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At a glance

Sodium Thiosulfate is indicated for sequential use with sodium nitrite for the treatment of acute cyanide poisoning that is judged to be life-threatening. It acts as a sulfur-donating substrate for the enzyme rhodanese, converting cyanide to the less toxic thiocyanate.

Indications
  • Acute cyanide poisoning (sequential use with sodium nitrite)
  • Calcium urolithiasis
  • Secondary preventive treatment for calciphylaxis in dialysis patients
Pharmacology

Sodium Thiosulfate acts as a sulfur donor for the enzyme rhodanese, which converts cyanide to thiocyanate. Thiocyanate is relatively non-toxic and easily eliminated in urine. It also reduces cisplatin toxicity by forming a complex with cisplatin and increases calcium solubility.

Dosage

Adult (Cyanide Poisoning):

  • After sodium nitrite 300 mg (over 5-20 min): 12.5 g sodium thiosulfate (50 ml of 25% or 25 ml of 50% solution) over 10 min
  • If symptoms recur: Repeat at half doses after 30 min

Pediatric (Cyanide Poisoning):

  • After sodium nitrite 4-10 mg/kg (max 300 mg): 400 mg/kg sodium thiosulfate (25-50% solution; max 12.5 g)
  • If symptoms recur: Repeat at half doses after 30 min
Side effects

Side Effects:

  • Osmotic disturbances
  • Oral: Catharsis (diarrhea) at high doses
  • Irritation to eyes, skin, and respiratory tract
Use in pregnancy

Use in Pregnancy: No adequate controlled studies; use in life-threatening situations only if needed; consult your doctor.

Pregnancy Category: C — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • Caution in edematous sodium-retaining conditions
  • Caution in pregnancy and lactation
  • Monitor renal function (especially in elderly)
  • Caution in sulfite-sensitive patients
Overdose effects

Limited information on large doses in humans; oral 3 g/day for 1-2 weeks reduced oxygen saturation to 75% (rightward shift of oxygen-hemoglobin dissociation curve); IV 20 mL of 10% did not change oxygen saturation.

Storage conditions

Store at controlled room temperature 20-25°C; protect from direct light; do not freeze.

Sodium Thiosulfate — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.