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Occupational & Environmental Epidemiology
CDC Public Health Emergency Preparedness & Response
Potassium Iodide Program
Does potassium iodide (KI) protect me from all potential problems that could result in the event of a nuclear accident?
NO. Potassium iodide (KI) is not a magic pill. It only provides protection for the thyroid gland against one type of radioactive material. It does not provide protection against whole body irradiation or other radioactive elements that would also be present in a nuclear power plant release. It is imperative that you protect your entire body from damaging radiation. KI will only protect the thyroid from radioactive iodine. IF THERE IS A NUCLEAR POWER PLANT EMERGENCY NEAR YOU, YOU MUST PROTECT YOUR WHOLE BODY FROM PENETRATING RADIATION AND OTHER RADIOACTIVE MATERIALS BESIDES RADIOACTIVE IODINE.
Why did North Carolina decide to distribute potassium iodide pills?
The decision to request KI from the NRC is the result of a review of the issue by a committee of public health, emergency management and radiation protection officials. The committee reviewed information about the effectiveness of KI in preventing thyroid cancer resulting from a release of radioactive iodine. Research after the Chernobyl nuclear accident showed that children in the affected area who received KI after the radioactive release did not develop thyroid cancer, while those who did not receive KI had a high rate of thyroid cancer.
The committee determined that it would be prudent to distribute KI to people in the 10-mile Emergency Planning Zone (EPZ). Should evacuation be delayed following a nuclear accident or other incident involving the release of radioactive iodine, KI would be readily available to individuals at greatest risk of exposure to radioactive iodine.
The pills are distributed through local health departments, working with county emergency management officials. North Carolina public health and emergency management officials, at both the state and county levels, work together to develop the distribution plan. Participation by the public will be voluntary.
Who is eligible to receive the pills?
People who live or work in the 10-mile Emergency Planning Zone (EPZ) around the McGuire Nuclear Power Plant, Shearon Harris Nuclear Power Plant, and the Brunswick Nuclear Power Plant are eligible. People who live or work in North Carolina's portion of the 10-mile EPZ around the Catawba Nuclear Plant, which is located in South Carolina, are also eligible. Pills will be distributed in the county where the EPZ is located.
Map of North Carolina Nuclear Power Plants and 10-mile Emergency Planning Zones(JPG, 95KB)
I don't live or work in the 10-mile EPZ, but I'm still concerned about this issue. Can I get the free pills?
You must live or work in the 10-mile EPZ to be eligible for receiving the free KI pills. Pills will be distributed in the county where the EPZ is located. Persons outside the 10-mile EPZ can purchase KI at a pharmacy or over the Internet.
My children attend school or are in child care in the 10-mile EPZ. Will they be eligible to receive the free pills?
Schools and child care providers in the 10-mile EPZ are eligible to receive KI for children in their care. These facilities work with the local health department to obtain KI tablets or KI liquid. The Department of Public Instruction, which regulates public schools, and the Division of Child Development, which regulates child care, are also involved in this process.
How does potassium iodide (KI) prevent thyroid cancer?
The thyroid gland is a butterfly-shaped gland located in the neck. Thyroid hormones regulate the body's metabolism, facilitate normal growth and development, and control the functioning of many organs. The thyroid absorbs and stores iodine because it is essential for the production of thyroid hormones. Taking KI literally "fills up" the thyroid gland with stable iodine, preventing it from absorbing radioactive iodine, which could cause thyroid cancer.
When does potassium iodide have to be taken in order to prevent uptake of radioactive iodine and reduce the risk of thyroid cancer?
For best results, potassium iodide should be taken prior to or at the time of exposure to radioactive iodine. However, taking potassium iodide within three or four hours after exposure could still block the uptake of some radioactive iodine and lower one's risk of thyroid cancer.
Are there some people who should NOT take potassium iodide?
The Food and Drug Administration (FDA) has determined that short-term administration of potassium iodide is safe for most individuals. There are some exceptions, however.
You should not take potassium iodide if you are allergic to iodine or have dermatitis herpetiformis or hypocomplementemic vasculitis. (Both are extremely rare conditions associated with hypersensitivity to iodine.)
If you have multinodular goiter, Graves' disease, autoimmune thyroiditis, or if you are taking any thyroid medication, you should consult with your doctor to determine if taking potassium iodide to prevent absorption of radioactive iodine would be potentially harmful. The Food and Drug Administration (FDA) recommends that KI should be used with caution in individuals with these conditions, especially if dosing extends beyond a few days.
Pregnant women, women who are breastfeeding, and newborns up to one month old should not receive more than one dose of KI.
If you have any questions as to whether it is safe for you to take KI, consult your doctor.
Will I need to visit my doctor after taking potassium iodide?
Most people do not need to visit their doctor after taking potassium iodide, but pregnant or breastfeeding women and newborns up to one-month old should visit their doctor after taking potassium iodide so that their thyroid function can be monitored.
