Betadine Surgical Scrub.

Povidone Iodine 7.5% w/v.

Surgical scrub.

For use as an antiseptic cleanser for pre-operative scrubbing and washing by surgeons and theatre staff, and pre-operative preparation of patients' skin.

For topical administration. Adults, the elderly and children: Apply full strength as a pre-operative antiseptic skin cleanser. Povidone iodine is not recommended for regular use in neonates and is contraindicated in very low birth weight infants (below 1500 grams).

Known or suspected iodine hypersensitivity. Regular use is contraindicated in patients and users with thyroid disorders (in particular nodular colloid goitre, endemic goitre and Hashimoto's thyroiditis).

Special caution is needed when regular applications to broken skin are made to patients with pre-existing renal insufficiency. Regular use should be avoided in patients on concurrent lithium therapy.

Absorption of iodine from povidone iodine through either intact or damaged skin may interfere with thyroid function tests. Contamination with povidone iodine of several types of tests for the detection of occult blood in faeces or blood in urine may produce false-positive results.

Regular use of povidone iodine should be avoided in pregnant or lactating women as absorbed iodine can cross the placental barrier and can be secreted into breast milk. Although no adverse effects have been reported from limited use, caution should be recommended and therapeutic benefit must be balanced against possible effects of the absorption on foetal thyroid function and development.

None known.

Povidone iodine may produce local skin reactions although it is considered to be less irritant than iodine. The application of povidone iodine to large wounds or severe burns may produce systemic adverse effects such as metabolic acidosis, hypernatraemia and impairment of renal function.

Excess iodine can produce goitre and hypothyroidism or hyperthyroidism. Systemic absorption of iodine after repeated application of povidone iodine to large areas of wounds or burns may lead to a number of adverse effects: metallic taste in mouth, irritation and swelling of the eyes, pulmonary oedema, skin reactions, gastrointestinal upset and diarrhoea, metabolic acidosis, hypernatraemia and impairment of renal function. In the case of accidental ingestion of large quantities of Betadine, symptomatic and supportive treatment should be provided with special attention to electrolyte balance and renal and thyroid function.

The active ingredient, povidone iodine, slowly liberates iodine when in contact with skin and mucous membranes. The activity of 'iodine' as a microbicide is then governed by a series of dissociations: I₂↔ I⁺ + I^- ; I₂ + H₂O ↔ H₂O I⁺ + I^- ; I₂ + I^- ↔ I₃^-. The microbicidal species H₂O I⁺ preferentially displaces oxygen as the end electron acceptor in the microorganism's respiratory cycle. H₂O I⁺ similarly interacts within the electron transport chain and reacts with the amino acids of the microbial cell membrane.

Betadine Surgical Scrub is intended for topical application and therefore a consideration of the absorption, distribution, metabolism and elimination of povidone iodine is largely without relevance.

None stated.

Sulphated nonylphenoxypoly(oxyethylene) ethanol ammonium salt; lauric diethanolamide;

ethoxylated lanolin 50%; Natrosol HXR; sodium hydroxide; purified water.

None stated.

36 months unopened.

Store below 25^oC and protect from light.

High density polyethylene containers fitted with steran lined white polypropylene caps containing 500ml of product.

None stated.

Medlock Medical Limited, Tubiton House, Medlock Street, Oldham, OL1 3HS.

PL 21248/0009.

6^th April 2005.

April 2006.