Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Injection:
Iodopen: 100 mcg/mL (10 mL [DSC])
Pharmacology
Mechanism of Action
Iodine is required for thyroid hormone synthesis.
Pharmacokinetics/Pharmacodynamics
Absorption
Rapid (oral)
Excretion
Urine (major); bile (minor)
Use: Labeled Indications
Iodine supplement: Supplement to intravenous solutions given for total parenteral nutrition (TPN) to prevent depletion of endogenous iodine stores and subsequent deficiency symptoms.
Contraindications
Known hypersensitivity to iodine or any component of the formulation; undiluted administration into a peripheral vein
Dosage and Administration
Dosing: Adult
Iodine supplement: IV: 1 to 2 mcg/kg/day (usual range: 75 to 150 mcg/day) administered in TPN solution. For women who are pregnant or breast-feeding, 2 to 3 mcg/kg/day administered in TPN solution
Dosing: Geriatric
Refer to adult dosing.
Dosing: Pediatric
Iodine supplement: Children and Adolescents: IV: 2 to 3 mcg/kg/day administered in TPN solution
Administration
IV: Administer in admixtures only. Do not administer undiluted into a peripheral vein; phlebitis may occur.
Dietary Considerations
Dietary reference intake for iodine (IOM 2001):
0 to 6 months: Adequate intake: 110 mcg/day
7 to 12 months: Adequate intake: 130 mcg/day
1 to 8 years: RDA: 90 mcg/day
9 to 13 years: RDA: 120 mcg/day
≥14 years: RDA: 150 mcg/day
Pregnancy: RDA: 220 mcg/day
Lactation: RDA: 290 mcg/day
Storage
Store at 20°C to 25°C (68°F to 77°F).
Drug Interactions
There are no known significant interactions.
Adverse Reactions
Frequency not defined.
Hematologic & oncologic: Eosinophilia, hemorrhage, lymph node hyperplasia
Hypersensitivity: Anaphylactic shock, angioedema, hypersensitivity
Neuromuscular & skeletal: Arthralgia
Miscellaneous: Fever
Warnings/Precautions
Concerns related to adverse effects:
- Hypersensitivity reactions: Hypersensitivity reactions, including anaphylactic shock (sometimes fatal), have been reported; evaluate patients for iodide sensitivity prior to administration and discontinue immediately if a reaction occurs.
Disease-related concerns:
- Renal impairment: Use with caution; iodine supplements in total parenteral nutrition solutions may need to be adjusted, reduced, or omitted.
Dosage form specific issues:
- Aluminum: The parenteral product may contain aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register 2002). See manufacturer's labeling.
Other warnings/precautions:
- Appropriate use: Sodium iodide is a hypotonic solution; administer in admixtures only.
- Other sources of iodine: Iodine is readily absorbed through skin, lungs, and mucous membranes; consider environmental and topical (eg, topical skin disinfectants, surgical swabs, solutions) sources of iodine and their contribution to iodine stores.
Monitoring Parameters
Periodically monitor thyroid function
Pregnancy
Pregnancy Considerations
Sodium iodide for injection may be used in pregnant women as an iodine supplement when needed in total parenteral nutrition (TPN). An adequate amount of iodine intake is essential for thyroid function. Iodine crosses the placenta and requirements are increased during pregnancy. Iodine deficiency in pregnancy can lead to neurologic damage in the newborn; an extreme form, cretinism, is characterized by gross mental retardation, short stature, deaf mutism, and spasticity. Large amounts of iodine during pregnancy can cause fetal goiter or hyperthyroidism (IOM 2001).
Patient Education
- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
- Have patient report immediately to prescriber bruising, bleeding, chills, joint pain, or swollen glands (HCAHPS).
- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.
