Iodixanol and Breastfeeding

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 in milk and infant serum

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.

Alternative drugs to consider

Diatrizoate, Iohexol

References

1. WebbJA ThomsenHS MorcosSK The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol 2005 15 1234 40 15609057 PubMed
2. ChenMM CoakleyFV KaimalA Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation. Obstet Gynecol 2008 112 333 40 18669732 PubMed
3. CopelJ El-SayedY HeineRP Committee Opinion No. 723: Guidelines for diagnostic imaging during pregnancy and lactation. Obstet Gynecol 2017 130 e210 e216 28937575 PubMed
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. ChruscickiA MortonAR AkbariA Composition of human breast milk in acute kidney injury. Obstet Med 2017 10 79 82 28680467 PubMed