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Frequently Asked Questions
What is NITHIODOTE?
Nithiodote is a Cyanide Antidote Kit that contains a vial of Sodium Nitrite Injection and a separate vial of Sodium Thiosulfate Injection.
What is NITHIODOTE used for?
Nithiodote is indicated for the treatment of acute cyanide poisoning that is judged to be life-threatening. Please read the Prescribing Information with Boxed Warning.
How is NITHIODOTE administered?
The Nithiodote are administered by intravenous injection.
| Age |
Intravenous Dose of Sodium Nitrite and Sodium Thiosulfate |
| Adults |
1.) Sodium Nitrite - 10 mL of a 3% solution (300 mg) of sodium nitrite at the rate of 2.5 to 5 mL/minute
2.) Sodium Thiosulfate - 50 mL of a 25% solution (12.5 g) of a sodium thiosulfate solution immediately following administration of sodium nitrite. |
| Children |
1.) Sodium Nitrite - 0.2 mL/kg of a 3% solution (6 mg/kg or 6-8 mL/m2 BSA) of sodium nitrite at the rate of 2.5 to 5 mL/minute not to exceed 10 mL (300 mg)
2.) Sodium Thiosulfate - 1 mL/kg of body weight using a 25% solution (250 mg/kg or approximately 30-40 mL/m2 of BSA) not to exceed 50 mL (12.5 g) total dose immediately following administration of sodium nitrite. |
If signs of cyanide poisoning reappear, repeat treatment using one-half the original dose of both sodium nitrite and sodium thiosulfate.
How does NITHIODOTE work?
Sodium nitrite reacts with hemoglobin to form methemoglobin. Cyanide has a high affinity for methemoglobin, and it binds to methemoglobin instead of other critical molecules.
Sodium thiosulfate helps to hasten the detoxification and excretion of cyanide. By reacting with it, thiosulfate converts cyanide to a less toxic molecule (thiocyanate) which can be readily excreted in the urine.
How is NITHIODOTE packaged?
Each box of Nithiodote includes a 10 milliliter vial of Sodium Nitrite Injection that contains 300 mg of sodium nitrite and a 50 milliliter vial of Sodium Thiosulfate Injection that contains 12.5 grams of sodium thiosulfate.
Why does NITHIODOTE consist of two different drug products?
Each drug product has a different action against cyanide. The combination of the two drug products significantly enhances the detoxification of cyanide compared to the individual effects of each.
When should NITHIODOTE be administered?
Treatment for cyanide poisoning should be started immediately, whether in the hospital or before arrival to the hospital. Comprehensive treatment includes support of vital functions, such as breathing and circulation. Nithiodote should be administered under the direction of a healthcare professional, when determined to be clinically appropriate, as an adjunct to appropriate supportive therapies.
Can NITHIODOTE be given to pediatric patients?
Yes, however, the corresponding doses of each drug product should be adjusted to account for each patient's weight according to the dosing table provided in the Nithiodote prescribing information.
Is NITHIODOTE "FDA-approved"?
Yes.
Where is NITHIODOTE manufactured?
Nithiodote and its active ingredients are manufactured in the United States.
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