Povidon-I

• Antiseptic for skin and mucous membranes:
  Preoperative skin preparation to reduce microbial flora and prevent surgical site infections.
• Wound care:
  Treatment and prevention of infection in minor burns, cuts, abrasions, and lacerations.
• Mucosal antisepsis:
  Oral, pharyngeal, vaginal, and rectal antiseptic applications (e.g., gargle or douche).
• Treatment of localized infections:
  Used in superficial bacterial and fungal infections of the skin and mucous membranes.
• Off-label and adjunctive uses:
  Management of chronic wounds, pressure ulcers, diabetic foot ulcers, and catheter site antisepsis.

• Topical use:
  Apply povidone iodine solution, ointment, or ointment-coated dressing directly to the affected area 1–3 times daily or as prescribed until healing occurs.
• Preoperative skin preparation:
  Apply liberally to the surgical site and surrounding area; allow to dry before incision.
• Mucosal application (e.g., gargle or vaginal douche):
  Dilute according to product instructions (commonly 0.5%–1%) and use as a rinse or soak for recommended durations.
• Special populations:
  Avoid deep wound or large surface area application in neonates and infants due to risk of systemic iodine absorption.
• Precautions:
  Avoid application on large, open wounds or severely damaged skin without medical supervision.

Povidone iodine is a complex of polyvinylpyrrolidone (povidone) and iodine that releases free iodine gradually when applied to tissues. Free iodine penetrates microbial cell walls, inactivates proteins and nucleic acids, and disrupts microbial metabolism. This leads to rapid and broad-spectrum microbicidal activity against bacteria, viruses, fungi, protozoa, and spores, preventing infection and promoting wound healing.

• Absorption:
  Minimal systemic absorption when applied topically on intact skin; increased absorption on large or damaged skin surfaces.
• Distribution:
  Systemic iodine distributes rapidly; excess iodine is primarily stored in the thyroid gland.
• Metabolism:
  Iodine is incorporated into thyroid hormones or excreted unchanged.
• Excretion:
  Primarily via the kidneys in urine.
• Onset:
  Immediate antiseptic action upon application.
• Half-life:
  Not applicable due to topical use and local action; systemic iodine half-life ~7–14 days in thyroid metabolism.

• Pregnancy:
  Category C. Topical use considered relatively safe; avoid extensive application due to potential fetal thyroid effects.
• Lactation:
  Minimal systemic absorption; considered safe for topical use. Caution if large areas are treated.
• Data limited: Avoid ingestion or mucosal application in pregnancy without medical supervision.

• Antiseptic
• Topical antimicrobial agent

• Known hypersensitivity or allergy to iodine or povidone iodine
• Patients with thyroid disorders (e.g., hyperthyroidism) without medical supervision
• Large open wounds in neonates and premature infants
• Use in persons with iodine dermatitis or dermatitis herpetiformis
• Avoid mucosal application in patients with thyroid disease unless supervised

• Risk of systemic iodine absorption with large area or prolonged application, potentially causing thyroid dysfunction or iodine toxicity.
• Use caution in pregnant or breastfeeding women, neonates, and patients with thyroid disease.
• May cause skin irritation, redness, or sensitization; discontinue if severe reactions occur.
• Avoid contact with eyes and deep tissues.
• Monitor for signs of iodism (metallic taste, burning sensation, swelling).

• Common:
  Local burning, itching, redness, or irritation at application site.
• Uncommon/Rare:
  Allergic reactions, contact dermatitis, rash, swelling.
• Serious:
  Iodine toxicity with extensive use (thyroid dysfunction, metabolic disturbances).
• Onset usually rapid with topical irritation; systemic effects rare but possible with misuse.

• May interfere with thyroid function tests and iodine uptake studies.
• Concurrent use with other topical antiseptics may increase irritation.
• Systemic iodine may interact with thyroid medications.
• No CYP450 enzyme involvement.

• Continued recommendation as first-line topical antiseptic in surgical site preparation and minor wound care.
• Increased caution advised for use in neonates and large wounds due to systemic absorption risks.
• Label updates emphasize avoiding ingestion and careful use in pregnancy and thyroid disease.

• Store at 20°C to 25°C (68°F to 77°F), protect from light and freezing.
• Keep container tightly closed.
• Avoid contamination by using sterile applicators or single-use packaging.