Side effects may include vomiting, joint pain, mood changes,
psychosis, and
ringing in the ears.[5] Safety, however, has not been well studied.[7] It is unclear if use during
pregnancy is safe for the baby.[5] Its use at the same time in the same intravenous line as
hydroxocobalamin is not recommended.[6] In cyanide poisoning, sodium nitrite creates
methemoglobinemia, which removes cyanide from the
mitochondria.[6] Sodium thiosulfate then binds with cyanide, creating the nontoxic
thiocyanate.[6]
In this use, sodium nitrite creates
methemoglobinemia which removes cyanide from
mitochondria.[6] Sodium thiosulfate then serves as a sulfur donor for the conversion of cyanide to the nontoxic
thiocyanate, catalyzed by the enzyme
rhodanase. The thiocyanate is then safely excreted in the urine.[6][11]
There are concerns that sodium thiosulfate may not have a fast enough onset of action to be very useful for this use without the additional use of other agents.[11]
In cases with both cyanide poisoning and
carbon monoxide poisoning, sodium thiosulfate by itself is recommended.[12]
In the European Union, sodium thiosulfate (Pedmarqsi) is indicated for the prevention of ototoxicity induced by cisplatin chemotherapy in people aged 1 month to < 18 years of age with localized, non-metastatic, solid tumors.[2] The most common side effects include vomiting, nausea (feeling sick),
hypernatremia (high blood levels of sodium),
hypophosphatemia (low blood levels of phosphate) and
hypokalemia (low blood levels of potassium).[2] Sodium thiosulfate (Pedmarqsi) was approved for medical use in the European Union in May 2023.[2]
However, it has been claimed that this treatment may cause severe
metabolic acidosis in some patients.[17][18]
Sodium thiosulfate has been observed to help in the treatment of a rare systemic fibrosis condition caused by
gadolinium-based
contrast media in patients with
kidney failure.[19]
Side effects may include vomiting, joint pain, mood changes,
psychosis, and
ringing in the ears.[5] Safety; however, has not been well studied.[7] It is unclear if use in
pregnancy is safe for the baby.[5] Use at the same time in the same intravenous line as
hydroxocobalamin is not recommended.[6]
History
Sodium thiosulfate came into medical use for cyanide poisoning in the 1930s.[24]
^
abcd"Pedmarqsi EPAR". European Medicines Agency. 2 June 2023.
Archived from the original on 3 June 2023. Retrieved 2 June 2023. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
^World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization.
hdl:
10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^
abHall AH, Dart R, Bogdan G (June 2007). "Sodium thiosulfate or hydroxocobalamin for the empiric treatment of cyanide poisoning?". Annals of Emergency Medicine. 49 (6): 806–13.
doi:
10.1016/j.annemergmed.2006.09.021.
PMID17098327.
^Auriemma M, Carbone A, Di Liberato L, Cupaiolo A, Caponio C, De Simone C, Tulli A, Bonomini M, Amerio P (October 2011). "Treatment of cutaneous calciphylaxis with sodium thiosulfate: two case reports and a review of the literature". American Journal of Clinical Dermatology. 12 (5): 339–46.
doi:
10.2165/11587060-000000000-00000.
PMID21834598.
S2CID28366905.
^Cicone JS, Petronis JB, Embert CD, Spector DA (June 2004). "Successful treatment of calciphylaxis with intravenous sodium thiosulfate". American Journal of Kidney Diseases. 43 (6): 1104–8.
doi:
10.1053/j.ajkd.2004.03.018.
PMID15168392.
^Selk N, Rodby RA (Jan–Feb 2011). "Unexpectedly severe metabolic acidosis associated with sodium thiosulfate therapy in a patient with calcific uremic arteriolopathy". Seminars in Dialysis. 24 (1): 85–8.
doi:
10.1111/j.1525-139X.2011.00848.x.
PMID21338397.
S2CID23196149.