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thiosulfate
V03AB06
Forms & Strengths
- Intravenous injection: 12.5 g / 50 mL (25%)
- Topical lotion: 20%
Adult Dosing
- Cyanide poisoning: 12.5 g IV over 10 minutes, following sodium nitrite
- Calciphylaxis: 25 g IV three times weekly during hemodialysis (off-label)
Pediatric Dosing
- Cyanide poisoning: 1.65 mL/kg (412.5 mg/kg) IV up to 12.5 g, following sodium nitrite
Indications
- Acute cyanide poisoning (adjunct or standalone)
- Calcific uremic arteriolopathy / Calciphylaxis (off-label)
Mechanism of Action
- Acts as a sulfur donor for the enzyme rhodanese, converting toxic cyanide to relatively nontoxic thiocyanate for renal excretion
Contraindications
- Known hypersensitivity to sodium thiosulfate or any component of the formulation
Adverse Reactions
- Nausea and vomiting
- Hypotension
- Headache
- Metabolic acidosis
- Transient disorientation
Drug Interactions
- May form toxic complexes if mixed in the same IV line with hydroxocobalamin
- Incompatible in solution with acids, heavy metal ions, and oxidizing agents
Curated Content: Needs Vetting Before Put to Clinical Use