potassium iodide (Rx, OTC)

Brand and Other Names:Pima Syrup, SSKI, more...iosat, ThyroSafe, ThyroShield
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 65mg
  • 130mg

oral solution

  • 65mg/mL
  • 325mg/5mL

oral solution (concentrated)

  • 1g/mL

Radiation Emergency

Indicted during environmental radiation emergency to block uptake of radioactive iodine isotopes in thyroid and reduce risk of thyroid cancer

130 mg PO qDay; not to exceed 1 dose/24 hr

Ideally initiate 1-48 hr prior to exposure

Continue daily dose until exposure risk has passed and/or until other measures (eg, evacuation, sheltering, control of the food and milk supply) have been successfully implemented

Risk reduction with acute exposure

  • KI initiated shortly before or immediately after acute exposure: 90-99% risk reduction
  • KI initiated within 3-4 hr after acute exposure: 50% risk reduction
  • KI initiated up to 12 hr after acute exposure: limited benefit may be achieved

Expectorant

SSKI: 300-600 mg PO q6-8hr

Thyrotoxic Crisis

250-500 mg (5-10 gtt of 1 g/mL) PO q4-6hr

Preoperative Thyroidectomy

50-250 mg (1-5 gtt of 1 g/mL) PO q8hr for 10-14 days

Other Indications & Uses

Cystic fibrosis, chronic sinusitis (adjunct)

Dosage Forms & Strengths

tablet

  • 65mg
  • 130mg

oral solution

  • 65mg/mL
  • 325mg/5mL

oral solution

  • 1g/mL

Radiation Emergency

Indicted during environmental radiation emergency to block uptake of radioactive iodine isotopes in thyroid and reduce risk of thyroid cancer

Infants <1 month: 16.25 mg PO qDay; not to exceed 1 dose/24 hr

1 month-3 years: 32.5 mg PO qDay; not to exceed 1 dose/24 hr

3-13 years: 65 mg PO qDay; not to exceed 1 dose/24 hr

>13 years or adolescents weighing >70 kg (154 lb): 130 mg PO qDay; not to exceed 1 dose/24 hr

Ideally initiate 1-48 hr prior to exposure

Continue daily dose until exposure risk has passed and/or until other measures (eg, evacuation, sheltering, control of the food and milk supply) have been successfully implemented

Risk reduction with acute exposure

  • KI initiated shortly before or immediately after acute exposure: 90-99% risk reduction
  • KI initiated within 3-4 hr after acute exposure: 50% risk reduction
  • KI initiated up to 12 hr after acute exposure: limited benefit may be achieved

Neonatal Graves Disease

SSKI: 1 gtt PO q8hr

Expectorant

SSKI: 60-250 mg PO q6hr

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Interactions

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            Contraindicated (1)

            • sodium iodide I-131

              potassium iodide will decrease the level or effect of sodium iodide I-131 by Other (see comment). Contraindicated. Discontinue iodide-containing supplements at least 10 days before administering sodium iodide I-131 and do not coadminister; thyroid agents decrease uptake of sodium iodide I-131 by the thyroid gland.

            Serious - Use Alternative (0)

              Monitor Closely (53)

              • amiloride

                potassium iodide and amiloride both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of potassium-sparing diuretics.

              • aspirin

                potassium iodide and aspirin both increase serum potassium. Use Caution/Monitor.

              • aspirin rectal

                potassium iodide and aspirin rectal both increase serum potassium. Use Caution/Monitor.

              • azilsartan

                potassium iodide and azilsartan both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ARBs; the effect may be the result of aldosterone suppression in patients receiving ARBs.

              • benazepril

                potassium iodide and benazepril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

              • candesartan

                potassium iodide and candesartan both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ARBs; the effect may be the result of aldosterone suppression in patients receiving ARBs.

              • captopril

                potassium iodide and captopril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

              • celecoxib

                potassium iodide and celecoxib both increase serum potassium. Use Caution/Monitor.

              • choline magnesium trisalicylate

                potassium iodide and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

              • diclofenac

                potassium iodide and diclofenac both increase serum potassium. Use Caution/Monitor.

