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Sodium thiosulfate

Class
Antidotes
Subclass
Thiosulfates
Substance name
Sodium thiosulfate
Brand names
Nithiodote®, Pedmark®
Common formulations
Solution for injection, Kit
Dosage and administration
Adults patients
Treatment of cyanide poisoning • Serious or life-threatening
•
12.5 g IV × 1 at a rate of 2.5-5 mL/min, followed by half the original dose if signs of poisoning reappear
Administered immediately after sodium nitrite 300 mg/10 mL intravenously infusion at a rate of 2.5-5 mL/min.
Indications for use
Labeled indications
Adults
•
Treatment of cyanide poisoning (serious or life-threatening)
Children
•
Treatment of allergic rhinitis (grass pollen-induced allergic rhinitis with or without conjunctivitis)
Safety risks
Warnings and precautions
Sulfite sensitivity
•
Maintain a high level of suspicion, as sodium thiosulfate drug product may contain trace impurities of sodium sulfite, but it should not deter administration of the drug in emergency situations, even if the patient is sulfite-sensitive.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
•
Monitor for toxicity.
Renal replacement therapy
Any modality
•
No guidance available.
Hepatic impairment
Any severity
•
No guidance available.
Pregnancy and breastfeeding
Pregnancy
All trimesters
•
Generally acceptable for use.
Breastfeeding
Halt breastfeeding temporarily.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Unknown frequency
•
Hypotension, headache, disorientation, nausea, vomiting, ↑bleeding time, change in taste, salty taste in mouth, hot flashes
Interactions
Drug(s)
Check Interactions
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