Is Diatrizoate safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Diatrizoate. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Limited information indicates that maternal doses of diatrizoate up to 38 g (containing 18.5 grams of iodine) produce low levels in milk. In addition, because diatrizoate is poorly absorbed orally, it is not likely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants. 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]
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
A woman who was 10 days postpartum received diatrizoate meglumine intravenously in a dose equivalent to 306 mg of iodine for phlebography. Bound iodine (presumably diatrizoate and any metabolites) in breastmilk was measured. Iodine was not found in the breastmilk until 2.25 hours after the dose when a concentration of 20 mg/L was detected. At 7 hours, a peak concentration of 22 mg/L occurred. Breastmilk iodine concentrations dropped after that until the concentration was 7.4 mg/L at 27 hours after the dose.[5]
One woman who was 7 weeks postpartum received 50 mL of an iodinated contrast medium containing 38 grams of sodium and meglumine salts of diatrizoate by rapid intravenous injection for urography (intravenous pyelogram; IVP). The total dose of iodine in this dose was 18.5 grams. Milk samples were expressed at 6, 9, 13 and 16.5 hours after the dose. Diatrizoate was undetectable (<2 mg/L) in any of the milk samples.[6]
A woman received 300 mL of sodium and meglumine salts of diatrizoate by intravenous injection for pulmonary angiography for a suspected pulmonary embolism 48 hours after delivery by cesarean section. This dose contained a total of 93 grams of iodine. All milk produced for the next 5 days (collection method not stated) was saved for analysis. The total amount of iodine excreted into milk during the first 24 hours after the dose was 31 mg or 0.03% of the dose administered. On the second and third days after administration, 0.008% (7.6 mg) and 0.0005% (0.5 mg), respectively, of the iodine dose was excreted in milk. By day 5, the concentration of iodine in milk was 119 mcg/L, compared to the mean of 70 mcg/L in 200 samples of normal breastmilk in the same laboratory.[7]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
“No published information” means the studies do not exist yet — not that Diatrizoate is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Diatrizoate” (LM528). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.