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Other brands with the same active ingredient
These brands contain the same active ingredient (Sodium Thiosulfate). Same strength and form. Confirm the switch with your doctor or pharmacist.
Indications & Uses
Thiotab is used together with sodium nitrite, given one after the other, to treat acute cyanide poisoning that is considered life-threatening. It should be used with caution when the diagnosis of cyanide poisoning is not certain.
Pharmacology
Sodium thiosulfate is used as an antidote for cyanide poisoning. It works by supplying sulphur to the enzyme rhodanese, which speeds up the conversion of cyanide into thiocyanate, a much less toxic substance. It is usually given together with sodium nitrite, though it may be used on its own in milder cases of poisoning.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Adults: Give after 300 mg of sodium nitrite has been administered over 5 to 20 minutes. The dose is 12.5 g of sodium thiosulfate (50 ml of a 25% solution or 25 ml of a 50% solution), given over 10 minutes. The methaemoglobin concentration should not exceed 30 to 40%. If symptoms of cyanide toxicity return, the doses of nitrite and thiosulfate may be repeated after 30 minutes at half the initial doses.
Children: Give after 4 to 10 mg/kg of sodium nitrite (maximum 300 mg) has been administered. The dose is 400 mg/kg of sodium thiosulfate, as a 25% or 50% solution (maximum 12.5 g). The methaemoglobin concentration should not exceed 30 to 40%. If symptoms of cyanide toxicity return, the doses of nitrite and thiosulfate may be repeated after 30 minutes at half the initial doses.
Side Effects
Osmotic disturbances may occur. Orally, high doses can cause catharsis.
Cautions & Contraindications
Warnings & Precautions
Thiotab may contain trace impurities of sodium sulfite. The presence of a trace amount of sulfites in Thiotab should not deter administration of the drug in emergency situations, even if the patient is sulfite-sensitive.
Pregnancy & Breastfeeding
Pregnancy Category C. Well-controlled studies in pregnant women have not been done. Sodium Thiosulfate Injection should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Whether sodium thiosulfate passes into human breast milk is not known. Since Sodium Thiosulfate Injection may be given in life-threatening situations, breastfeeding is not a reason to avoid its use. As many drugs do pass into breast milk, nursing mothers should be monitored carefully after receiving Sodium Thiosulfate Injection. There is no information available on when it is safe to resume breastfeeding after the drug is given.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Pediatric use: The medical literature has case reports of sodium nitrite being given together with Sodium Thiosulfate to children with cyanide poisoning. But no clinical studies have looked at the safety or efficacy of Sodium Thiosulfate in children.
Geriatric use: Sodium Thiosulfate is cleared mostly by the kidney, so the risk of adverse reactions may be greater in people with impaired renal function. Elderly patients are more likely to have reduced renal function. Care should be taken when choosing the dose, and it may be useful to monitor renal function.
Overdose
We don't have much information on what large doses of Sodium Thiosulfate do in humans. In one report, people who took 3 g of Sodium Thiosulfate by mouth each day for 1 to 2 weeks had their arterial oxygen saturation (measured on room air) fall as low as 75%. This happened because the oxygen hemoglobin dissociation curve shifted to the right. One week after they stopped taking Sodium Thiosulfate, their oxygen saturations went back to baseline. A single intravenous dose of 20 mL of 10% Sodium Thiosulfate reportedly did not change oxygen saturations.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Sodium Thiosulfate at a controlled room temperature, between 20°C and 25°C. Keep it away from direct light, and don't let it freeze.
Common questions about Clear-Plus 15 mg
What is Clear-Plus 15 mg Tablet?
Clear-Plus 15 mg Tablet is a medicine that contains Sodium Thiosulfate. It is made by Indo-Bangla Pharmaceuticals Ltd. It belongs to the Antidote preparations group of medicines.
What is Clear-Plus used for?
Thiotab is used together with sodium nitrite, given one after the other, to treat acute cyanide poisoning that is considered life-threatening. It should be used with caution when the diagnosis of cyanide poisoning is not certain.
What are the side effects of Clear-Plus?
Osmotic disturbances may occur. Orally, high doses can cause catharsis.
Can I take Clear-Plus during pregnancy or while breastfeeding?
Pregnancy Category C. Well-controlled studies in pregnant women have not been done. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Clear-Plus?
We don't have much information on what large doses of Sodium Thiosulfate do in humans. In one report, people who took 3 g of Sodium Thiosulfate by mouth each day for 1 to 2 weeks had their arterial oxygen saturation (measured on room air) fall as low as 75%. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Clear-Plus?
Keep Sodium Thiosulfate at a controlled room temperature, between 20°C and 25°C. Keep it away from direct light, and don't let it freeze.
Do I need a prescription for Clear-Plus?
Clear-Plus is a prescription (Rx) medicine. Take it as your doctor advises.