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povidone-iodine (Betadine)
Indications:
- topical antiseptic
- chronic rhinosinusitis
- nasopharyngeal decolonization of SARS-CoV2 povidone-iodine mouthwash & nasal spray may reduce infectious SARS-CoV2 in adults with mild to moderate COVID-19 [4]
Contraindications:
1) hypersensitivity to iodine
2) pregnancy
Pregnancy category: D
Dosage:
- apply PRN
surgical scrub: 7.5%
topical solution: 10%, 1 pint.
swab-stick: 10%.
povidone-iodine mouthwash 5 & 10 mg/mL (RxNorm)
Adverse effects:
1) rash
2) local edema
3) systemic absorption in burn patients resulting in iododerma, metabolic acidosis & renal impairment
4) thyroid dysfunction manifested by increased serum TSH 3.4 vs 2.1 mIU/L at baseline in 42% using mouthwash & nasal spray for COVID-19 [4]
- serum TSH returned to baseline 7-12 days later
- no change in thyroid hormone (free T4, free T3) noted [4]
Toxicity:
- highly toxic if ingested
- sodium thiosulfate is antidote
Mechanism of action:
1) antibacterial
2) antifungal
3) antiprotozoal
4) lytic for spores
General
topical antiseptic
Database Correlations
PUBCHEM cid=410087
References
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
- Lexi-Comp, 2006
- Panchmatia R, Payandeh J, Al-Salman R et al
The efficacy of diluted topical povidone-iodine rinses in the management
of recalcitrant chronic rhinosinusitis: a prospective cohort study.
Eur Arch Otorhinolaryngol. 2019 Dec;276(12):3373-3381.
PMID: 31560120
- Walker M
Anti-COVID Mouthwash: Spit, Don't Swallow?
- Some reduction in viral load in infected patients, pilot study finds.
MedPage Today February 4, 2021
https://www.medpagetoday.com/infectiousdisease/covid19/91049
- Guenezan J, Garcia M, Strasters D et al
Povidone Iodine Mouthwash, Gargle, and Nasal Spray to Reduce
Nasopharyngeal Viral Load in Patients With COVID-19A Randomized
Clinical Trial.
JAMA Otolaryngol Head Neck Surg. Published online February 4, 2021.
PMID: 33538761
https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2775984
Component-of
benzocaine/povidone iodine
betamethasone/bupivacaine/isopropanol/povidone iodine
betamethasone/isopropanol/lidocaine/povidone iodine
bupivacaine/dexamethasone/isopropanol/povidone iodine
bupivacaine/h2o/isopropanol/lidocaine/methylprednisolone/povidone iodine/sodium chloride
bupivacaine/isopropanol/lidocaine/methylprednisolone/povidone iodine
bupivacaine/isopropanol/lidocaine/povidone iodine
bupivacaine/lidocaine/povidone iodine
bupivacaine/lidocaine/povidone iodine/triamcinolone
dexamethasone/isopropanol/lidocaine/povidone iodine
dexamethasone/isopropanol/povidone iodine
ethanol topical/povidone iodine
ethanol/isopropanol/povidone iodine
ethanol/povidone iodine
inhalation agent/lidocaine/povidone iodine/triamcinolone
iodine/isopropanol/povidone iodine
isopropanol/ketorolac/lidocaine/povidone iodine
isopropanol/lidocaine/methylprednisolone/povidone iodine
isopropanol/povidone iodine
lidocaine/povidone iodine/triamcinolone
Components
iodine [I]
iodophor
povidone