Povidone-iodine
Antiseptics, disinfectants and sterilants
Antiseptics, disinfectants and sterilants
An iodophor: iodine carried by a polymer and released slowly to kill bacteria, fungi and many viruses. Used to prepare skin and hands; it has no lasting effect.
Also called: iodopovidone, PVP-iodine
Quick facts
- Group
- Antiseptics, disinfectants and sterilants
- Target
- Microbial proteins and membranes (free iodine)
- Used for
- Preoperative skin preparation
- Key effects
- Irritation and redness of the skin
- Monitor
- Skin beneath · Irritation or redness
- ATC
- D08AG02
No doses: the clinician sets them by the current guideline.
Mechanism of action
Povidone-iodine is an iodophor, a complex of iodine with the surfactant polymer polyvinylpyrrolidone. The complex holds little free iodine and releases more as it is diluted; that free iodine is the active microbicide. It keeps the activity of iodine: it kills vegetative bacteria, mycobacteria, fungi and lipid-containing viruses, and can kill spores with prolonged exposure, so its spectrum is somewhat broader than chlorhexidine's. It irritates and sensitises skin less than iodine tincture, but it needs to dry on the skin before it is fully active and it has no persistent activity once removed.
- Polyvinylpyrrolidone carries iodine and releases free iodine
- Free iodine kills bacteria, mycobacteria, fungi and enveloped viruses
- It must dry on the skin to act fully
- No residual activity once it is removed
Indications
- Preoperative skin preparation and surgical hand scrub Surgical site infection →
- Irrigation of the incisional wound with aqueous solution before closure (WHO: may be considered) Surgical site infection →
- Antisepsis of skin and minor wounds
Adverse effects
Common
- Irritation and redness of the skin
- Irritation with prolonged contact with the wet solution
Contraindications
- Allergy to iodine or to any ingredient
- Use in the eyes (skin products)
Key interactions
- Radioactive iodine (diagnosis or treatment) and thyroid uptake tests
- Stable iodine absorbed from it can block uptake and spoil the test or treatment for weeks.
What is monitored
- Skin beneath and around the prepared area after long procedures
- Irritation or redness; stop if it develops
Administration and safety
- Left to dry on the skin before incision; it needs that time to become fully active.
- Pooling beneath the patient and soaked drapes are avoided during preoperative prepping.
- Antiseptic and disinfectant products differ in iodine content and are diluted only as the manufacturer directs.
- Not used in the eyes unless the product is made for eye use.
Nursing care
- Ask about iodine allergy before use.
- Check under the patient for pooled solution and wet linen after prepping.
- Tell the team about recent povidone-iodine exposure before thyroid scans or radioiodine treatment.
- Stop and report if irritation or redness develops.
Pharmacokinetics
- Absorption
- Some iodine is absorbed; as a source of stable iodine it can interfere with thyroid uptake studies and radioiodine treatment.
- Onset and duration
- Acts once it has dried on the skin; short-lived.
Test yourself
Think of the answer, then tap the question to see it.
What is an iodophor?
A complex of iodine with a carrier (here polyvinylpyrrolidone) that releases free iodine slowly and irritates skin less than iodine tincture.
What advantage and what disadvantage does povidone-iodine have compared with chlorhexidine?
Somewhat broader spectrum, including spores with prolonged exposure, but no persistent activity on the skin.
What safety step prevents severe skin reactions during preoperative povidone-iodine prep?
Avoiding pooling of the wet solution beneath the patient.
Connections
← Back to the class: Antiseptics, disinfectants and sterilants
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - POVIDONE-IODINE solution (DailyMed (U.S. National Library of Medicine), 2026); Global guidelines for the prevention of surgical site infection (World Health Organization, 2018); eEML - Electronic Essential Medicines List (World Health Organization, 2025).
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Representative model, for educational purposes only.