The Basics
What is Sodium Pertechnetate Tc 99m?
Used as an agent for brain imaging.
Brand names for Sodium Pertechnetate Tc 99m
Radiogenix System
How Sodium Pertechnetate Tc 99m is classified
Radiopharmaceuticals, Technetium Compounds, Diagnostic Agents
Sodium Pertechnetate Tc 99m During Pregnancy
Sodium Pertechnetate Tc 99m 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 Sodium Pertechnetate Tc 99m while pregnant
There are no available data with Sodium Pertechnetate Tc-99m use in pregnant women to inform any drug-associated risks of developmental outcomes. Animal reproductive studies have not been conducted with Sodium Pertechnetate Tc-99m. All radiopharmaceuticals, including Sodium Pertechnetate Tc-99m, have the potential to cause fetal harm depending on the fetal stage of development and the magnitude of the radiation dose. If considering Sodium Pertechnetate Tc-99m administration to a pregnant woman, inform the patient about the potential for adverse pregnancy outcomes based on the radiation dose from Sodium Pertechnetate Tc-99m and the gestational timing of exposure. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies are 2-4% and 15-20%, respectively
Taking Sodium Pertechnetate Tc 99m While Breastfeeding
What are recommendations for lactation if you're taking Sodium Pertechnetate Tc 99m?
Information in this record refers to the use of sodium pertechnetate Tc 99m as a diagnostic agent. The United States Nuclear Regulatory Commission states that breastfeeding should be interrupted temporarily after administration of sodium pertechnetate Tc 99m to a nursing mother. The duration of breastfeeding interruption depends on the dose administered (see table). 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.[1][2] The milk that is pumped by the mother during the time of breastfeeding interruption can either be discarded or stored refrigerated frozen 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.[3] 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.[4] 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.[5]
| Dose | Duration of Interruption |
|---|---|
| 1100 MBq (30 mCi) | 24 hours[6] |
| 440 MBq (12 mCi) | 12 hours[6][7] |
| 185 MBq (5 mCi) | 4 to 12 hours[4][7] |
Maternal / infant drug levels
Information in this record refers to the use of sodium pertechnetate Tc 99m as a diagnostic agent. The United States Nuclear Regulatory Commission states that breastfeeding should be interrupted temporarily after administration of sodium pertechnetate Tc 99m to a nursing mother. The duration of breastfeeding interruption depends on the dose administered (see table). 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.[1][2] The milk that is pumped by the mother during the time of breastfeeding interruption can either be discarded or stored refrigerated frozen 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.[3] 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.[4] 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.[5]
| Dose | Duration of Interruption |
|---|---|
| 1100 MBq (30 mCi) | 24 hours[6] |
| 440 MBq (12 mCi) | 12 hours[6][7] |
| 185 MBq (5 mCi) | 4 to 12 hours[4][7] |
Possible effects of Sodium Pertechnetate Tc 99m on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Sodium Pertechnetate Tc 99m
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. 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
2. 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
3. Mountford PJ, O’Doherty MJ. Exposure of critical groups to nuclear medicine patients. Appl Radiat Isot. 1999;50:89-111. PMID: 10028630
4. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000;41:863-73. PMID: 10809203
5. 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
6. 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/
7. International Atomic Energy Agency. Radiation Protection and Safety in Medical Uses of Ionizing Radiation, IAEA Safety Standards Series No. SSG-46, IAEA, Vienna. 2018. https://www.iaea.org/publications/11102/radiation-protection-and-safety-in-medical-uses-of-ionizing-radiation
8. 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. PMID: 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.
