Sodium Thiosulfate Uses, Benefits, Dosage, and Side Effects

Summary of Key Points

Sodium Thiosulfate is a versatile medication used to treat conditions such as cyanide poisoning, calciphylaxis, and nephrotoxicity. It works by neutralizing harmful substances in the body and promoting healing. Available in various forms and strengths, Sodium Thiosulfate should always be used under the guidance of a healthcare provider. If you have any questions about your dosage or treatment, consult one of our telemedicine providers today.

Names of Medication

Generic Name: Sodium Thiosulfate

US Brand Name: Sodium Thiosulfate

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, both the generic and brand names are the same: Sodium Thiosulfate.

Pharmacologic Category

Sodium Thiosulfate belongs to the following pharmacologic categories:

1. Antidote
2. Calcium Chelator
3. Detoxifying Agent

Sodium Thiosulfate Dosing Guidelines

Always consult your healthcare provider before making any changes to your dose. Sodium Thiosulfate is used to treat several conditions, and the dosage varies depending on the specific condition being addressed:

Sodium Thiosulfate for Cyanide Poisoning

Adult Dose: 12.5 grams IV (intravenous) once, administered immediately after exposure.

Frequency: Single dose, may be repeated if necessary.

Sodium Thiosulfate for Calciphylaxis

Adult Dose: 25 grams IV three times per week.

Frequency: Administered after dialysis sessions for patients with end-stage renal disease.

Sodium Thiosulfate for Cystinuria

Adult Dose: 10 to 20 grams orally per day, divided into 3 to 4 doses.

Frequency: Daily, as prescribed by your healthcare provider.

Sodium Thiosulfate for Hypercalcemia

Adult Dose: 5 to 25 grams IV over several hours.

Frequency: As needed, depending on calcium levels.

Sodium Thiosulfate for Nephrotoxicity

Adult Dose: 4 grams/m² IV every 4 hours for 12 doses.

Frequency: Administered after exposure to nephrotoxic agents.

If you are unsure about your dosage or have concerns, please reach out to one of our telemedicine providers for immediate guidance.

Dosage Forms and Strengths

Sodium Thiosulfate is available in the following forms and strengths:

1. Injection: 25% solution (250 mg/mL)
2. Oral: Compounded solution, typically prepared by a pharmacy

Administration Instructions for Sodium Thiosulfate

Sodium Thiosulfate is typically administered by a healthcare professional, especially when given intravenously. If you are prescribed the oral form, follow the instructions provided by your doctor or pharmacist carefully. Take the medication exactly as prescribed and avoid skipping doses. If you miss a dose, contact your healthcare provider for advice.

Sodium Thiosulfate Side Effects and Adverse Reactions

Like all medications, Sodium Thiosulfate can cause side effects. While not everyone experiences them, it’s important to be aware of potential reactions:

1. Nausea and Vomiting: Common. You may feel nauseous or vomit after taking the medication.
2. Headache: Common. Some patients report mild to moderate headaches.
3. Low Blood Pressure (Hypotension): Less common. This can cause dizziness or fainting, especially after IV administration.
4. Allergic Reactions: Rare. Symptoms may include rash, itching, or swelling, which require immediate medical attention.
5. Metabolic Acidosis: Rare. A serious condition where the body produces too much acid, requiring urgent care.

If you experience severe or unusual symptoms, contact your healthcare provider immediately. For non-emergency concerns, our telemedicine providers are available to assist you.

Contraindications for Sodium Thiosulfate

A contraindication is a specific situation where a medication should not be used because it could cause harm. It’s important to know if you have any contraindications before starting Sodium Thiosulfate. Below are some of the main contraindications:

1. Severe renal impairment: Sodium Thiosulfate is processed by the kidneys. If you have severe kidney problems, your body may not clear the medication properly, leading to a buildup and potential toxicity.
2. Hypersensitivity or allergy to Sodium Thiosulfate: If you’ve had an allergic reaction to Sodium Thiosulfate in the past, you should not take it again, as this could lead to serious allergic reactions, including anaphylaxis.
3. Severe dehydration or electrolyte imbalance: Sodium Thiosulfate can affect your body’s fluid and electrolyte balance. If you are already dehydrated or have an imbalance, this medication could worsen your condition.

If you have any of these conditions, discuss them with your healthcare provider before starting Sodium Thiosulfate. You can schedule a telemedicine appointment with one of our providers to review your medical history and determine if this medication is safe for you.

