The Full Story
Povidone, also known as polyvinylpyrrolidone (PVP), was originally developed as a plasma expander for trauma victims. Now it is commonly used in artificial tears and eye lubricating products. Some contact lens manufacturers even incorporate povidone into their lens to act as a wetting agent to increase moisture retention. Povidone is also used as a binder in controlled-release tablets and in liquid oral medications. You can frequently find it listed in cosmetic products such as hair spray, lipstick, gels, toothpaste, and shampoos.
Large ingestions of povidone are expected to cause only minimal symptoms such as diarrhea. If povidone gets into the eyes or onto the skin, it might cause irritation and pain. There have been reports of severe allergic reactions occurring in sensitive people, but this reaction is rare. Symptoms of a severe allergic reaction include wheezing; difficulty breathing; dizziness; chest tightness; hives; and swelling of the lips, face, tongue, or throat. If these symptoms occur, call 911 immediately regardless of the suspected cause.
When povidone is combined with iodine, it is most commonly used as an antiseptic for the skin (e.g., Betadine), but it can also be used in less concentrated forms for the eyes and vagina. Surgeons use it to disinfect skin prior to surgery. The 10% solution is used most often to disinfect skin, but it also comes in diluted concentrations as low as 0.3%.
Common side effects seen with both povidone-iodine eye drops and skin formulations include local swelling, irritation, itching, and rash. With overuse, povidone-iodine can have corrosive effects. With eye exposures, patients should irrigate the eyes for 15 minutes immediately after an exposure. Any persistent eye pain or symptoms might need medical examination and treatment. Ingestion can cause stomach upset, vomiting, diarrhea, and burns of the gastrointestinal tract.
In excessive doses, there is a risk for iodine toxicity, which can lead to kidney failure, changes in electrolyte concentrations, or other organ failure. Toxicity is most commonly seen when topical povidone-iodine is used chronically and in large amounts.
Certain people (burn victims, pregnant women, patients with kidney dysfunction, and those with thyroid disorders) should speak with their healthcare provider prior to using povidone-iodine because they might be more sensitive to the effects of povidone-iodine.
If you suspect someone is having symptoms from a povidone overdose, check the webPOISONCONTROL® online tool for guidance or call Poison Control at 1-800-222-1222.
Diana M. Pei, PharmD
Certified Specialist in Poison Information
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Iodine. Poisindex System [Internet database]. Greenwood Village (CO): Thomson Micromedex; Updated periodically [cited 20 Aug 2019].
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Michavila-Gomez AV, Moreno-Palanques MA, Ferrer-Vazquez M, Ferriols-Leisart R, Bartolomé B. Anaphylactic reaction to povidone secondary to drug ingestion in a young child. Allergol Immunopathol (Madr) 2012;40(4):259-61.
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- Keep all medications in child-resistant containers and stored away from children and pets.
- Keep povidone-iodine in its original, labeled container at all times.
- Before using povidone-iodine, read the Drug Facts section of the medication label carefully and be sure to understand and follow its instructions.
- Use as little as possible and never more than the amount specified on the label.
This Really Happened
Case 1. A 61-year-old woman called Poison Control after she meant to take a dose of cough medicine but unintentionally took a gulp of povidone-iodine 10% solution instead. She soon developed throat irritation and vomited once. When Poison Control called back 7 hours later, her tongue was irritated and a little swollen, but she was otherwise feeling much better. A day later, all symptoms had resolved.
Case 2. A nursing home called Poison Control because a 71-year-old woman grabbed a cup that contained Betadine and drank some thinking it was coffee. She drank about half a teaspoonful (2.5 mL). Immediately afterward, she had a few episodes of vomiting. When Poison Control followed up 3 hours later, her symptoms had resolved.
Case 3. An ER physician called Poison Control regarding a 38-year-old man who had swallowed a tablespoonful of Betadine 10% solution mistaking it for medication. He vomited a few times at home. In the ER, his main complaints were throat irritation and nausea. He was given anti-nausea medication and crackers and was watched in the ER. Poison Control followed up with him at home the next day, and all of his symptoms had resolved.