Use of sodium thiosulfate in the treatment of calciphylaxis has been described primarily in case series and case reports and in a single retrospective review, it demonstrated beneficial effects in most patients, with partial to complete resolution of skin lesions and reductions in radiotracer activity on bone scans. Consider consultation with a poison control center at 1-80. Thiosulfate: ~3 hours (Howland 2011) Thiocyanate: 2.7 days, prolonged with renal impairment to ~9 days Use: Labeled IndicationsĬyanide poisoning: Treatment of acute, life-threatening cyanide poisoning in combination with sodium nitrite. Urine (~20% to 50% thiosulfate as unchanged drug) Half-Life Elimination
IV: V d: Thiosulfate: 0.15 L/kg (Howland 2011) Thiocyanate: 0.25 L/kg Excretion
Cyanide toxicity: Serves as a sulfur donor in rhodanese-catalyzed formation of thiocyanate (much less toxic than cyanide)Įxtravasation management: Neutralizes the reactive species of mechlorethamine reduces the formation of hydroxyl radicals which cause tissue injury Pharmacokinetics/Pharmacodynamics Distribution
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