              • diflunisal

                potassium iodide and diflunisal both increase serum potassium. Use Caution/Monitor.

              • drospirenone

                potassium iodide and drospirenone both increase serum potassium. Use Caution/Monitor.

              • enalapril

                potassium iodide and enalapril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

              • eprosartan

                potassium iodide and eprosartan both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ARBs; the effect may be the result of aldosterone suppression in patients receiving ARBs.

              • etodolac

                potassium iodide and etodolac both increase serum potassium. Use Caution/Monitor.

              • fenoprofen

                potassium iodide and fenoprofen both increase serum potassium. Use Caution/Monitor.

              • flurbiprofen

                potassium iodide and flurbiprofen both increase serum potassium. Use Caution/Monitor.

              • fosinopril

                potassium iodide and fosinopril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

              • ibuprofen

                potassium iodide and ibuprofen both increase serum potassium. Use Caution/Monitor.

              • ibuprofen IV

                potassium iodide and ibuprofen IV both increase serum potassium. Use Caution/Monitor.

              • ibuprofen/famotidine

                potassium iodide and ibuprofen/famotidine both increase serum potassium. Use Caution/Monitor.

              • indomethacin

                potassium iodide and indomethacin both increase serum potassium. Use Caution/Monitor.

              • iodine (radioactive)

                potassium iodide, iodine (radioactive). Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Concomitant use with antithyroid drugs may potentiate the hypothyroid and goitrogenic effects of potassium iodide.

              • irbesartan

                potassium iodide and irbesartan both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ARBs; the effect may be the result of aldosterone suppression in patients receiving ARBs.

              • ketoprofen

                potassium iodide and ketoprofen both increase serum potassium. Use Caution/Monitor.

              • ketorolac

                potassium iodide and ketorolac both increase serum potassium. Use Caution/Monitor.

              • ketorolac intranasal

                potassium iodide and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.

              • lisinopril

                potassium iodide and lisinopril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

              • lithium

                potassium iodide, lithium. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Concomitant use with antithyroid drugs may potentiate the hypothyroid and goitrogenic effects of potassium iodide.

              • losartan

                potassium iodide and losartan both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ARBs; the effect may be the result of aldosterone suppression in patients receiving ARBs.

              • meclofenamate

                potassium iodide and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • mefenamic acid

                potassium iodide and mefenamic acid both increase serum potassium. Use Caution/Monitor.

              • meloxicam

                potassium iodide and meloxicam both increase serum potassium. Use Caution/Monitor.

              • methimazole

                potassium iodide, methimazole. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Concomitant use with antithyroid drugs may potentiate the hypothyroid and goitrogenic effects of potassium iodide.

              • moexipril

                potassium iodide and moexipril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

              • nabumetone

                potassium iodide and nabumetone both increase serum potassium. Use Caution/Monitor.

              • naproxen

                potassium iodide and naproxen both increase serum potassium. Use Caution/Monitor.

              • olmesartan

                potassium iodide and olmesartan both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ARBs; the effect may be the result of aldosterone suppression in patients receiving ARBs.

              • oxaprozin

                potassium iodide and oxaprozin both increase serum potassium. Use Caution/Monitor.

              • perindopril

                potassium iodide and perindopril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

              • piroxicam

                potassium iodide and piroxicam both increase serum potassium. Use Caution/Monitor.

              • potassium citrate

                potassium iodide and potassium citrate both increase serum potassium. Use Caution/Monitor.

              • potassium phosphate

                potassium iodide and potassium phosphate both increase serum potassium. Use Caution/Monitor.

              • propylthiouracil

                potassium iodide, propylthiouracil. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Concomitant use with antithyroid drugs may potentiate the hypothyroid and goitrogenic effects of potassium iodide.

              • quinapril

                potassium iodide and quinapril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

              • ramipril

                potassium iodide and ramipril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

              • sacubitril/valsartan

                potassium iodide and sacubitril/valsartan both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ARBs; the effect may be the result of aldosterone suppression in patients receiving ARBs.

