Iobenguane I 131

Drug Levels and Effects:




Summary of Use during Lactation:


Elective diagnostic nuclear medicine procedures should be delayed until the patient is no longer breastfeeding.[1] Information in this record refers to the use of iobenguane I 131 (I 131 meta-iodobenzylguanidine;I 131 MIBG) as a diagnostic agent. The International Commission on Radiological Protection states that breastfeeding should be interrupted for more than 3 weeks following diagnostic use of I 131 MIBG. This usually will result in permanent discontinuation of breastfeeding for this infant. Mothers could ask to have their milk tested at a nuclear medicine facility at their hospital and when milk radioactivity will give the infant a dose below 1 mSv, they may safely resume breastfeeding.[2] A method for measuring milk radioactivity and determining the time when a mother can safely resume breastfeeding has been published.[3] Patients receiving iobenguane I 131usually receive potassium iodide prior to the diagnostic examination to block theirthyroidgland's uptake of the I-131 that is released from the I 131 MIBG. Iodide may interfere with the infant'sthyroidfunction.


Drug Levels:


I 131 is a beta and high-energy gamma emitter with a main gamma emission energy of 364 keV and a physical half-life of 8.04 days.[4] Iodide is actively secreted into breastmilk and actively taken up by the mother's and infant'sthyroidglands.


Effects in Breastfed Infants:


Relevant published information was not found as of the revision date.


Possible Effects on Lactation:


Relevant published information was not found as of the revision date.


References:


1. Parker JA, Daube-Witherspoon ME, Graham LS et al. Procedure guideline for general imaging: 3.0. Society of Nuclear Medicine. 2004. http://interactive.snm.org/docs/General_Imaging_v3.0.pdf
2. ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Annex D. Ann ICRP. 2008;38:163-84. PMID:19154964
3. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000;41:863-73. PMID:10809203
4. 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/



Substance Identification:




Substance Name:

Iobenguane I 131

CAS Registry Number:

77679-27-7

Drug Class:


  • Radiopharmaceuticals

  • Technetium Compounds


  • Administrative Information:




    LactMed Record Number:


    805


    Last Revision Date:


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