Gadodiamide and Breastfeeding

Summary of use during lactation

Gadodiamide releases more free gadolinium than some other gadolinium-containing contrast agents and has been removed from the market in several countries. Some European guidelines recommend a 24-hour interruption of breastfeeding after a dose, but guidelines developed by several North American professional organizations state that breastfeeding need not be disrupted after a nursing mother receives a gadolinium-containing contrast medium.[1-4] Other agents are preferred, especially while nursing a newborn or preterm infant.

Drug levels in milk and infant serum

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

Effects in breastfed infants

A mother with neuromyelitis optica was nursing her 38-day-old male infant. Each breastfeeding session was about 15 minutes every 2 hours. She was given gadodiamide (dose not specified) before an MRI scan. She withheld breastfeeding for 6 to 8 hours after the injection. Her infant experienced no immediate adverse effects.[5]

Effects on lactation and breastmilk

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

Alternative drugs to consider

Gadobutrol, Gadoteridol, Gadoterate

References

1. 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-e628937575 PubMed
2. European Society of Urogenital Radiology. ESUR guidelines on contrast media. 2018;Version 10.0.http://www.esur-cm.org/index.php/en/
3. American College of Radiology Committee on Drugs and Contrast Media. Administration of contrast media to breast-feeding mothers. In, ACR manual on contrast media. 2023;Version 2023:120-1. https://www.acr.org/Clinical-Resources/Contrast-Manual
4. Bookwalter CA, McDonald RJ, Packard AT, et al. Contrast media in pregnant and lactating patients, from the AJR special series on contrast media. AJR Am J Roentgenol 2024;224:e243141539046138 PubMed
5. Acar S, Keskin-Arslan E, Erol-Coskun H, et al. Gadodiamide use during breastfeeding. Reprod Toxicol 2018;80:59-60.doi:10.1016/j.reprotox.2018.07.071