The Basics
What is Technetium Tc 99m Red Blood Cells?
Used in blood pool imaging, including cardiac first pass and gated equilibrium imaging and for detection of sites of gastrointestinal bleeding.
Brand names for Technetium Tc 99m Red Blood Cells
Na
How Technetium Tc 99m Red Blood Cells is classified
Radiopharmaceuticals, Technetium Compounds, Diagnostic Agents
Technetium Tc 99m Red Blood Cells During Pregnancy
Technetium Tc 99m Red Blood Cells pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Technetium Tc 99m Red Blood Cells while pregnant
N/A
Taking Technetium Tc 99m Red Blood Cells While Breastfeeding
What are recommendations for lactation if you're taking Technetium Tc 99m Red Blood Cells?
Information in this record refers to the use of technetium Tc 99m red blood cells as a diagnostic agent. The United States Nuclear Regulatory Commission[1] and the International Commission on Radiological Protection[2] recommend that breastfeeding should be interrupted temporarily after administration of in vivo labeled red blood cells but need not be interrupted after administration of in vitro labeled red blood cells (see table). To follow the principle of keeping exposure as low as reasonably achievable , some experts recommend nursing the infant just before administration of the radiopharmaceutical and interrupting breastfeeding for 6 hours after the dose, then expressing the milk completely once and discarding it. During the period of interruption, the breasts should be emptied regularly and completely. If the mother has expressed and saved milk prior to the examination, she can feed it to the infant during the period of nursing interruption.[3][4][5] The milk that is pumped by the mother during the time of breastfeeding interruption can either be discarded or stored refrigerated and given to the infant after 10 physical half-lives, or about 60 hours, have elapsed. Mothers need not refrain from close contact with their infants after usual clinical doses.[6] Mothers concerned about the level of radioactivity in their milk could ask to have it tested at a nuclear medicine facility at their hospital. When the radioactivity is at a safe level she may resume breastfeeding. A method for measuring milk radioactivity and determining the time when a mother can safely resume breastfeeding has been published.[7] For nursing mothers who work with Tc 99m substances in their workplace, there is no need to take any precautions other than those appropriate for general radiation protection.[8]
| Labelng Method | Dose | Duration of Interruption |
|---|---|---|
| in vivo | 740 MBq (20 mCi) | 6[1] to 12[2] hours |
| in vitro | 1000 MBq (30 mCi) | None required[1][2] |
Maternal / infant drug levels
Information in this record refers to the use of technetium Tc 99m red blood cells as a diagnostic agent. The United States Nuclear Regulatory Commission[1] and the International Commission on Radiological Protection[2] recommend that breastfeeding should be interrupted temporarily after administration of in vivo labeled red blood cells but need not be interrupted after administration of in vitro labeled red blood cells (see table). To follow the principle of keeping exposure as low as reasonably achievable , some experts recommend nursing the infant just before administration of the radiopharmaceutical and interrupting breastfeeding for 6 hours after the dose, then expressing the milk completely once and discarding it. During the period of interruption, the breasts should be emptied regularly and completely. If the mother has expressed and saved milk prior to the examination, she can feed it to the infant during the period of nursing interruption.[3][4][5] The milk that is pumped by the mother during the time of breastfeeding interruption can either be discarded or stored refrigerated and given to the infant after 10 physical half-lives, or about 60 hours, have elapsed. Mothers need not refrain from close contact with their infants after usual clinical doses.[6] Mothers concerned about the level of radioactivity in their milk could ask to have it tested at a nuclear medicine facility at their hospital. When the radioactivity is at a safe level she may resume breastfeeding. A method for measuring milk radioactivity and determining the time when a mother can safely resume breastfeeding has been published.[7] For nursing mothers who work with Tc 99m substances in their workplace, there is no need to take any precautions other than those appropriate for general radiation protection.[8]
| Labelng Method | Dose | Duration of Interruption |
|---|---|---|
| in vivo | 740 MBq (20 mCi) | 6[1] to 12[2] hours |
| in vitro | 1000 MBq (30 mCi) | None required[1][2] |
Possible effects of Technetium Tc 99m Red Blood Cells on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Technetium Tc 99m Red Blood Cells
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Howe DB, Beardsley M, Bakhsh S. Appendix U. Model procedure for release of patients or human research subjects administered radioactive materials. In, NUREG-1556. Consolidated guidance about materials licenses. Program-specific guidance about medical use licenses. Final report. U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards. 2008;9, Rev. 2. http://www.nrc.gov/reading-rm/doc-collections/nuregs/staff/sr1556/v9/r2/
2. Mattsson S, Johansson L, Leide Svegborn S et al. Radiation dose to patients from radiopharmaceuticals: A compendium of current information related to frequently used substances. Annex D. Recommendations on breast-feeding interruptions. Ann ICRP. 2015;44 (2 Suppl):319-21. PMID: 26069086
3. Mountford PJ, Coakley AJ. A review of the secretion of radioactivity in human breast milk: data, quantitative analysis and recommendations. Nucl Med Commun. 1989;10:15-27. PMID: 2645546
4. Early PJ, Sodee DB. Principles and practice of nuclear medicine. 2nd ed. St. Louis. Mosby-Year Book, Inc. 1995:1380-1.
5. National Radiation Protection Board (UK). Administration of radioactive substances advisory committee. Notes for guidance on the clinical administration of radiopharmaceuticals and use of sealed radioactive sources. 2019. https://assets.publishing.service.gov.uk/government/…/file/…/ARSAC_NfG_2019.pdf
6. Mountford PJ, O’Doherty MJ. Exposure of critical groups to nuclear medicine patients. Appl Radiat Isot. 1999;50:89-111. PMID: 10028630
7. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000;41:863-73. PMID: 10809203
8. Almen A, Mattsson S. Radiological protection of foetuses and breast-fed children of occupationally exposed women in nuclear medicine – Challenges for hospitals. Phys Med. 2017;43:172-7. PMID: 28882410
9. Mitchell KB, Fleming MM, Anderson PO et al. ABM Clinical Protocol #30: Radiology and Nuclear Medicine Studies in Lactating Women. Breastfeed Med. 2019;14:290-4. 31107104
10. Leide-Svegborn S, Ahlgren L, Johansson L et al. 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;43:808-21. 26732471
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
