Version May 2024
Antiseptic for minor cuts, scrapes, and burns: Topical: Apply small amount directly to affected area 1 to 3 times daily.
Antiseptic (preoperatively): Topical: Apply to operative site prior to surgery; once dry remove immediately with 70% alcohol.
Wound cleansing (Iodosorb, Iodoflex): Topical: Apply to clean wound; maximum: 50 g/application and 150 g/week. Change dressing ~3 times/week; reduce applications as exudate decreases. Do not use for >3 months; discontinue when wound is free of exudate.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
(For additional information see "Iodine: Pediatric drug information")
Antiseptic for minor cuts, scrapes, burns: Children and Adolescents: Topical: Apply small amount to affected area 1 to 3 times daily
There are no dosage adjustments provided in the manufacturer's labeling, however, adjustment likely unnecessary due to limited systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling, however, adjustment likely unnecessary due to limited systemic absorption.
The following adverse drug reactions are derived from product labeling unless otherwise specified.
Postmarketing:
Endocrine & metabolic: Hypothyroidism (Fujita 2022), increased thyroid stimulating hormone level (Fujita 2022)
Local: Application-site reaction (application-site edema, application-site erythema, application-site irritation, application-site pain, eczema, and local hypersensitivity reaction)
Hypersensitivity to iodine or any component of the formulation
Iodosorb, Iodoflex: Hashimoto thyroiditis, history of Graves disease, or nontoxic nodular goiter; pregnancy; breastfeeding; children <6 months of age (Iodosorb).
Dosage form specific issues:
• Iodoflex, Iodosorb: For use as topical application to wet wounds only; not effective on dry wounds. Wounds may appear larger during the first few days of treatment due to reduction of edema. Use in conjunction with treatment for the underlying condition.
• Tincture: For external use only by health care provider; avoid use in eyes. Avoid use with electrocautery procedures. Discontinue use if irritation or redness develops. Keep away from heat, hot surfaces, open flames, and sparks; do not smoke near.
Other warnings/precautions:
• Appropriate use: Not for application to large areas of the body or for use with tight or air-excluding bandages. When used as a topical antiseptic, improper use may lead to product contamination. Although infrequent, product contamination has been associated with reports of localized and systemic infections. To reduce the risk of infection, ensure antiseptic products are used according to the labeled instructions; avoid diluting products after opening; and apply single-use containers only one time to one patient and discard any unused solution (FDA Drug Safety Communication, 2013).
• OTC labeling: When used for self-medication (OTC), do not use on deep wounds, puncture wounds, animal bites, or serious burns without consulting with health care provider. Notify health care provider if condition does not improve within 7 days.
Some products may contain up to 47% alcohol. Iodine and/or alcohol may be systemically absorbed in some patients; the extent of percutaneous absorption is dependent on several factors, including epidermal integrity (intact vs abraded skin) and age of the patient. Percutaneous absorption of iodine is increased in neonates (especially preterm neonates); risk of systemic absorption and adverse effects higher in neonates due to larger skin surface area to body mass ratio (Mancini 2004).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tincture, External:
GoodSense Iodine: (30 mL)
Generic: 2% (30 mL, 473 mL, 500 mL, 4000 mL, 20000 mL); 7% (59 mL, 480 mL); (473 mL)
Yes
Topical: For external use only; avoid contact with eyes. Wash hands thoroughly before and after use.
Iodoflex: Apply pad to clean wound. Once applied cover wound with dry sterile gauze or other dressing; may apply compression bandaging when appropriate. Change dressing when pad changes color from brown to yellow/gray (~3 times/week). May soak gauze for a few minutes to aid in removal. Remove pad with sterile water or saline; gently blot fluid from surface, leaving wound slightly moist before applying another pad.
Iodosorb: Clean wound and surrounding area with a gentle stream of sterile water or saline; do not dry wound surface. Apply 1/8" to 1/4" thickness of gel to dry sterile gauze, then place prepared gauze onto clean wound. Change dressing when gel changes color from brown to yellow/gray (~3 times/week). Remove with sterile water, saline, or wound cleanser; gently blot fluid from surface, leaving wound slightly moist before reapplying gel.
OTC antiseptic: Apply a small amount to affected area; may cover with sterile bandage once dried.
Topical: Tincture: For external use only. Apply to affected areas; do not apply to large areas of the body; avoid tight bandages because iodine may cause burns on occluded skin.
Antiseptic: Prevention of infection of minor burns, cuts, and scrapes.
Antiseptic (preoperatively): Topical antiseptic to disinfect the skin preoperatively.
Wound cleansing: Topically to clean wet ulcers and wounds (eg, infected surgical and traumatic wounds, pressure sores, venous stasis ulcers); protects and decreases infection.
Iodine may be confused with codeine, Iopidine, Lodine
The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drugs that have a heightened risk of causing significant patient harm when used in error.
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: Iodine may diminish the therapeutic effect of Sodium Iodide I131. Management: Discontinue topical iodine at least 3 weeks before sodium iodide I-131 administration, and avoid concurrent use. Risk X: Avoid combination
Iodine is absorbed systemically following topical application. Endogenous iodine concentrations in cord blood may increase following maternal use of topical iodine containing products; transient hypothyroidism in the newborn may occur following maternal use during pregnancy or at delivery (Bachrach 1984; Danziger 1987; Delange 1988; Tahirović 2009).
Some products may contain up to 47% alcohol, which may also be systemically absorbed in some patients.
Iodine is present in breast milk; concentrations vary depending on maternal dietary intake (IOM 2001).
Endogenous concentrations of iodine in breast milk may increase following maternal use of topical iodine containing products; transient hypothyroidism in the breastfed newborn may occur (Delange 1988; Dorea 2002; Koga 1995).
Thyroid function should be monitored in pregnant women, neonates, and young infants if repeat applications over large areas are needed.
Iodine is required for thyroid hormone synthesis. Iodine is also known to be a powerful broad spectrum germicidal agent effective against a wide range of bacteria, viruses, fungi, protozoa, and spores. Iodosorb and Iodoflex contain iodine in hydrophilic beads of cadexomer which allows a slow release of iodine into the wound and absorption of fluid, bacteria, and other substances from the wound
Absorption: Topical: Amount absorbed systemically depends upon concentration and characteristics of skin
Distribution: Primarily trapped by the thyroid
Metabolism: Degraded by amylases normally present in wound fluid
Excretion: Urine (>90%)
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