Prophylactic treatment for radiation exposure, a potent antibiotic against variety of pathogens, an expectorant and an antithyroid agent used to treat certain thyroid conditions.
Description SSKI® (Potassium Iodide Oral Solution, USP) is a saturated solution of potassium iodide containing 1 gram of potassium iodide per ml.
Potassium iodide or SSKI (saturated solution of potassium iodide) is an inorganic salt that combines iodine and potassium in a relatively high dosage.
Potassium iodide or the salt taken in tablet form can act as a potent antibiotic against a variety of pathogens. SSKI is an expectorant used to treat lung conditions where it is helpful to thin mucous so it may be coughed up more easily. SSKI is also an antithyroid agent used to treat certain thyroid conditions. Potassium iodide is also the standard prophylactic treatment for radiation exposure, as potassium iodide saturates the thyroid with iodine, which in turn prevents the body from taking up radioactive iodine isotopes from the environment.
Caution: SSKI/Potassium Iodide is not typically taken as a nutritional supplement, since it provides a dosage many times above standard nutritional requirements for iodine.
Natural Cures: Potassium iodide can be used in the case of radiation exposure, against fungal skin infections, as an expectorant, and as a general antibiotic.
RDA:150 mcg (iodine) Expectorant: Oral: SSKI®: 300-600 mg 3-4 times/day
Preoperative thyroidectomy (unlabeled use): Oral: 50-250 mg (1-5 drops SSKI®) 3 times/day; administer for 10 days before surgery
To reduce risk of thyroid cancer following nuclear accident: Oral: Adults (including pregnant/lactating women): Oral: 130 mg once daily. Note: Dosing should continue until risk of exposure has passed or other measures are implemented.
Thyroid gland protection during radiopharmaceutical use (unlabeled use): Oral: Tablet: 130 mg once daily or Solution (SSKI®): 4 drops 3 times/day. Note: Begin at 1-48 hours prior to exposure. Continue potassium iodide after radiopharmaceutical administration until risk of exposure has diminished (treatment duration and time of initiation is dependent on the radiopharmaceutical, consult specific protocol).
Thyrotoxic crisis (unlabeled use): Oral: 250 mg (5 drops SSKI®) every 6 hours (Nayak, 2006)
Sporotrichosis (cutaneous, lymphocutaneous; unlabeled use): Oral: Initial: 5 drops (SSKI®) 3 times/day; increase to 40-50 drops (SSKI®) 3 times/day as tolerated until 2-4 weeks after lesions have resolved (usual duration 3-6 months) (Kauffman, 2007)
Preoperative thyroidectomy (unlabeled use): Refer to adult dosing.
To reduce risk of thyroid cancer following nuclear accident :
Neonates: 16.25 mg once daily
Children 1 month to 3 years: 32.5 mg once daily
Children 3-18 years: 65 mg once daily
Children >68 kg: Refer to adult dosing
Note: Dosing should continue until risk of exposure has passed or other measures are implemented.
Thyroid gland protection during radiopharmaceutical use (unlabeled use): Oral (Olivier, 2003; Giammarile, 2008):
Neonates: 16 mg once
Infants <5 kg: 16 mg once daily
Children 1 month to 3 years or 5-15 kg: 32 mg once daily
Children 3-13 years or 15-50 kg: 65 mg once daily
Children >13 years or >50 kg: 130 mg once daily
Note: Begin at 1-48 hours prior to exposure. Continue potassium iodide after radiopharmaceutical administration until risk of exposure has diminished (treatment duration and time of initiation is dependent on the radiopharmaceutical, consult specific protocol.
Thyrotoxic crisis (unlabeled use): Oral: (Hassoun, 2008)
Infants: 100 mg (2 drops SSKI®) 4 times/day
Children: Refer to adult dosing.
Contraindicated in patients with a known sensitivity to iodides. Warnings Potassium iodide can cause fetal harm, abnormal thyroid function, and goiter when administered to a pregnant woman. Because of the possible development of fetal goiter, if the drug is used during pregnancy or if the patient becomes pregnant during therapy, apprise the patient of the potential hazard. Precautions
General: In some patients, prolonged use of iodides can lead to hypothyroidism. Iodides should be used with caution in patients having Addison’s disease, cardiac disease, hyperthyroidism, myotonia congenita, tuberculosis, acute bronchitis, or renal function impairment.
Drug Interactions: Concurrent use with lithium or antithyroid drugs may potentiate the hypothyroid and goitrogenic effects of these medications. Concurrent use with potassium-containing medications, potassium- sparing diuretics and angiotensin-converting enzyme inhibitors (ACE inhibitors) may result in hyperkalemia and cardiac arrhythmias or cardiac arrest.Drug/Laboratory Test Interactions: Thyroid function tests may be altered by iodide.
Nursing Mothers: Potassium iodide is excreted in breast milk. Use by nursing mothers may cause skin rash and thyroid suppression in the infant. Pediatric Use: Safety and effectiveness in children have not been established.
Nayak B and Burman K, “Thyrotoxicosis and Thyroid Storm,” Endocrinol Metab Clin North Am, 2006,35(4):663-86, vii. [PubMed 17127140]
Kauffman CA, Bustamante B, Chapman SW, et al, “Clinical Practice Guidelines for the Management of Sporotrichosis: 2007 Update by the Infectious Diseases Society of America,” Clin Infect Dis, 2007, 45(10):1255-65. [PubMed 17968818]
Olivier P, Colarinha P, Fettich J, et al, “Guideline for Radioiodinated MIBG Scintigraphy in Children,” Eur J Nucl Med Mol Imaging, 2003, 30(5):B45-50. [PubMed 12658506]
Giammarile F, Chiti A, Lassmann M, et al, “EANM Procedure Guidelines for 131I-meta-iodobenzylguanidine (131I-mIBG) Therapy,” Eur J Nucl Med Mol Imaging, 2008, 35(5):1039-47. [PubMed 18274745]
Hassoun A and Oberfield SE, “Renal, Endocrine, and Metabolic Disorders,” in Roger’s Textbook of Pediatric Intensive Care, 3rd ed, David G Nichols, ed, Philadelphia, PA: Lippincott, Williams, & Wilkins, 2008; p.1658.