Sodium thiosulfate (intravenous route)


      Brand Name

      US Brand Name

      Pedmark


      Description

      Sodium thiosulfate may be used to lessen some of the side effects of cisplatin (a cancer medicine). It is also used with another medicine in the emergency treatment of cyanide poisoning.

      Sodium thiosulfate is also used to reduce the risk of hearing loss in children 1 month of age and older who are receiving medicines (eg, cisplatin) for cancer that have not spread throughout the body.

      This medicine is to be given only by or under the immediate supervision of your doctor.

      This product is available in the following dosage forms:

      • Solution

      Before Using

      In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

      Allergies

      Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

      Pediatric

      Although there is no specific information comparing use of sodium thiosulfate in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

      Appropriate studies have not been performed on the relationship of age to the effects of Pedmark® in children younger than 1 month of age or in children with cancer that has spread (metastatic). Safety and efficacy have not been established.

      Use in children younger than 1 month of age is not recommended because Pedmark® may increase the risk of hypernatremia (high sodium levels in the blood).

      Geriatric

      Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing the use of sodium thiosulfate in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

      No information is available on the relationship of age to the effects of Pedmark® in geriatric patients.

      Breastfeeding

      There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

      Drug Interactions

      Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

      Other Interactions

      Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

      Other Medical Problems

      The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

      • Allergy to sulfites, history of or
      • Asthma or
      • Hypernatremia (high sodium levels in the blood) or
      • Hypokalemia (low potassium levels in the blood)—Use with caution. May make these conditions worse.
      • Edema (swelling of feet or lower legs) or
      • Heart disease or
      • High blood pressure (hypertension) or
      • Kidney disease or
      • Liver disease or
      • Toxemia of pregnancy—Sodium thiosulfate may cause the body to retain (keep) water, which may make these conditions worse.
      • Kidney disease—Use with caution. The effects may be increased because of the slower removal of the medicine from the body.

      Proper Use

      Pedmark®: A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins. It must be given slowly, so the needle will need to stay in place for at least 15 minutes.

      This medicine is given 6 hours after receiving cancer medicine (eg, cisplatin).

      You may also receive other medicine (eg, allergy medicine, steroid medicine) or medicine to prevent nausea or vomiting before receiving this medicine.


      Precautions

      It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

      This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have chest pain, cough, difficulty swallowing, dizziness, fast heartbeat, hives, itching, or skin rash, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, trouble breathing, or unusual tiredness or weakness.

      This medicine may increase sodium and decrease potassium in your blood. Check with your doctor right away if you have muscle weakness, seizures, or unusual tiredness or weakness.


      Side Effects

      Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

      Check with your doctor or nurse immediately if any of the following side effects occur:

      More common

      • Black, tarry stools
      • bone pain
      • chills
      • cough or hoarseness
      • decreased urine
      • dizziness
      • dry mouth
      • fast heartbeat
      • fever
      • high blood pressure
      • increased thirst
      • irritability
      • loss of appetite
      • lower back or side pain
      • mood changes
      • muscle pain, cramps, or twitching
      • nausea
      • numbness or tingling in the hands, feet, or lips
      • painful or difficult urination
      • pale skin
      • seizures
      • sore throat
      • swelling of the feet or lower legs
      • trouble breathing
      • ulcers, sores, or white spots in the mouth
      • unusual bleeding or bruising
      • unusual tiredness or weakness
      • vomiting

      Incidence not known

      • Blurred vision
      • chest tightness
      • confusion
      • difficulty swallowing
      • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
      • drowsiness
      • headache
      • hives, itching, or skin rash
      • muscle tremors
      • nervousness
      • pounding in the ears
      • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
      • restlessness
      • slow or fast heartbeat
      • stomach cramps
      • sweating

      Get emergency help immediately if any of the following symptoms of overdose occur:

      Symptoms of overdose

      • Agitation
      • blurred vision
      • mental changes
      • muscle cramps
      • nausea and vomiting
      • pain in the joints
      • ringing in the ears
      • seeing, hearing, or feeling things that are not there

      Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

      More common

      • Swelling or inflammation of the mouth

      Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

      Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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