Sodium Thiosulfate

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What is Sodium Thiosulfate

Sodium thiosulfate is a relatively non-toxic substance. It is used as an antidote for cyanide toxicity by increasing the rate of detoxification of cyanide by the enzyme rhodanase.

Sodium thiosulfate has been used off-label for nephrotoxicity prophylaxis during cisplatin therapy and for treatment of extravasation of cytotoxic agents such as cisplatin, dacarbazine, mechlorethamine, and mustine.

There are case reports that support the use of sodium thiosulfate to treat calciphylaxis as well as information that supports its effectiveness in protection against ototoxicity associated with carboplatin; further investigation is needed for both indications.

Constant IV infusion of sodium thiosulfate has caused hypovolemia in animals; slow IV administration is recommended in acute cyanide poisoning.

Indications & Dosage

  • calciphylaxis
  • cyanide toxicity
  • extravasation
  • Malassezia furfur
  • nephrotoxicity prophylaxis

Side Effects

  1. confusion
  2. diarrhea
  3. dysgeusia
  4. dyspnea
  5. headache
  6. hypotension
  7. hypovolemia
  8. increased urinary frequency
  9. nausea
  10. prolonged bleeding time
  11. pruritus
  12. rash
  13. thiocyanate toxicity
  14. urticaria
  15. vomiting

Monitoring Parameters

  • arterial blood gases (ABGs)
  • CBC with differential
  • serum creatinine/BUN

Contraindications

  • breast-feeding
  • edema
  • hypotension
  • infants
  • neonates
  • pregnancy

Interactions

There are no drug interactions associated with Sodium Thiosulfate products.

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