Povidone Iodine

Registered South African indications:

• Skin infections
• Wounds/cuts/abrasions
• Burns

Contraindications

Cream

• Hypersensitivity to the active ingredient or any of its excipients
• Hyperthyroidism or other acute thyroid diseases (especially nodular colloidal goitre, endemic goitre, Hashimoto’s thyroiditis)
• Before and after radioiodine therapy for hyperthyroidism, until a lasting cure has been obtained. It should not be used for 4 weeks prior to radioiodine scintigraphy or radioiodine treatment of thyroid carcinoma
• Children under 2 years of age or children of very low weight (1500 grams)
• Not to be used on patients on concurrent lithium therapy

Ointment

• Hypersensitivity to the active ingredient or any of its excipients
• With non-toxic nodular colloid goitre
• Pregnancy
• Breastfeeding
• Application to large areas of broken skin (e.g., severe and extensive burns) should be avoided as excessive absorption of iodine may occur

Cautions

• Pregnancy (cre)
• Breastfeeding (cre)
• Renal impairment
• Hepatic impairment
• Thyroid disorders
• Allergy to iodine
• Prolonged use

Forms avail. in SA and covered in this monograph: cre, oin

Impetigo

• Topical (oin): Apply to affected area, 8hrly

Minor skin infections
Minor wounds/cuts/abrasions
Minor burns

• Topical (oin): Apply to affected area, 12hrly
• Topical (cre): Apply to affected area, as needed

Affected area should be cleaned and dried before application

Occlusive dressings may be used

Paed. forms avail. in SA and covered in this monograph: cre, oin

Acute treatment and prevention of infections in minor wounds, cuts, abrasions and burns

Younger than 2 years

• Contraindicated

Between 2-6 years

• Topical (cre): Apply 1-2 small pea sized amounts each day

Between 6-8 years

• Topical (cre): Apply 2 small pea sized amounts twice a day

Between 9-13 years

• Topical (cre): Apply 3 small pea sized amounts twice a day

Between 13-18 years

• Topical (cre): Apply 5 small pea sized amounts twice a day

Povidone iodine cream is not to be used in children under 2 years of age or children of very low weight (1500 grams) (see contraindications)

The affected area may then be covered with a dressing or bandage if required

Povidone iodine ointment: No information available

Pregnancy

Cream

• Caution; not recommended
• During pregnancy, povidone iodine should only be used if strictly indicated and its use should be kept to the absolute minimum, since absorbed iodine can pass through the placenta
• Povidone-iodine use may induce transient hypothyroidism with elevation of TSH (thyroid stimulating hormone) in the foetus or in the newborn. A check of the child’s thyroid function may be necessary

Ointment

• Contraindicated

Breastfeeding

Cream

• Caution; not recommended
• During lactation, povidone iodine should only be used if strictly indicated and its use should be kept to the absolute minimum, since absorbed iodine can be secreted in breast milk
• Iodine is excreted in breast milk and is present in higher concentrations in the breast milk compared to those in the serum. Also, any oral ingestion of the cream by the infant must be avoided, therefore, breastfeeding women should ensure they do not apply povidone iodine to the breast when they are breastfeeding

Ointment

• Contraindicated

Renal impairment

• Caution; no dose adjustment recommended

Hepatic impairment

• Caution; no information available

Elderly

• No dose adjustment recommended

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warnings

Endocrine and Metabolic Disorders

• Hypothyroidism 
• Interference with thyroid function tests

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity
• Local irritation  

• Lithium

None routine

Povidone-iodine is a multivalent broad spectrum local antiseptic having bactericidal and fungicidal properties. The effect on vegetative cells of various bacteria and fungi is due to the liberation of free iodine from the complex. Many virusses, protozoa, yeasts, cysts and spores are also susceptible

Povidone-Iodine is available in several formulations. Please note the list below gives examples of products which are available and is not necessarily comprehensive. The listing of a product does not constitute endorsement of the product by EMGuidance; likewise, failure to list a product does not imply that EMGuidance disapproves of the product. This information is put together on the basis of the National Government's Medicines Price Registry at the time of publication

Cream 5%

• Betadine (Adcock/Mundipharm)
• Biocream (B Braun)

Ointment 10%

• Barrs Povidone Iodine (Barrs)
• Betadine (Adcock/Mundipharm)
• Dermadine (Cipla)
• Podine (Aspen)
• Septadine (Ranbaxy)
• Septisooth (Aspen)

Also available in the following forms: Vaginal gel, douche, surgical scrub, solution, shampoo and oral antiseptic.