Betadine Throat Spray Overdosage

In the event of accidental or deliberate ingestion of large quantities of BETADINE Throat Spray, patients must be advised to immediately contact the doctor or nearest hospital.
Overdose can cause symptoms like metallic taste in the mouth, increased salivation, burning or pain in the throat or mouth, irritation and swelling in the eyes, breathing difficulties due to pulmonary oedema, skin reactions, gastrointestinal upset and diarrhoea, metabolic acidosis, hypernatraemia and renal impairment up to anuria and circulatory collapse. Systemic toxicity may result in renal impairment (including anuria), tachycardia, hypotension, circulatory failure, oedema of glottis resulting in asphyxia, or pulmonary oedema, seizures, fever and metabolic acidosis. Hyperthyroidism or hypothyroidism may also develop.
Therapy: Symptomatic and supportive treatment should be provided, with special attention to electrolyte balance and renal and thyroid function.
For severe hypotension, intravenous fluid should be administered; vasopressors should be added if necessary.
Endotracheal intubation may be required if caustic injury to the upper airway results in significant swelling and oedema.
Vomiting should not be induced. Patient should be maintained in a position to keep the airways open and prevent aspiration (in case of vomiting).
If the patient is not vomiting and can tolerate oral feeding, then ingestion of starchy food (e.g. potato, flour, starch, bread) may help convert iodine to less toxic iodide. If no signs of bowel perforation are present, irrigation of the stomach with starch solution via nasogastric tube may be utilized (gastric effluent will turn dark blue-purple and the colour can be used as a guide in determining when lavage can be terminated).
Haemodialysis effectively clears iodine and should be employed in severe cases of iodine poisoning particularly if renal failure is present. Continuous venovenous haemodiafiltration is less effective than haemodialysis.
In case of thyroid dysfunction, treatment with povidone-iodine should be discontinued.