300mg in 10mL ampoule


  • Management of severe cyanide poisoning evidenced by altered level of consciousness, seizures, hypotension or significant acidosis.
  • Given in conjunction with sodium thiosulphate in moderate to severe toxicity, where hydroxocobalamin (Cyanokit 5g) is not available.

Medication box with the name DBL Soduim Nitrite Injection.

Consultation with a clinical toxicologist is recommended through the local toxicology service or Poisons Information Centre 13 11 26.


300mg IV over 5 minutes (children 4-10mg/kg), repeat half of this dose at 30mins if no clinical improvement.

Stocking recommendations

Tertiary centre Regional centre Rural centre Remote centre
0-5 ampoules 0-5 ampoules 0-2 ampoules 0 ampoules


If available, hydroxocobalamin (Cyanokit 5g) is the preferred antidote for cyanide poisoning. Sodium thiosulfate plus sodium nitrite are an acceptable alternative if hydroxocobalamin is unavailable


Fact sheet developed by Queensland Poisons Information Centre.

This fact sheet is about the use of these antidotes in Australia, and may not apply to other countries. Children’s Health Queensland Hospital and Health Service cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this fact sheet.

Last updated: July 2023