Iodine : Dosing

by MedlinePlus

(Page 3 of 5)

Standardization:

Oral iodineis available in various preparations, for example as Lugol solution (5% iodine, 10% potassium iodide), containing approximately 8mg iodide/drop; or as saturated solution of potassium iodide (SSKI, PIMA), containing approximately 50mg iodide/drop.

Topical iodineis available in various preparations, for example as povidone-iodine which comes in different concentrations.

Adults (18 years and older):

U.S. Recommended Daily Allowance (RDA): 150mcg daily in adults ages 18 and older (220mcg daily for pregnant women, 290mcg daily for breastfeeding women).

Tolerable Upper Intake Levels (UL):1100mcg daily in adults ages 18 and older.

Hyperthyroidism, Graves disease, thyroid storm: As an adjunct to prescription drug inhibitors of thyroid function (such as propylthiouracil or methimazole), saturated solution of potassium iodide (SSKI, PIMA) 1-5 gtt by mouth every 8 hours, or Lugol solution (8mg iodide per drop) 2-6 gtt (1 mL) every 8 hours has been used. For thyrotoxicosis, parenteral treatment may be used, and sodium iodide 1 gram by slow intravenous drip every 8-12 hours has been given. Management should be under the supervision of a licensed healthcare professional. Lower doses may be used in pregnancy.

Preoperative before thyroidectomy: Lugol solution 5-10 gtt three times daily, or 2-6 gtt twice or three times daily given 10-21 days prior to surgery has been used. Use for longer than 14 days can lead to "iodide escape" with rebound thyrotoxicosis, and should be avoided. In pregnant women there is a risk of fetal goiter, although brief administration of lower doses (6-40mg per day) can be considered. Potassium iodide (SSKI, PIMA) 1-2 gtt three times daily mixed in juice or water has also been given. Administration of these preparations should be under the direction of the operating surgeon.

Skin/wound sterilization: Various concentrations of iodine have been used, for example 2% tincture or 2% aqueous solution to affected areas; 10% povidone-iodine applied prior to insertion of catheters; 0.9% iodine ointment for diabetic foot ulcers; and 1% povidone-iodine for wound irrigation. Use as directed.

Iodine deficiency: Iodine deficiency is rare in industrialized countries due to supplementation of table salt and cattle feed with iodine. In areas of endemic iodine deficiency, various doses of iodine have been used as prevention or treatment, including 200mg or 2mL of iodized oil daily by mouth. For prolonged supplementation, a single annual intramuscular injection with 1mL Lipiodol UF (480mg of iodine) or 570mg of oral iodine has been used. In those with goiter induced by iodine deficiency, correction may not be practical, and treatment should involve thyroid hormone replacement with levothyroxine sodium (Synthroid, Levoxyl, Levothroid).

Goiter: In those with goiter induced by iodine deficiency, correction may not be practical, and treatment should involve thyroid hormone replacement with levothyroxine sodium (Synthroid, Levoxyl, Levothroid). If practical, iodine deficiency can be corrected, although iodine deficiency is rare in industrialized countries due to supplementation of table salt and cattle feed with iodine. See above dosing for iodine deficiency. Other causes of goiter should also be considered, under the supervision of a licensed healthcare professional. For endemic goiter, 400mcg of iodine dialy as di-iodotyrosine has been used, or 150mcg iodine/500mcg iodide with levothyroxine has been used. For gestational goiter, under medical supervision, doses of 50-200mcg of iodide daily has been used.

Radiation emergencies: Potassium iodide (KI) should be taken just prior to, or as soon as possible after exposure. For adults exposed to 10 centigrays (cGy) of radiation or more, KI 130mg is given (for pregnant or lactating women, 120mg KI is administered for radiation exposure of 5cGy or more).

Water sterilization: Salt iodization of water supplies on a large-scale basis can be performed with the addition of iodide or iodate salt with an iodine content varying from 7-100mg/kg of salt. For individual use,tincture of iodine 3-10 drops per quart of water has been used, with 15 minutes for anti-microbial effects to occur.

Cataract surgery antisepsis: 1% povidone-iodine solution used preoperatively.

Mouthwash: As an antibacterial mouthwash, 10-20mL of povidone-iodine mouthwash has been used as a rinse and gingival sulcus irrigant. For prevention of plaque and gingivitis, mouth rinses have been used up to twice daily. For chemotherapy mucositis prevention, povidone-iodine rinses have been used up to four times daily.

Chronic suppurative otitis media: 5% povidone-iodine ear drops, three drops taken three times daily for 10 days has been used, although other approaches such as antibiotics should be considered and discussed with a supervising healthcare professional.

Upper airway sterilization: 1% povidone-iodine solution inhaled via nebulizer twice daily has been used, with gargle twice daily.

Children (younger than 18 years):

Recommended Daily Allowance (RDA):50mcg daily for infants 0-12 months; 90mcg daily for 1-8 years; 120mcg daily for 9-13 years; 150mcg daily for 14-18 years.

Adequate Intake (AI) for infants:110mcg daily for ages 0-6 months; 130mcg daily for 7-12 months.

Tolerable Upper Intake Levels (UL): 200mcg/day for ages 1-3 years; 300mcg/day for 4-8 years; 600mcg/day for 9-13 years; 900mcg/day for 14-18 years (including pregnancy and lactation).

Radiation emergencies: Potassium iodide (KI) should be taken just prior to, or as soon as possible after exposure. For infants, babies, and children, KI is administered for exposure of 5 centigrays (cGy) or more. For birth through 1 month, 16mg can be administered; for 1 month through 3 years, 32mg can be administered; for 3-12 years, 65mg can be administered; for adolescents ages 12-18 years, 65mg can be administered (or up to 120mg if the adolescent is approaching adult size).

Skin/wound sterilization: Various concentrations of iodine have been used, for example 2% tincture or 2% aqueous solution to affected areas.

Thyroid disorders: Children should be managed under medical supervision.

Iodine deficiency: Iodine deficiency is rare in industrialized countries due to supplementation of table salt and cattle feed with iodine. In areas of endemic iodine deficiency, various doses of iodine have been used as prevention or treatment in children, including 150mcg/day.

Ophthalmia neonatorum prevention:1 drop of 2.5% povidone-iodine applied at birth has been used. No advantage of a second drop has been found.

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