviation)

Drug trade names

References

  1. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  2. Leide-Svegborn S, Ahlgren L, Johansson L, Mattsson S. 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. 2016Abstract
  3. Liepe K, Becker A. 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. 2016Abstract Full text (in our servers)
  4. ARSAC: Administration of Radioactive Substances Advisory Committee. Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and Use of Sealed Radioactive Sources. Section 7 Conception, Pregnancy and Breastfeeding, p. 25-30. ARSAC Support Unit. Centre for Radiation, Chemical and Environmental Hazards. Public Health England. 2016Abstract Full text (link to original source) Full text (in our servers)
  5. ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Annex D. Recommendations on breast-feeding interruptions, p. 163-165. Ann ICRP. 2008Abstract Full text (link to original source) Full text (in our servers)
  6. Howe DB, Beardsley M, Bakhsh S. U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards. Consolidated guidance about materials licenses. Program-specific guidance about medical use licenses. Final report. Appendix U, Table U.3. NUREG-556. Vol.9, Rev 2. 2008 Full text (link to original source) Full text (in our servers)
  7. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000Abstract Full text (link to original source) Full text (in our servers)
  8. Mountford PJ, O'Doherty MJ. Exposure of critical groups to nuclear medicine patients. Appl Radiat Isot. 1999Abstract
  9. Evans JL, Mountford PJ, Herring AN, Richardson MA. Secretion of radioactivity in breast milk following administration of 99Tcm-MAG3. Nucl Med Commun. 1993Abstract
  10. Rubow SM, Ellmann A, le Roux J, Klopper J. Excretion of technetium 99m hexakismethoxyisobutylisonitrile in milk. Eur J Nucl Med. 1991Abstract