Last update May 28, 2019

Tc 99m pentetate

Low Risk

Possibly 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 sodium pertechnetate (99mTc) solution, the technetium (99mTc) pentetate solution obtained is used in scintigraphy for the diagnosis of renal, cerebral, pulmonary or gastroesophageal disease by intravenous, inhaled or oral administration.

Between 0.01% and 0.2% 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 Penetrate (Mitchell 2019, ARSAC 2019 p51, US.NCR 2016 tab U.3, ICRP 2008 p163, Stabin 2000).

Some agencies (ARSAC 2019, ICRP 2008, Ahlgren 1985, Mountford 1985 y 1984) 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.
If the dose administered was ≥ 800 MBq, a 5-hour interruption is recommended (ARSAC 2019 p51).

Milk expressed after 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).


See below the information of these related products:

  • Occupational exposure to radionuclides (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Scintigraphy ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)

Alternatives

We do not have alternatives for Tc 99m pentetate.

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

Tc 99m pentetate is also known as Technetium 99m Pentetate (DTPA). Here it is a list of alternative known names::


Tc 99m pentetate in other languages or writings:

Group

Tc 99m pentetate belongs to this group or family:

Tradenames

Main tradenames from several countries containing Tc 99m pentetate in its composition:

Pharmacokinetics

Variable Value Unit
Protein Binding 10 - 20 %
T½ 3.1 - 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 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. 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)
  6. 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)
  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. Ahlgren L. Excretion of radionuclides in human breast milk after administration of radiopharmaceuticals. Error in table. J Nucl Med. 1986 Abstract Full text (link to original source) Full text (in our servers)
  12. Hedrick WR, Di Simone RN, Keen RL. Radiation dosimetry from breast milk excretion of radioiodine and pertechnetate. J Nucl Med. 1986 Abstract Full text (link to original source) Full text (in our servers)
  13. Ahlgren L, Ivarsson S, Johansson L, Mattsson S, Nosslin B. Excretion of radionuclides in human breast milk after the administration of radiopharmaceuticals. J Nucl Med. 1985 Abstract Full text (link to original source) Full text (in our servers)
  14. Mountford PJ, Coakley AJ, Hall FM. Excretion of radioactivity in breast milk following injection of 99Tcm-DTPA. Nucl Med Commun. 1985 Abstract
  15. Mountford PJ, Hall FM, Wells CP, Coakley AJ. Breast-milk radioactivity after a Tc-99m DTPA aerosol/Tc-99m MAA lung study. J Nucl Med. 1984 Abstract Full text (link to original source) Full text (in our servers)
  16. Wyburn JR. Human breast milk excretion of radionuclides following administration of radiopharmaceuticals. J Nucl Med. 1973 Abstract Full text (link to original source) Full text (in our servers)

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