Sestamibi for Nuclear Stress Test

[cegustin]

I am a midwife with a patient who is breastfeeding her 18 month old and had to undergo a Nuclear stress test for cardiac issues (unsure exact). She was exposed to 10.2 mCi Sestamibi and another 31.4 mCi Sestamibi. Prior to the test she was told that she would need to pump and dump for 24 hours. Upon showing up for the test she was told she should wean and should actually not even come in contact with her son for a few days. I can't find much online about this drug and am hoping you can lend some insight.

I did find a link to prescribing info here: http://www.cardiolite.com/healthcare-professionals/prescribing-info.asp It does not address breastfeeding well- "should be substituted for formula." The drug half life is 6 hours but I am not sure how to translate that into a breastfeeding rec for this type of agent. She has sent me an SOS after the fact and is currently pumping and dumping.

Thank you!

[admin]

Cegustin:

This all depends on the radioactive agent used. GENERALLY, sestamibi is bound to Technetium - 99, which has a 6 hour half-life and is largely decayed to background by 24 to 30 hours. As a rule, the radioisotope is about the safest of the group, and many authors suggest you don't even have to stop breastfeeding. I suggest pump and discarding for 24 hours.

IF this is the radioactive agent used, then she could probably withhold breastfeeding for 24 hours and very little radioactivity would get to the infant. As for close contact, it is generally not a problem with this isotope, but for the most safety, she should limit contact for about 24 hours or so. Its probably not necessary, but it completely avoids all radioactivity to the infant.


Tom Hale Ph.D.