Veterinary Drug Handbook (VDH) is the reference veterinarians turn to when they want an independent source of information on the drugs that are used in veterinary medicine today.


Chemistry - Used systemically for cyanide or arsenic poisoning and topically as an antifungal, sodium thiosulfate occurs as large, colorless crystals or coarse, crystalline powder. It is very solublein water, deliquescent in moist air and effloresces in dry air at temperatures >33°C.

Storage, Stability, Compatibility

Unless otherwise stated by the manufacturer, store at roomtemperature. Crystals should be stored in tight containers.


By administering thiosulfate, an exogenous source of sulfur is available to thebody, thereby allowing it hasten the detoxification of cyanide using the enzyme rhodanese.
Rhodanese (thiosulfate cyanide sulfurtransferase) converts cyanide to the relatively nontoxicthiocyanate ion. Thiocyanate is then excreted in the urine.
Sodium thiosulfate's topical antifungal activity is probably due to its slow release of colloidalsulfur.
While sodium thiosulfate has been recommended for treating arsenic (and some other heavymetal) poisoning, it's proposed mechanism of action is not known. Presumably the sulfate moietymay react with and chelate the metal, allowing its removal.

Uses, Indications

Sodium thiosulfate (alone or in combination with sodium nitrite) is useful inthe treatment of cyanide toxicity. It has been touted for use in treating arsenic or other heavy metalpoisonings, but its efficacy is in question for these purposes. However, because sodium thiosulfateis relatively non-toxic and inexpensive, it may be tried to treat arsenic poisoning. When used incombination with sodium molybdate sodium thiosulfate may be useful for the treatment of copperpoisoning.
Sodium thiosulfate may also be useful for the topical treatment for some fungal infections (Tinea).
In humans, sodium thiosulfate has been used to reduce the nephrotoxicity of cisplatin therapy.

Pharmacokinetics - SODIUM THIOSULFATE

Sodium thiosulfate is relatively poorly absorbed from the GI tract. Whensubstantial doses are given PO, it acts a saline cathartic. When administered intravenously, it isdistributed in the extracellular fluid and then rapidly excreted via the urine.

Contraindications, Precautions, Reproductive Safety

There are no absolute contraindicationsto the use of the drug. Safe use during pregnancy has not been established; use when benefitsoutweigh the potential risks.

Adverse Effects, Warnings

The drug is relatively non-toxic. Large doses by mouth may causeprofuse diarrhea. Injectable forms should be given slowly IV.

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