Drug Interactions with Sodium Thiosulfate

Sodium Thiosulfate can interact with other medications, potentially affecting its effectiveness or increasing the risk of side effects. Below are some medications that may interact with Sodium Thiosulfate:

1. Cisplatin (Platinol): Sodium Thiosulfate is sometimes used to reduce the toxic effects of Cisplatin, a chemotherapy drug. However, the timing of administration is crucial, as improper timing can reduce Cisplatin’s effectiveness.
2. Sodium Nitrite: When used with Sodium Thiosulfate to treat cyanide poisoning, timing and dosing must be carefully managed by a healthcare provider to ensure safety and effectiveness.
3. Calcium supplements: Sodium Thiosulfate can lower calcium levels in the blood. If you are taking calcium supplements, your healthcare provider may need to adjust your dose or monitor your calcium levels closely.

Always inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. If you’re unsure, one of our telemedicine providers can help you review your medication list.

Sodium Thiosulfate in Pregnancy

Is it safe to take Sodium Thiosulfate during pregnancy?

The safety of Sodium Thiosulfate during pregnancy has not been fully established. While animal studies have not shown harm to the fetus, data on human pregnancies remains limited. If you are pregnant or planning to become pregnant, it’s essential to discuss the potential risks and benefits of using Sodium Thiosulfate with your healthcare provider. In certain situations, such as life-threatening cyanide poisoning, the benefits may outweigh the risks. Our telemedicine providers are available to help you make an informed decision based on your specific circumstances.

Sodium Thiosulfate while Breastfeeding

Is it safe to take Sodium Thiosulfate while breastfeeding?

There is limited information on whether Sodium Thiosulfate passes into breast milk. Due to the lack of comprehensive data, it’s recommended to exercise caution when using this medication while breastfeeding. Be sure to discuss the potential risks and benefits with your healthcare provider. If you need to take Sodium Thiosulfate while breastfeeding, your provider may suggest monitoring your baby for any possible side effects. For personalized advice, you can consult one of our telemedicine providers.

Estimated Cost of Sodium Thiosulfate

The cost of a 30-day supply of Sodium Thiosulfate without insurance can vary depending on the pharmacy and your location. With a GoodRx coupon, the price typically ranges between $50 and $100. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a coupon service like GoodRx to find the most affordable option.

Possible Alternatives to Sodium Thiosulfate

Depending on the condition being treated, there may be alternative therapies or lifestyle changes that could help. Always consult your healthcare provider before making any adjustments to your treatment plan. Below are some potential alternatives for conditions commonly treated with Sodium Thiosulfate:

1. Cystinuria: Increasing water intake and using medications like potassium citrate may help reduce the formation of cystine stones. Dietary modifications, such as reducing salt and animal protein, can also be beneficial.
2. Cyanide poisoning: Other antidotes, such as hydroxocobalamin (Cyanokit), may be used as alternatives to Sodium Thiosulfate in certain cases.
3. Calciphylaxis: In addition to Sodium Thiosulfate, treatments may include dialysis adjustments, wound care, and medications to lower calcium and phosphate levels.
4. Hypercalcemia: Medications such as bisphosphonates, calcitonin, or corticosteroids may be used to lower elevated calcium levels in the blood.
5. Osteoporosis: Lifestyle changes like weight-bearing exercises, calcium and vitamin D supplementation, and medications such as bisphosphonates (e.g., Alendronate) can help manage osteoporosis.
6. Chronic kidney disease: Managing blood pressure and blood sugar, along with dietary changes, can help slow the progression of chronic kidney disease. Medications like ACE inhibitors or ARBs may also be prescribed.
7. Heart failure: Lifestyle modifications, such as reducing sodium intake and engaging in regular exercise, along with medications like beta-blockers or ACE inhibitors, can help manage heart failure.
8. Diabetic foot ulcers: Proper wound care, blood sugar control, and, in some cases, antibiotics or surgical intervention may be necessary to treat diabetic foot ulcers.
9. Acute kidney injury: Treatment focuses on addressing the underlying cause, such as dehydration or infection, and may involve temporary dialysis in severe cases.
10. Nephrotoxicity: Avoiding nephrotoxic drugs, staying well-hydrated, and closely monitoring kidney function can help prevent or manage nephrotoxicity.

Always consult your healthcare provider before making any changes to your treatment plan. If you’re seeking a second opinion or need advice on alternative treatments, our telemedicine providers are available to assist you.

Recent Updates on Sodium Thiosulfate Research

Recent studies have explored the use of Sodium Thiosulfate in treating calciphylaxis, a rare but serious condition often seen in patients with chronic kidney disease. Research suggests that Sodium Thiosulfate may help reduce pain and improve wound healing in these patients. However, more studies are needed to fully understand its long-term benefits and potential side effects.

There is also ongoing research into the use of Sodium Thiosulfate for preventing nephrotoxicity in patients undergoing chemotherapy, particularly with drugs like Cisplatin. Early results are promising, but further clinical trials are necessary to confirm its effectiveness and safety in this context.

As new research emerges, staying informed about the latest findings is important. If you have any questions about how these developments might affect your treatment, our telemedicine providers are here to help.

James Kingsley

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