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potassium iodide
V03AB21
Forms & Strengths
- Oral Solution: 1 g/mL (SSKI)
- Oral Solution: 325 mg/5 mL (Lugol's solution contains ~100 mg iodine/mL)
Adult Dosing
- Thyroid blocking in radiation emergency: 130 mg orally once daily
- Preoperative preparation for thyroidectomy: 50-250 mg (1-5 drops of SSKI) orally 3 times daily for 10 days before surgery
- Expectorant: 300-600 mg orally every 4 hours as needed
Pediatric Dosing
- Radiation emergency (>1 month to 18 years, <70 kg): 65 mg orally once daily
- Radiation emergency (newborn to 1 month): 32.5 mg orally once daily
- Expectorant (pediatric): Safety and efficacy not well established; use lowest effective dose
Indications
- Blocking thyroid uptake of radioactive iodine during radiation emergencies
- Adjunct preoperatively in hyperthyroidism (thyroid storm or preparation for thyroidectomy)
- Expectorant for chronic pulmonary diseases with mucous congestion
Mechanism of Action
- High doses of circulating iodide temporarily inhibit thyroid hormone synthesis and release (Wolff-Chaikoff effect)
- Saturates the thyroid gland with stable iodide to prevent uptake of radioactive iodine isotopes
- Expectorant action via direct and reflex stimulation of respiratory tract secretion
Contraindications
- Hypersensitivity to iodine
- Dermatitis herpetiformis
- Hypocomplementemic vasculitis
- Hyperthyroidism (except in specific pre-surgical or thyroid storm settings)
- Nodular thyroid gland with heart disease
Adverse Reactions
- Gastrointestinal upset, diarrhea, nausea, vomiting
- Hypothyroidism or hyperthyroidism (iod_based goiter)
- Allergic reactions (rash, angioedema, salivary gland swelling)
- Iodism (metallic taste, burning mouth, sore teeth, increased salivation, head cold symptoms)
Drug Interactions
- Lithium: Concomitant use may produce synergistic hypothyroid effects
- Potassium-sparing diuretics and ACE inhibitors: Increased risk of hyperkalemia due to potassium content in the formulation
- Antithyroid drugs (e.g., methimazole, propylthiouracil): Increased risk of pronounced hypothyroidism
Curated Content: Needs Vetting Before Put to Clinical Use