Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Drugline nr 20721

Publicerat 2004-03-01

Question

Is it advisable to breast-feed after administration of Visipaque (iodixanol) for a CT scan of the mother?

The child is four days old and the advise from the X-ray department was to discard the milk for 24 hours post-examination.

Answer

Iodixanol is a hexaiodinized dimeric radiocontrast agent that is said to be non-dissociating (1). It is water-soluble and is protein bound to less than 2%. It is excreted mainly by glomerular filtration and its half-life is approximately 2 hours with normal renal function. Eighty percent of a given dose is excreted in the urine within four hours (2).

There are no data on passage to breast milk on either iodixanol or the monomeric radiocontrast agents iohexol or ioversol (3), but there is no reason to believe that there is a major difference between plasma and milk concentrations. Iodide can accumulate in breast milk of mothers using iodine antiseptics or subjected to examinations with dissociating radiocontrast agents (3). Iodixanol can be given even to small children (<7 kg) (2). No data on oral bioavailability have been found.

To minimise the nursing infant's exposure to the agent, it could be recommended to discard the milk for 4-5 half-lives, but to do so for 24 hours seems to long considering the risks of failing breast-feeding.

Conclusion

There is a lack of data on radiocontrast agents and lactation. It could be recommended to pump and discard the milk for 8-10 hours post-examination to minimise the infant´s exposure.

Böttiger Y
Ohlsson S

References

  1. O´Neil MJ, Smith A, Heckelman PE, Obenchain JR Jr, Gallipeau JAR, D´Arecca MA, Budavari S, editors. The Merck Index. An encyclopedia of chemicals, drugs, and biologicals. 13th ed. Whitehous station NJ: Merck & Co., Inc.; 2001
  2. FASS 2003 (The Swedish catalogue of approved medical products)
  3. Briggs GB, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 6th ed. Baltimore: Williams & Wilkins; 2002

Senast ändrad 2018-09-20