What are the potential side effects from taking potassium iodide?
Taking one or two doses of potassium iodide is safe for most people. Any side effects are usually mild and of short duration.
Can you give me more specific information on side effects?
In Poland, approximately seven million adults and 10.5 million children under the age of 16 received at least one dose of KI after the Chernobyl accident. Of those receiving KI in Poland, 12 of 3,214 newborns (0.37 per cent) showed temporary changes in thyroid function. Side effects among children and adults were generally mild. These included gastrointestinal disturbances (approximately 2% in children and felt to be due to the bad taste of KI solution) and minor rash (approximately 1% in children and adults.) Persons with iodine sensitivity may have allergic reactions. Only two cases were observed in Poland and both were in adults who where known to be sensitive to iodine. Inflammation of the salivary gland is possible but no cases were reported in Poland.
How will I know if and when I should take potassium iodide?
If there is risk of exposure to radioactive iodine from inhalation of contaminated air or ingestion of contaminated food or drink that cannot be prevented by evacuation, sheltering, or food and milk control, then North Carolina public health officials will issue an advisory to take KI.
If there is a serious emergency at one of the nuclear power plants, emergency management officials will notify the public through sirens near the plants and the Emergency Alert System (EAS). After receiving the notification, you should stay tuned to the Emergency Alert System and local broadcasting stations for information on what actions you should take, including instructions related to evacuation and whether you and your family should take potassium iodide.
YOU SHOULD NOT TAKE POTASSIUM IODIDE UNLESS NORTH CAROLINA PUBLIC HEALTH OFFICIALS ISSUE AN ADVISORY TO DO SO.
How long will KI protect my thyroid?
One dose of KI protects the thyroid for 24 hours. In a situation where evacuation is delayed beyond 24 hours, a second dose may be necessary if a significant risk of exposure to radioactive iodine is still present.
Potassium iodide pills come in 130-milligram (mg) tablets and will have to be divided for children and adolescents.
The FDA recommends the following doses of KI for different risk groups:
| Age Groups | KI dose (mg) | # of 130 mg tablets | # of 65 mg tablets |
| Adults over 18 | 130 | 1 | 2 |
| Children over 3 yrs through 18 yrs* | 65 | 1/2 | 1 |
| Over 1 month through 3 years | 32 | 1/4 | 1/2 |
| Birth through 1 month | 16 | 1/8 | 1/4 |
*Adolescents approaching adult size (> 70 kg) should receive the full adult dose (130 mg).
Taking a whole pill is easy, but how can I best split the pills?
You may use a pill cutter or a sharp knife on a hard surface. The 130-mg tablets are scored so that they may be easily cut in half. Each half of the tablet should contain about 65 mg of KI. Cutting a half tablet in half will result in a quarter tablet containing about 32 mg of KI. Cutting a quarter tablet in half will result in an eighth tablet containing about 16 mg of KI.
How do I give potassium iodide (KI) to young children?
Children three to 18 years old should take a half pill. Children at the low end of that age range may have difficulty, or refuse to, swallow a pill. You can crush the half pill into a fine powder, by grinding it with the back of a teaspoon. The powder can then be mixed with something your child would swallow, like applesauce or pudding. If you put the powder into a liquid like milk or water, the powder will settle out in a minute or two. If this happens, mix it again to ensure that your child gets his or her complete dose.
Children a month to three years old should take a quarter pill. It is best to crush the pill into a fine powder and mix it with water or milk.
Newborns up to a month old should take an eighth of a 130 mg pill. It is very difficult to cut a pill into eighths, dividing powder is easier. You should crush the entire tablet to a fine powder. Divide the powder into eight equal piles. Put an eighth of the powder into a baby bottle, add breast milk or formula, shake the mixture thoroughly and immediately administer it to the newborn. You could also wet your finger, a pacifier or a nipple and dip it into the dose; allow the baby to suck it from your finger, pacifier or nipple.
Can I take more than one dose?
Most people can safely take another dose of KI every 24 hours. Newborns through one month of age and pregnant or breastfeeding women should not take a second dose, but should consult with their physician. In individuals with known thyroid disease, repeat dosing beyond a few doses is not advised.
If one dose protects me, won't doubling or tripling the dose protect me more?
No. More will not help you, and it may increase your risk of side effects.
The tablets have a five-year shelf life. As with all medicine, you should check the expiration date yearly. If your tablets are expired, contact your local health department to see if your tablets' expiration date has been extended or to obtain new tablets.
You should store potassium iodide tablets in a place where they are safe and out of the reach of children, but also readily accessible if you should need them. They should be stored at room temperature (59 to 86 degrees F). Do not store them in your car. Keep the package dry and foil packets intact.
How do I get more information on this issue?
See the Centers for Disease Control and Prevention (CDC) KI information web pages. 