              • salsalate

                potassium iodide and salsalate both increase serum potassium. Use Caution/Monitor.

              • sulindac

                potassium iodide and sulindac both increase serum potassium. Use Caution/Monitor.

              • telmisartan

                potassium iodide and telmisartan both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ARBs; the effect may be the result of aldosterone suppression in patients receiving ARBs.

              • tolmetin

                potassium iodide and tolmetin both increase serum potassium. Use Caution/Monitor.

              • trandolapril

                potassium iodide and trandolapril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

              • valsartan

                potassium iodide and valsartan both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ARBs; the effect may be the result of aldosterone suppression in patients receiving ARBs.

              Minor (0)

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                Adverse Effects

                Frequency Not Defined

                Arrhythmia

                Skin rash

                Gastrointestinal irritation or bleeding

                Diarrhea

                Paresthesia

                Swelling or neck or throat

                Goiter

                Hypothyroidism

                Hyperthyroidism

                Myxedema

                Thyroid adenoma

                Allergic reactions (fever, rash)

                Lymph node swelling

                Salivary gland swelling/tenderness

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                Warnings

                Contraindications

                Iodine sensitivity (although allergy to radiocontrast media, contact dermatitis from iodine-containing antibacterials, allergy to seafood should NOT be considered evidence of potassium iodide allergy)

                Hyperthyroidism

                Respiratory failure

                Cautions

                Avoid repeat dosing in neonates or women who are pregnant or breastfeeding if possible; in acute radiation exposure, prioritize these individuals for evacuation; although these precautions should be taken, the benefits of short-term use of KI to block uptake of radioactive iodine by the thyroid gland far exceed its chances of side effects

                Prescribe for radiation exposure only upon order from authorities

                Caution in tuberculosis

                Iodine poisoining (Iodism): Metallic taste, sore mouth, severe headache

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                Pregnancy & Lactation

                Pregnancy Category: D

                Increased risk of thyroid suppression in the fetus and neonate leads to a specific recommendation that newborns and pregnant women be given priority with regard to evacuation, safe shelter, and safe food/milk during radiation emergency in order to obviate, as possible, the need for repeat dosing with KI

                Lactation: Excreted in breast milk

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Expectorant: Iodine helps to increase respiratory secretions and decrease viscosity

                Hyperthyroidism: Suppresses thyroid hormone synthesis

                Thyroid protective: Systemically circulating potassium iodide is readily taken up by thyroid gland by sodium/iodide transporter in basal membrane; concentration gradient of thyroid gland to plasma is 20-50:1

                Pharmacokinetics

                Distribution: Significant extracellular distribution, with most accumulation in thyroid gland

                Onset: Therapeutic effects in hyperthyroidism observed within 24 hr

                Maximum effect: After 10-15 days of therapy

                Duration of effect: Therapeutic effect may persist up to 6 weeks after chronic administration; 24 hr for radioactive iodine exposure

                Metabolism: Unknown

                Excretion: Renal

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                Patient Handout

                Patient Education
                potassium iodide oral

                POTASSIUM IODIDE - ORAL

                (poh-TASS-ee-um EYE-oh-dyed)

                COMMON BRAND NAME(S): SSKI

                USES: Potassium iodide is used to loosen and break up mucus in the airways. This helps you cough up the mucus so you can breathe more easily if you have long-term lung problems (e.g., asthma, chronic bronchitis, emphysema). This medication is known as an expectorant.Potassium iodide is also used along with antithyroid medicines to prepare the thyroid gland for surgical removal, to treat certain overactive thyroid conditions (hyperthyroidism), and to protect the thyroid in a radiation exposure emergency. It works by shrinking the size of the thyroid gland and decreasing the amount of thyroid hormones produced.In a radiation emergency, potassium iodide blocks only the thyroid from absorbing radioactive iodine, protecting it from damage and reducing the risk of thyroid cancer. Use this medication along with other emergency measures that will be recommended to you by public health and safety officials (e.g., finding safe shelter, evacuation, controlling food supply).

