Sodium Thiosulfate (Systemic)
   
Sodium Thiosulfate (Systemic)
US Brand Names
• Cyanide Antidote Package
Canadian Brand Names
• Cyanide Antidote Package
Description
Sodium thiosulfate (SOE-dee-um thye-oh-SUL-fate) may be used to lessen some of the side effects of cisplatin (a cancer medicine). It is also used with another medicine in the emergency treatment of cyanide poisoning.
Sodium thiosulfate is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:
Before Receiving This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. When sodium thiosulfate is to be used to lessen the side effects of cancer medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to sodium thiosulfate. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy
Studies on effects in pregnancy have not been done in humans or animals.
Breast-feeding
It is not known whether sodium thiosulfate passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who receive this medicine and who wish to breast-feed should discuss this with their doctor.
Children
Although there is no specific information comparing use of sodium thiosulfate in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.
Older adults
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing the use of sodium thiosulfate in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.
Other medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Other medical problems
The presence of other medical problems may affect the use of sodium thiosulfate. Make sure you tell your doctor if you have any other medical problems, especially:
• Edema (swelling of feet or lower legs) or
• Heart disease or
• High blood pressure (hypertension) or
• Kidney disease or
• Liver disease or
• Toxemia of pregnancy-Sodium thiosulfate may cause the body to retain (keep) water, which may make these conditions worse
Administration
Dosing
The dose of sodium thiosulfate will be different for different patients. The following information includes only the average doses of sodium thiosulfate.
• For injection dosage form:
o For use with cisplatin (a cancer medicine):
§ Adults and teenagers-The first dose, given just before the cancer medicine, is usually 4 grams per square meter of body surface area, injected into a vein. The second dose is started at the same time as the cancer medicine. It is usually 12 grams per square meter of body surface area, injected into a vein over a period of six hours.
o For cyanide poisoning:
§ Adults and teenagers-The usual dose is 12.5 grams injected into a vein at a rate of 0.625 to 1.25 grams (2.5 to 5 milliliters [mL]) per minute.
§ Children-The usual dose is 412.5 milligrams (mg) per kilogram (kg) (187 mg per pound) of body weight or 7 grams per square meter of body surface area injected into a vein at a rate of 0.625 to 1.25 grams (2.5 to 5 mL) per minute.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Symptoms of overdose
Agitation; blurred vision; hallucinations (seeing, hearing, or feeling things that are not there); mental changes; muscle cramps; nausea and vomiting; pain in the joints; ringing in the ears.
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
March 30, 1994 
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