Generic Name:

Trade Name:

Action:

Thiosulfate is utilized by rhodenase to convert cyanide to thiocyanate

Cisplatin toxicity: sodium thiosulfate combines with cisplatin to form a complex that is nontoxic to both normal and cancerous cells

Increases solubility of calcium

Indications:

Injection site extravasation (Refer to Nursing Policy for management 08-02-01 VESICANTS: TREATMENT FOR EXTRAVASATION )

Cisplatin nephropathy; prophylaxis

Calciphylaxis

Antidote for cyanide toxicity associated with the use of Nitroprusside

Administration Guidelines:

Usual Dose and Route:

Extravasation: Refer to nursing policy for appropriate management

Cisplatin Nephropathy: 12g/m 2 IV over 6 hours or 9g/m 2 IV push then 1.2g/m 2 as a continuous infusion over 6 hours (mixed in sterile water for injection or NS)

Cisplatin Intraperitoneal Prophylaxis: 5 gram IV in 100mLs of normal saline prior to cisplatin infusion, then 18 grams in 1000mLs of normal saline over 6 hours, beginning at the start of cisplatin intraperitoneal infusion.

Calciphylaxis: 25 grams IV over 60 minutes every other day. May be administered as straight drug.

Antidote for nitroprusside-associated cyanide toxicity: 12.5 grams IV over 10 minutes after 300mg of sodium nitrite. A half-dose of each may be repeated if necessary. May also be dosed on hemoglobin levels (contact Pharmacy for further details). May be administered as straight drug.

Standard Concentration:

Vial Sizes:

250mg/mL 50ml (25%) preservative free

Infusions will be prepared by the Pharmacy Department:

(but not limited to):

5 gram/100mL 0.9% sodium chloride

18 gram/1000mL 0.9% sodium chloride

25 gram/100mL intravenous solution (straight drug)

Special Considerations:

Safety in pregnancy/lactation has not yet been established

Infuse over at least 10minutes to avoid Hypotension

Precautions and Side Effects:

Infusion related hypotension

Monitor for signs of thiocyanate toxicity