Last update: May 28, 2019

Technetium 99m Mertiatide (MAG3)

Low Risk for breastfeeding


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

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 mertiatide (Tc 99m) test solution obtained is used in renal scintigraphy.

0.071% 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 (ARSAC 2019, US.NCR 2016, ICRP 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 be resumed immediately after a diagnostic test with Tc 99m mertiatide (Mitchell 2019, ARSAC 2019 p51, ICRP 2008 p163, Stabin 2000, Evans 1993).
If the dose administered was ≥ 200 MBq, a 2-hour interruption is recommended (ARSAC 2019 p51).

Some agencies (ARSAC 2019, ICRP 2008) consider it more prudent to discontinue breastfeeding for about 4 hours, expressing breast milk once and instead offering milk previously expressed and stored in a refrigerator prior to testing.

Milk expressed after the scintigraphy 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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Alternatives

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

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Technetium 99m Mertiatide (MAG3) is also known as


Technetium 99m Mertiatide (MAG3) in other languages or writings:

Group

Technetium 99m Mertiatide (MAG3) belongs to this group or family:

Tradenames

Main tradenames from several countries containing Technetium 99m Mertiatide (MAG3) in its composition:

Pharmacokinetics

Variable Value Unit
T1/2 3,6 - 4,9 hours

References

  1. 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. 47-53. ARSAC Support Unit. Centre for Radiation, Chemical and Environmental Hazards. Public Health England. 2019 Abstract Full text (link to original source) Full text (in our servers)
  2. Mitchell KB, Fleming MM, Anderson PO, Giesbrandt JG; Academy of Breastfeeding Medicine.. ABM Clinical Protocol #30: Radiology and Nuclear Medicine Studies in Lactating Women. Breastfeed Med. 2019 Jun;14(5):290-294. Abstract
  3. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  4. 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. 2016 Abstract
  5. 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. 2016 Abstract Full text (in our servers)
  6. US.NRC - Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards. Apéndice U, Tabla U.3. Consolidated guidance about materials licenses. Program-specific guidance about medical use licenses. Draft Report for Comment. Appendix U, Table U.3. NUREG-1556. Vol.9, Rev 3. 2016 Full text (link to original source) Full text (in our servers)
  7. 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. 2008 Abstract Full text (link to original source) Full text (in our servers)
  8. US.NRC - Howe DB, Beardsley M, Bakhsh S. U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards. Apéndice U, Tabla U.3. 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)
  9. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000 Abstract Full text (link to original source) Full text (in our servers)
  10. Mountford PJ, O'Doherty MJ. Exposure of critical groups to nuclear medicine patients. Appl Radiat Isot. 1999 Abstract
  11. Evans JL, Mountford PJ, Herring AN, Richardson MA. Secretion of radioactivity in breast milk following administration of 99Tcm-MAG3. Nucl Med Commun. 1993 Abstract
  12. Rubow SM, Ellmann A, le Roux J, Klopper J. Excretion of technetium 99m hexakismethoxyisobutylisonitrile in milk. Eur J Nucl Med. 1991 Abstract

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