Version May 2024
Iodine supplement: IV: 1 to 2 mcg/kg/day (usual range: 75 to 150 mcg/day) administered in parenteral nutrition (PN). For women who are pregnant or breastfeeding, 2 to 3 mcg/kg/day administered in PN.
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage may need to be adjusted, reduced, or omitted.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
Iodine supplement: Children and Adolescents: IV: 2 to 3 mcg/kg/day administered in parenteral nutrition (PN).
There are no dosage adjustments provided in the manufacturer's labeling; use with caution; dosage may need to be adjusted, reduced, or omitted.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Hematologic & oncologic: Eosinophilia, hemorrhage, lymph node hyperplasia
Hypersensitivity: Anaphylactic shock, angioedema, hypersensitivity
Neuromuscular & skeletal: Arthralgia
Miscellaneous: Fever
Known hypersensitivity to iodine or any component of the formulation; undiluted administration into a peripheral vein
Concerns related to adverse effects:
• Hypersensitivity reactions: Hypersensitivity reactions, including anaphylactic shock (sometimes fatal), have been reported; evaluate patients for iodide sensitivity prior to administration and discontinue immediately if a reaction occurs.
Disease-related concerns:
• Renal impairment: Use with caution; iodine supplements in total parenteral nutrition solutions may need to be adjusted, reduced, or omitted.
Dosage form specific issues:
• Aluminum: The parenteral product may contain aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register 2002). See manufacturer's labeling.
Other warnings/precautions:
• Appropriate use: Sodium iodide is a hypotonic solution; administer in admixtures only.
• Other sources of iodine: Iodine is readily absorbed through skin, lungs, and mucous membranes; consider environmental and topical (eg, topical skin disinfectants, surgical swabs, solutions) sources of iodine and their contribution to iodine stores.
Iodopen has been discontinued in the US for more than 1 year.
Solution (Iodopen Injection)
100 mcg/mL (per mL): $1.25
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Injection:
Micro I: 100 mcg/mL (10 mL)
IV: Administer in admixtures only. Do not administer undiluted into a peripheral vein; phlebitis may occur.
IV: Administer in admixtures only. Do not administer undiluted into a peripheral vein; phlebitis may occur.
Iodine supplement: Supplement to IV solutions given for parenteral nutrition to prevent depletion of endogenous iodine stores and subsequent deficiency symptoms.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Sodium Iodide I131: Sodium Iodide may diminish the therapeutic effect of Sodium Iodide I131. Management: Discontinue sodium iodide supplementation at least 10 days before sodium iodide I-131 administration, and avoid concurrent use. Risk X: Avoid combination
Iodine is an essential trace element; maternal requirements are increased during pregnancy (IOM 2001).
An adequate amount of iodine intake is essential for thyroid function. Iodine deficiency in pregnancy can lead to neurologic damage in the newborn; an extreme form, cretinism, is characterized by gross intellectual disability, short stature, deaf mutism, and spasticity. Large amounts of iodine during pregnancy can cause fetal goiter or hyperthyroidism (IOM 2001).
Sodium iodide for injection may be used in pregnant patients as an iodine supplement when needed in parenteral nutrition. Sodium iodide may also be used in the management of thyroid storm or thyrotoxic heart failure in pregnant patients (ACOG 2020).
Iodine is present in breast milk; concentrations vary depending on maternal dietary intake (IOM 2001).
Requirements are increased during lactation (IOM 2001). Sodium iodide for injection may be used in breastfeeding patients as an iodine supplement when needed in parenteral nutrition.
Dietary reference intake for iodine (IOM 2001):
0 to 6 months: Adequate intake: 110 mcg/day
7 to 12 months: Adequate intake: 130 mcg/day
1 to 8 years: RDA: 90 mcg/day
9 to 13 years: RDA: 120 mcg/day
≥14 years: RDA: 150 mcg/day
Pregnancy: RDA: 220 mcg/day
Lactation: RDA: 290 mcg/day
Deficiency: 24-hour urinary collection for iodine content is used to determine inadequate body stores. A level <5 mcg/dL suggests a deficiency. For pregnant women, a value <2 mcg/dL increases the risk of the infant being born with cretinism. Elevated levels of T3 >24 ng/dL in adults 20 to 49 years of age and >181 ng/dL in adults 50 to 90 years of age indicate an iodine deficiency (McKeever 2017).
Toxicity: Elevated thyroid-stimulating hormone (TSH) and Jod-Basedow phenomenon: Nodular goiter, weight loss, tachycardia, muscle weakness, and skin warmth indicate iodine toxicity (McKeever 2017).
Iodine is required for thyroid hormone synthesis.
Absorption: Rapid (oral)
Excretion: Urine (major); bile (minor)
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