Is Gallium Ga 68 Dotatate 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 Gallium Ga 68 Dotatate. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Gallium Ga 68 dotatate is used for localization of somatostatin receptor positive neuroendocrine tumors. It can found in lactating breasts in higher than usual amounts.[1] Labeling in the U.S. advises nursing mothers to pump and discard breastmilk for 12 hours after a dose, based on isotope's physical half-life alone. However, one group of investigators and the International Atomic Energy Agency recommend pumping and discarding breastmilk for 4 hours after a dose of 100 to 200 MBq, then resuming breastfeeding.[2,3]
Mothers concerned about the level of radioactivity in their milk could ask to have it tested at a nuclear medicine facility at their hospital. When the radioactivity is at a safe level, she may resume breastfeeding. A method for measuring milk radioactivity and determining the time when a mother can safely resume breastfeeding has been published.[4]
Nursing mothers should not work with radioactive substances used in PET scans in their workplace.[5]
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
Ga 68 decays primarily by positron-emission with a half-life 68 minutes and a mean energy of 836 keV followed by photonic annihilation radiations of 511 keV.[6]
Maternal Levels. A nursing mother who was 7 months postpartum was administered 200 MBq of Ga68 dotatate for quantitative PET-CT imaging. An expressed breastmilk sample at about 90 minutes post injection contained 2.8 kBq of gallium 68. The authors calculated that the effective dose of radiation to the infant would be 1.03 mSv if it were fed at 4 hours after the dose, and 12 mSv if it were fed immediately after injection. They recommend avoiding breastfeeding for 4 hours after the dose, pumping and discarding the milk, then resuming breastfeeding.[2]
A woman received an injection of 150 MBq of Ga 68 dotatate for a PET scan. Milk samples were measured at 80 and 135 minutes after administration. The authors estimated that the infant would receive an effective dose of 0.014mSv if the patient resumed breastfeeding 80 minutes after administration. If a 4-hour interruption in breastfeeding were used, the infant would potentially receive 0.003 mSv.[7]
Infant Levels. Relevant published information was not found as of the revision date.
“No published information” means the studies do not exist yet — not that Gallium Ga 68 Dotatate 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 “Gallium Ga 68 Dotatate” (LM1244). 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.