Povidone-iodine

How it works

It releases free iodine, which oxidises microbial cell components and is rapidly microbicidal against bacteria, viruses, fungi and spores.

Prescribing in practice

• Avoid regular or prolonged use in pregnancy and breastfeeding and in neonates, as absorbed iodine can affect thyroid function, particularly with large or repeated applications.
• Use with caution in patients with thyroid disorders and avoid in those with known iodine hypersensitivity.
• Absorption increases when applied to large wounds, broken skin or mucous membranes, or under occlusion, so limit the area and duration in such cases.

Monitoring

For extensive or prolonged use, particularly in neonates or pregnancy, consider monitoring thyroid function and watch for local sensitivity.

Counselling the patient

• It stains skin and clothing brown, which washes off skin over time.
• Tell your clinician if you have a thyroid condition or an iodine allergy.
• Avoid using it regularly over large areas without advice, especially in pregnancy or for babies.

Evidence & guidelines

Povidone-iodine is a long-established broad-spectrum antiseptic widely used for skin antisepsis and wound care, supported by extensive clinical use and the SPC.