• Management of severe cyanide poisoning evidenced by altered level of consciousness, seizures, hypotension or significant acidosis.
  • Must be given with either hydroxocobalamin (preferred) or sodium nitrite.

Vial with the name Natriumthiosulfate.


12.5g IV (child 400mg/kg) in 200mL 5% glucose over 30 min.

Stocking recommendations

Tertiary centre Regional centre Rural centre Remote centre
25g 25g 0-25g 0


If available, hydroxocobalamin 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