Sodium thiosulfate (medical use)
Sodium thiosulfate, structural formula
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Sodium thiosulfate, also spelled sodium thiosulphate, is used as a medication to treat cyanide poisoning, pityriasis versicolor, and to decrease side effects from cisplatin. For cyanide poisoning it is often used after the medication sodium nitrite and typically only recommended for severe cases. It is either given by injection into a vein or applied to the skin.
Side effects may include vomiting, joint pain, mood changes, psychosis, and ringing in the ears. Safety; however, has not been well studied. It is unclear if use in pregnancy is safe for the baby. Use at the same time in the same intravensous line as hydroxocobalamin is not recommended. In cyanide poisoning sodium nitrite creates methemoglobinemia which removes cyanide from mitochondria. Sodium thiosulfate then binds with cyanide creating the nontoxic thiocyanate.
Sodium thiosulfate came into medical use for cyanide poisoning in the 1930s. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The cost in the United States per dose as of 2013 is about 20 USD while together with sodium nitrite it costs 110 USD.
In cyanide poisoning there are concerns that sodium thiosulfate may not have a fast enough onset of action to be very useful without the additional use of other agents.
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