Last update March 31, 2019

Technetium 99m Exametazime (HMPAO)

Compatible

Safe substance and/or breastfeeding is the best option.

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 exametazime (Tc 99m) test solution obtained is used in single photon emission computed tomography (SPECT) for the diagnosis of brain conditions, hidden foci of infection and extension of inflammatory bowel disease by leukocyte labelling.

0.1% 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 exametazime (ARSAC 2019 p51, ICRP 2008 p163, Marshall 1996).

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

Milk expressed after the diagnostic test 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).


See below the information of these related products:

  • Occupational exposure to radionuclides (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Scintigraphy (Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.)

Alternatives

We do not have alternatives for Technetium 99m Exametazime (HMPAO) since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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

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Other names

Technetium 99m Exametazime (HMPAO) is also known as


Technetium 99m Exametazime (HMPAO) in other languages or writings:

Group

Technetium 99m Exametazime (HMPAO) belongs to this group or family:

Tradenames

Main tradenames from several countries containing Technetium 99m Exametazime (HMPAO) in its composition:

Pharmacokinetics

Variable Value Unit
T½ 7.5 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. 53-58. ARSAC Support Unit. Centre for Radiation, Chemical and Environmental Hazards. Public Health England. 2020 Consulted on Dec. 4, 2023 Abstract Full text (link to original source) Full text (in our servers)
  2. Mattsson S, Leide-Svegborn S, Andersson M. X-RAY AND MOLECULAR IMAGING DURING PREGNANCY AND BREASTFEEDING-WHEN SHOULD WE BE WORRIED? Radiat Prot Dosimetry. 2021 Oct 12;195(3-4):339-348. Abstract Full text (link to original source)
  3. IAEA - International Atomic Energy Agency. Radiation Protection and Safety in Medical Uses of Ionizing Radiation IAEA Safety Standards Series No. SSG-46, 2018 Abstract Full text (link to original source)
  4. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  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 (link to original source) Full text (in our servers)
  6. 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
  7. 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)
  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. 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)
  10. 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)
  11. Mountford PJ, O'Doherty MJ. Exposure of critical groups to nuclear medicine patients. Appl Radiat Isot. 1999 Abstract
  12. Marshall DS, Newberry NR, Ryan PJ. Measurement of the secretion of technetium-99m hexamethylpropylene amine oxime into breast milk. Eur J Nucl Med. 1996 Abstract

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