Sodium Thiosulfate Dosage

Usual Adult Dose for Cyanide Poisoning

50 mL, slow IV, immediately after sodium nitrite infusion

Comments:

• Use concomitantly with sodium nitrite.
• Administer as soon as possible after diagnosis of life-threatening cyanide poisoning.
• If suspicion of cyanide poisoning is high, initiate treatment without delay.
• Use as an adjunct to supportive therapies
• When the diagnosis of cyanide poisoning is uncertain, carefully weigh the potential risks against the potential benefits, especially if the patient is not in extremis.

Use: For sequential use with sodium nitrite for the treatment of acute cyanide poisoning that is judged to be life-threatening.

Usual Pediatric Dose for Cyanide Poisoning

1 mL/kg (30 to 40 mL/m(2)), slow IV, immediately after sodium nitrite infusion
Maximum dose: 50 mL

Comments:

• Use concomitantly with sodium nitrite.
• Administer as soon as possible after diagnosis of life-threatening cyanide poisoning.
• If suspicion of cyanide poisoning is high, initiate treatment without delay.
• Use as an adjunct to supportive therapies
• When the diagnosis of cyanide poisoning is uncertain, carefully weigh the potential risks against the potential benefits, especially if the patient is not in extremis.

Use: For sequential use with sodium nitrite for acute cyanide poisoning that is judged to be life-threatening.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

• If signs of poisoning reappear, repeat treatment using half the original dose.

Anemia:

• Reduce dose proportionally to the hemoglobin concentration.

Hypotension:

• Decrease rate of infusion if significant hypotension is noted.

Dialysis

Data not available

Other Comments

Storage requirements:

• Store at controlled room temperature.
• Protect from direct light.
• Do not freeze.

IV compatibility:

• Not compatible with hydroxocobalamin.

Monitoring:

• Monitor blood pressure during the infusion.
• Monitor patients at least 24 to 48 hours for adequate oxygenation, perfusion, and for signs of recurrence of cyanide toxicity.
• When possible, obtain hemoglobin/hematocrit at treatment initiation.
• Pulse oximetry and calculated oxygen saturation based on measured PO(2) are unreliable in the presence of methemoglobinemia.

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer