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Sodium Iodide

Pronunciation

(SOW dee um EYE oh dide)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Injection:

Iodopen: (10 mL)

Brand Names: U.S.

  • Iodopen

Pharmacologic Category

  • Trace Element, Parenteral

Pharmacology

Iodine is required for thyroid hormone synthesis.

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

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

Dietary reference intake for iodine (IOM 2001):

Adults: RDA: 150 mcg/day

Pregnancy: RDA: 220 mcg/day

Breast-feeding: RDA: 290 mcg/day

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Iodine supplement: Children and Adolescents: IV: 2 to 3 mcg/kg/day administered in TPN solution

Dietary reference intake for iodine (IOM, 2001):

Infants 0 to 6 months: Adequate intake: 110 mcg/day

Infants 7 to 12 months: Adequate intake: 130 mcg/day

Children 1 to 8 years: RDA: 90 mcg/day

Children 9 to 13 years: RDA: 120 mcg/day

Adolescents ≥14 years: RDA: 150 mcg/day

Pregnancy: RDA: 220 mcg/day

Breast-feeding: RDA: 290 mcg/day

Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer's labeling; however, dosage may need to be adjusted, reduced, or omitted.

Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer's labeling.

Administration

IV: Administer in admixtures only. Do not administer undiluted into a peripheral vein; phlebitis may occur.

Compatibility

Compatible with electrolytes and other trace elements in amino-acid/dextrose solutions used for total parenteral nutrition.

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 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.

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