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Sodium Thiosulfate

Antidote preparations Prescription
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Indications

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.

⚠️ Always consult a registered physician before taking any medicine.

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.

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.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor 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.