sodium thiosulfate (Intravenous route)

SOE-dee-um thye-oh-SUL-fate

Available Dosage Forms:

  • Solution

Therapeutic Class: Cyanide Antidote

Uses For sodium thiosulfate

Sodium thiosulfate may be used to lessen some of the side effects of cisplatin (a cancer medicine). It is also used with another medicine in the emergency treatment of cyanide poisoning.

Sodium thiosulfate is to be administered only by or under the immediate supervision of your doctor.

Before Using sodium thiosulfate

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For sodium thiosulfate, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to sodium thiosulfate or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Although there is no specific information comparing use of sodium thiosulfate in children with use in other age groups, sodium thiosulfate is not expected to cause different side effects or problems in children than it does in adults.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing the use of sodium thiosulfate in the elderly with use in other age groups, sodium thiosulfate is not expected to cause different side effects or problems in older people than it does in younger adults.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of sodium thiosulfate. Make sure you tell your doctor if you have any other medical problems, especially:

  • Edema (swelling of feet or lower legs) or
  • Heart disease or
  • High blood pressure (hypertension) or
  • Kidney disease or
  • Liver disease or
  • Toxemia of pregnancy—Sodium thiosulfate may cause the body to retain (keep) water, which may make these conditions worse

Proper Use of sodium thiosulfate

Dosing

The dose of sodium thiosulfate will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of sodium thiosulfate. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form:
    • For use with cisplatin (a cancer medicine):
      • Adults and teenagers—The first dose, given just before the cancer medicine, is usually 4 grams per square meter of body surface area, injected into a vein. The second dose is started at the same time as the cancer medicine. It is usually 12 grams per square meter of body surface area, injected into a vein over a period of six hours.
    • For cyanide poisoning:
      • Adults and teenagers—The usual dose is 12.5 grams injected into a vein at a rate of 0.625 to 1.25 grams (2.5 to 5 milliliters [mL]) per minute.
      • Children—The usual dose is 412.5 milligrams (mg) per kilogram (kg) (187 mg per pound) of body weight or 7 grams per square meter of body surface area injected into a vein at a rate of 0.625 to 1.25 grams (2.5 to 5 mL) per minute.

sodium thiosulfate Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Symptoms of overdose
  • Agitation
  • blurred vision
  • hallucinations (seeing, hearing, or feeling things that are not there)
  • mental changes
  • muscle cramps
  • nausea and vomiting
  • pain in the joints
  • ringing in the ears

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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