A Comprehensive Pharmacological and Clinical Monograph of Povidone-Iodine (DB06812)

Executive Summary

Povidone-iodine (PVP-I), identified by DrugBank ID DB06812, is a cornerstone of modern antisepsis. It exists as a stable chemical complex of elemental iodine with the polymer polyvinylpyrrolidone (PVP), a formulation designed to overcome the significant limitations of historical iodine tinctures. This monograph provides an exhaustive analysis of its chemical properties, historical context, pharmacological profile, clinical utility, and safety considerations. The development of PVP-I in 1955 marked a pivotal advancement, creating an "iodophor" that acts as a reservoir, providing sustained release of free iodine. This mechanism confers a broad-spectrum microbicidal activity against bacteria (including antibiotic-resistant strains), viruses, fungi, and protozoa, while significantly reducing the local irritation and systemic toxicity associated with elemental iodine solutions.

The mechanism of action is multifactorial, involving the rapid penetration of microbial cells by free iodine, followed by the denaturation of essential proteins, oxidation of cellular lipids, and disruption of nucleic acids. This multi-pronged attack makes the development of microbial resistance exceedingly rare. Clinically, PVP-I is utilized across a vast range of applications, from pre- and post-operative skin disinfection and surgical hand scrubbing to first aid for minor wounds, management of chronic ulcers, ophthalmic prophylaxis, and oropharyngeal decontamination. It is available in numerous formulations, including solutions, scrubs, ointments, powders, and specialized preparations for vaginal and ocular use, with concentrations tailored to specific applications.