Sodium thiosulfate 

Category:

  • Miscellaneous

Description:

  • Antidote, toxicology agent

Indications:

  • Acne vulgaris

  • Cyanide toxicity

  • Tinea versicolor

Contraindications:

  • Discontinue if irritation occurs while using topical formulation

  • Use in or around eyes

Precautions:

  • Pregnancy category C

Adverse Reactions (Side Effects):

  • diarrhea

Dosage:

Administered intravenously, topically (no commercial topical agents available)

Cyanide toxicity: 

  • Adult: 

    • Following administration of sodium nitrite (IV 300mg over 3-5 minutes), the usual dose of sodium thiosulfate is 12.5g (50ml of a 25% solution or 25ml of a 50% solution) over 10 minutes

  • Child: 

    • Following administration of sodium nitrite (0.15-0.33 ml/kg or 6-8 ml/square meter of a 3% solution; approximately 4.5-10 mg/kg), the suggested dose of sodium thiosulfate is 1.65 ml/kg or 28 ml/square meter of a 25% solution (412.5 mg/kg); 

    • alternatively, dosing can be based on the child’s hemoglobin (hg) concentration:

      • If hg concentration is 8g, initial dose IV 1.10 ml/kg as a 25% solution

      • If hg concentration is 10g, initial dose IV 1.35 ml/kg as a 25% solution

      • If hg concentration is 12g, initial dose IV 1.65 ml/kg as a 25% solution

      • If hg concentration is 14g, initial dose IV 1.95 ml/kg as a 25% solution

  • NOTE: If symptoms of cyanide toxicity recur, one half of each dose of sodium nitrite and sodium thiosulfate may be repeated after 30 minutes

Treatment of acne secondary to oily skin: 

  • Adults: 

    • Apply thin layer of sodium thiosulfate lotion twice daily after thoroughly washing affected area

Treatment of tinea versicolor: 

  • Adult and child: 

    • Apply a 20%-25% solution in a thin layer to affected areas twice daily.  

  • May take weeks or months of continued therapy after condition clears to prevent relapse

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