                HOW TO USE: Take this medication by mouth with a full glass of water (8 ounces or 240 milliliters) as directed by your doctor or public health and safety officials. To avoid stomach upset, take after meals or with food. Drink plenty of liquids with this medication unless otherwise directed. If you are taking the tablets, do not lie down for at least 10 minutes after taking this medication. If you are using the drops or liquid medication, use the dropper that comes with the bottle or a medication spoon/device to measure the correct dose. Liquid forms of this product may be mixed in water, milk, formula, or juice before taking. Do not use this medication if the solution turns brownish-yellow.Dosage is based on your medical condition and response to therapy. In children, dosage is also based on age. Do not increase your dose, take it more often, or take it for longer than prescribed or recommended because of the increased risk of side effects.In a radiation emergency, take this drug only when public health and safety officials tell you to do so. Read the Patient Information Leaflet that comes with the medication. Start treatment as soon as possible for the best protection. Take this medication usually once every 24 hours. The length of treatment will be determined by public health and safety officials and depends on several factors (e.g., whether you continue to be exposed to the radiation, and whether you are pregnant, breast-feeding, or have a newborn baby). See also Precautions.If so directed, use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.Inform your doctor if your condition persists or worsens.

                SIDE EFFECTS: Nausea, vomiting, stomach ache, diarrhea, metallic taste in the mouth, fever, headache, or acne may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: burning mouth/throat, sore teeth/gums, swelling inside the mouth, increased saliva, eye irritation/swollen eyelids, severe headache, swelling of the front of the neck/throat (goiter), signs of decreased thyroid gland function (e.g., weight gain, cold intolerance, slow/irregular heartbeat, constipation, unusual tiredness), confusion, numbness/tingling/pain/weakness of the hands/feet.Seek immediate medical attention if any of these rare but very serious side effects occur: chest pain, black stools, vomit that looks like coffee grounds, bloody diarrhea.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing, fever with joint pain.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before taking potassium iodide, tell your doctor or pharmacist if you are allergic to it; or to iodine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: current attack/worsening of bronchitis (if taking potassium iodide to thin mucus in the lungs), a certain type of skin condition (dermatitis herpetiformis), a certain type of blood vessel disease (hypocomplementemic vasculitis), nodular thyroid disease with heart disease.Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain thyroid disorders (e.g., multinodular goiter, Graves' disease, autoimmune thyroiditis), overactive thyroid disease (unless you are specifically prescribed potassium iodide to treat hyperthyroidism), tuberculosis, high potassium blood level, kidney disease, Addison's disease, a certain muscle disorder (myotonia congenita).Caution is advised when this drug is given to newborn babies younger than 1 month old. Treatment for more than 1 day should be avoided because repeated dosing increases the risk of blocking thyroid function, possibly affecting the newborn's brain development. If treatment is needed for longer than 1 day, discuss the risks and benefits with the doctor. Treated babies should be given thyroid function tests.During pregnancy, this medication should be used only when clearly needed. Treatment for more than 1 day should be avoided because repeated dosing increases the risk of blocking thyroid function in the unborn baby, possibly causing harm. If treatment is needed for longer than 1 day, discuss the risks and benefits with your doctor.Caution is advised when this drug is used by women who are breast-feeding. This drug passes into breast milk. Treatment for more than 1 day should be avoided if you are breast-feeding because repeated dosing increases the risk of blocking thyroid function in the nursing infant. This effect may cause harm, especially in newborns younger than 1 month old. If treatment is needed for longer than 1 day, discuss with your doctor the risks and benefits, as well as whether you should stop breast-feeding.

                DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: ACE inhibitors (e.g., captopril, lisinopril), angiotensin receptor blockers (ARBs such as losartan, valsartan), certain "water pills" (potassium-sparing diuretics such as amiloride, spironolactone, triamterene), drospirenone, eplerenone, lithium, potassium-containing drugs (including supplements such as potassium chloride).This document does not contain all possible interactions. Before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: Do not share this medication with others.Laboratory and/or medical tests (e.g., thyroid function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

                MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not freeze. If crystals form in the solution, dissolve them by placing the closed bottle in a container of warm water, then gently shake the bottle. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.