Drug formLiquid (for external use)
ATC categoryUrology, Nephrology
ATC subcategoryTopical antimicrobials
Generic namePovidone Iodine
Each ml of Betaiodine, 10% solution, contains:
active ingredient: povidone iodine – 100 mg;
excipients: sodium phosphate dibasic, citric acid, glycerin, nonoxynol 9, water purified.
2-Pyrrolidinone, 1-ethenyl-, homopolymer, compd. with iodine; 25655-41-8.
Antiseptic; D08AG02; G01AX11.
Betaiodine – povidone-iodine – is an iodophore that is used as a disinfectant and antiseptic mainly for the treatment of contaminated wounds and pre-operative preparation of the skin and mucous membranes as well as for the disinfection of equipment.
Iodophores are loose complexes of iodine and carrier polymers. Solutions of povidone-iodine gradually release iodine to exert an effect against bacteria, fungi, viruses, protozoa, cysts, and spores; povidone-iodine is thus less potent than preparations containing free iodine but it is less toxic.
Iodine is slightly absorbed when applied to the skin. When taken by mouth, iodine preparations (which are converted to iodide) are transported to, and concentrated in, the thyroid gland. Iodides not taken up by the thyroid are excreted mainly in the urine, with smaller amounts appearing in the faeces, saliva, and sweat. They cross the placenta and are distributed into breast milk.
For once-only use:
For repeated, time-limited use:
Antiseptic wound treatment (e.g. decubitus and varicose ulcers), burns, infected and superinfected dermatoses.
Antiseptic and disinfectant
Used as a disinfectant or antiseptic for the skin or mucosa, e.g., prior to surgery, biopsies, injections, punctures, blood-taking and bladder catheterisations Betaiodine should be applied undiluted.
For the disinfection of skin areas with a sparse distribution of sebaceous glands the exposure time is at least one minute, in skin areas with a dense distribution of sebaceous glands at least 10 minutes. The skin should be kept moist for the entire duration of the exposure time with the undiluted preparation.
For the antiseptic treatment of superficial wounds Betaiodine is applied undiluted to the areas to be treated.
In antiseptic topical therapy of burn wounds. Betaiodine is generally applied undiluted to the areas to be treated.
For antiseptic irrigation washes and baths Betaiodine can be diluted. The following dilutions are recommended as standard rations:
Betaiodine is intended for topical application either undiluted or diluted.
Normal tap water is suitable for dilution. Where conditions approximating isotonicity are desired, physiological saline or Ringer’s solution can be used.
For application to the eye solutions buffered with phosphate buffer solutions are recommended.
Dilutions must always be freshly prepared and used immediately.
Sufficient Betaiodine must be applied to wet the area to be treated completely. The antiseptic film that forms as it dries can be easily rinsed off with water.
Due to the possibility of skin irritations when used for preoperative disinfection of the skin the “formation of a puddle” under the patient should be avoided.
In repeated use, the frequency and duration of application depends on the indication for use. Betaiodine, freshly prepared for each use, can be applied several times daily.
Wound treatment should be continued for as long as there are signs of an infection or a marked risk of infection of the wound. Should infection reoccur after discontinuing treatment with Betaiodine, treatment can be resumed.
The brown colouration caused by Betaiodine is a property of the preparation and indicates its efficacy. Considerable decolouration indicates exhaustion of the efficacy of the preparation.
Betaiodine can cause hypersensitivity reactions and irritation of the skin and mucous membranes, although severe reactions are rare and povidone-iodine is considered to be less irritant than iodine.
The application of Betaiodine to severe burns or to large areas otherwise denuded of skin may produce the systemic adverse effects associated with iodine and metabolic acidosis, hypernatraemia, and renal impairment. Hyperthyroidism or hypothyroidism may occur after ingestion or absorption of large quantities. Hypothyroidism has occurred in neonates both as a result of absorption of iodine from Betaiodine applied to the neonate and also to the mother during pregnancy or breast feeding. Betaiodine application is contra-indicated in premature neonates or those weighing less than 1.5 kg.
Regular or prolonged use should be avoided in patients with thyroid disorders or those receiving lithium therapy.
Following inadvertent oral intake of large amounts of povidone-iodine, symptoms of acute iodine in-toxication can manifest such as abdominal pain and cramps, nausea, vomiting, diarrhoea, dehydration, drop in blood pressure (persistent), tendency to collapse, epiglottitis, haemorrhagic diathesis (mucosal membranes and kidneys), cyanosis, renal damage (acute tubular necroses up to anuria [after1-3 days]), parathesias, fever and pulmonary oedemas. Following long-term excessive intake of iodine, hyperthyroidism, tachycardia, restlessness, tremor and headache can occur as symptoms.
In the literature, symptoms of intoxication after the intake of more than 10g povidone-iodine were reported.
Therapeutic measures to treat cases of intoxication
Immediate administration of foodstuffs containing starch and protein, e.g., corn flour stirred into milk or water, or gastric lavage with 5% sodium thiosulphate solution or starch suspension.
After absorption has already taken place toxic serum iodine concentrations can be reduced effectively by peritoneal dialysis or haemodialysis.
Thyroid function must be monitored carefully clinically to rule out or identify at any early stage any possible iodine-induced hyperthyroidism.
Further therapy is carried out as required to manage other possible existing symptoms such as metabolic acidosis and renal dysfunction, for example.
Treatment of iodine-induced hyperthyroidism
The treatment of iodine-induced hyperthyroidism is conducted as clinically indicated. Mild forms may require no treatment, pronounced forms may require anti-thyroid medical therapy (which is, however, effective only after a delay). In the most severe cases (thyrotoxic crisis), intensive therapy, plasmapheresis or thyroidectomy may be required.
Betaiodine should only be applied after careful diagnosis
− over a prolonged period (>14 days) and on extensive areas (e.g., over 10% of the body surface area), in patients with:
− to an extremely limited extent in neonates and nursing infants up to the age of 6 months as the risk of hypothyroidism cannot be completely ruled out. After applying Betaiodine function should be checked. In the case of hypothyroidism, early treatment with thyroid hormones must be carried out until thyroid function becomes normal. Accidental oral intake by the nursing infant must be avoided.
Regular or prolonged use should be avoided with patients with thyroid disorders or those receiving lithium therapy.
During pregnancy and the lactation period, Betaiodine– as in all preparations containing iodine – must only be administered following a very careful assessment of the risk/benefit and in extremely limited amounts. After applying Betaiodine thyroid function must be monitored in the child. In the event of hypothyroidism, immediate treatment with thyroid hormones must be carried out until thyroid function returns to n ormal.
The accidental oral intake of Betaiodine by the nursing infant as a result of contact with the treated site of the nursing mother’s body must be avoided.
If, due to the nature and the extent of the application of Betaiodine, a marked absorption of iodine is to be expected, it must be taken into account that, as a result, the iodine content of the mother’s milk may also increase.
Effect on diagnostic tests:
A brown colored liquid having a characteristic iodine odor.
Solution for topical use is filled into 30 ml, 60 ml and 100 ml plastic bottles inserted together with leaflet in cardboard box.
1, 3.6, 4 liters in plastic bottles closed with caps.
Store in a cool and dry place, out of the reach of children. Protect from light.
To be dispensed withоut prescription.