Summary of Use during Lactation

Intravenous iodinated contrast media are poorly excreted into breastmilk and poorly absorbed orally so they are not likely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants. One report of very small amounts of iodine from iodixanol in breastmilk supports this generalization. Guidelines developed by several professional organizations state that breastfeeding need not be disrupted after a nursing mother receives an iodine-containing contrast medium.[1-4]

Drug Levels

Maternal Levels. A mother was given 100 mL of iodixanol (containing 320 mg of iodine per mL) intravenously immediately postpartum for diagnosis of severe abdominal pain. She was found to have a hematoma resulting in acute tubular necrosis with a serum creatinine of 2.5 mg/dL (222 micromoles/L). Breastmilk samples taken on days 1 and 4 postpartum contained 55 and 28 mg/L of iodine, respectively. The authors calculated that the infant would receive 0.017% of the total administered maternal dose of iodine on day 1 and 0.05% on day 4 postpartum.[5] However, these values could be somewhat different in a patient with normal kidney function.

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

Effects in Breastfed Infants

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

Effects on Lactation and Breastmilk

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

Alternate Drugs to Consider

Diatrizoate, Iohexol

References

1.

Webb JA, Thomsen HS, Morcos SK, et al. The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol. 2005;15:1234–40. [PubMed: 15609057]

2.

Chen MM, Coakley FV, Kaimal A, et al. Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation. Obstet Gynecol. 2008;112:333–40. [PubMed: 18669732]

3.

Copel J, El-Sayed Y, Heine RP, et al. Committee Opinion No. 723: Guidelines for diagnostic imaging during pregnancy and lactation. Obstet Gynecol. 2017;130:e210–e216. [PubMed: 28937575]

4.

American College of Radiology Committee on Drugs and Contrast Media. Administration of contrast media to breast-feeding mothers. In, ACR manual on contrast media. 2022;Version 2022:106-7. https://www​.acr.org/Clinical-Resources​/Contrast-Manual.

5.

Chruscicki A, Morton AR, Akbari A, et al. Composition of human breast milk in acute kidney injury. Obstet Med. 2017;10:79–82. [PMC free article: PMC5480647] [PubMed: 28680467]

Substance Name

Iodixanol

CAS Registry Number

92339-11-2

Drug Class

Breast Feeding

Lactation

Milk, Human

Contrast Media

Diagnostic Agents