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sodium thiosulfate (Rx)Brand and Other Names:

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injection solution

  • 100mg/mL (10%)
  • 250mg/mL (25%)

Cyanide Poisoning

12.5 g IV (infuse over 10-20 minutes)

Cisplatin Extravasation

2 mL 1/6 molar solution through IV cannula for every 100 mg cisplatin; remove needle, then inject 0.1 mL injections clockwise around extravasation area up to 1 mL; repeat several times within the 3-4 hr of extravasation incident

Cisplatin Nephrotoxicity

4 g/m² IV bolus followed by 12 g/m² IV infusion over 6 hr

Preparation of 1/6 Molar Solution

4 mL of 10% solution + 6 mL sterile water for injection

1.6 mL of 25% solution + 8.4 mL sterile water for injection

Orphan Designations

Calciphylaxis: 25 g IV 3 times per week following dialysis for 6 weeks to 9 months; other protocols exist

Mechlorethamine extravasation: 2 mL 10% solution through IV cannula for every 2 mg mechlorethamine extravasated; remove needle, then inject 10 mL of 1/6 molar solution SC

Sulfur mustard poisoning

Dermatomyositis

Orphan sponsor

  • Hope Pharmaceuticals; 16416 N. 92nd Street, Suite 125; Scottsdale, AZ 85260

Administration

Monitor for thiocyanate toxicity

Dosage Forms & Strengths

injection solution

  • 100mg/mL (10%)
  • 250mg/mL (25%)

Cyanide Poisoning

7 g/m² IV (maximum 12.5 g), infuse over at least 10 minutes 

Platinum-Induced Ototoxicity (Orphan)

Prevention of platinum-induced ototoxicity in pediatric patients

Orphan sponsor

  • Adherex Technologies, Inc; 501 Eastowne Dr Suite 140; Chapel Hill, NC 27514
  • Hope Pharmaceuticals; 16416 N. 92nd Street Suite 125; Scottsdale, AZ 85260
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Adverse Effects

Frequency Not Defined

Hypotension (infusion rate-dependent)

Nausea/vomiting

Disorientation

Headache

Prolonged bleeding therapy

Hypersensitivity reactions

Contact dermatitis

Warmth

Local irritation

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Pregnancy & Lactation

Pregnancy Category: C

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Mechanism of Action

Thiosulfate is sulfur donor utilized by rhodenase to convert cyanide to less toxic thiocyanate

Cisplatin toxicity: Na-thiosulfate combines w/ cisplatin to form a complex nontoxic to both normal/cancerous cells

Increases solubility of calcium

Pharmacokinetics

Half-life: 3 hr (thiosulfate); 3 days (thiocyanate); 9 days (renal impairment)

Excretion: Urine (20-50%)

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Formulary

FormularyPatient Discounts

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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  • View the formulary and any restrictions for each plan.
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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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