Comparative Pharmacology
Head-to-head clinical analysis: NITHIODOTE versus SODIUM THIOSULFATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NITHIODOTE versus SODIUM THIOSULFATE.
NITHIODOTE vs SODIUM THIOSULFATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nithiodote (sodium nitrite and sodium thiosulfate) is a cyanide antidote. Sodium nitrite induces methemoglobinemia, which competitively binds cyanide, while sodium thiosulfate serves as a sulfur donor for the enzyme rhodanese, converting cyanide to thiocyanate, which is renally excreted.
Sodium thiosulfate acts as a cyanide antidote by providing a sulfur donor for the enzyme rhodanese, which converts cyanide to the less toxic thiocyanate. It also acts as a reducing agent and chelator of calcium, forming soluble calcium thiosulfate complexes.
NITHIODOTE (sodium nitrite) 10 mg/kg IV push over 2 minutes, followed by sodium thiosulfate 50 mg/kg IV push over 10 minutes. Repeat half doses after 30 minutes if needed.
12.5 g (50 mL of 25% solution) intravenously over 10 minutes for cyanide poisoning; for cisplatin otoprotection: 9 g/m² intravenously over 15 minutes after cisplatin.
None Documented
None Documented
Terminal elimination half-life: 2.5–3 hours in adults with normal renal function; prolonged in renal impairment.
Terminal elimination half-life: 0.65 hours (IV in cyanide poisoning); context: rapid redistribution and excretion, requiring repeated doses.
Primarily renal as unchanged drug and metabolites; biliary/fecal excretion minimal (<5%).
Renal: >90% unchanged; minor biliary/fecal.
Category C
Category C
Cyanide Antidote
Cyanide Antidote