Sodium Thiosulfate

AHFS Class: Antifungals, Miscellaneous (84:04.08.92)

ATC Class: D08AX07
VA Class: AD200

View the associated Essentials monograph.

Introduction

Sodium thiosulfate is used as an antifungal agent.

Uses

Sodium thiosulfate is used topically in the treatment of tinea versicolor. Sodium thiosulfate also is used systemically (as an injection) as an adjunct in the management of cyanide poisoning (specialized references or the manufacturers’ labeling should be consulted) and to reduce the risk of nephrotoxicity associated with cisplatin therapy (see Cisplatin 10:00).

Cautions

Therapy with sodium thiosulfate should be discontinued if irritation or sensitivity occurs. The lotion or solution should not be applied to or near the eyes.

Dosage and Administration

Sodium thiosulfate is applied topically in the form of a 25% lotion or solution (no longer commercially available in the US). A commercially available lotion also containing salicylic acid may be used. Alternatively, aqueous solutions of the drug are prepared extemporaneously.

For the treatment of tinea versicolor, a thin film of sodium thiosulfate 25% lotion or solution is applied to the involved areas twice daily; these areas should be thoroughly cleansed and dried before applying the lotion or solution. Although evidence of active infection may disappear within a few days, treatment is usually continued for several weeks to months.

Chemistry

Sodium thiosulfate is used as an antifungal agent. Sodium thiosulfate occurs as large, colorless crystals or a coarse, crystalline powder. The drug is deliquescent in moist air and effloresces in dry air at temperatures greater than 33°C. Sodium thiosulfate is very soluble in water and insoluble in alcohol. Solutions of the drug are neutral or faintly alkaline to litmus.

Preparations

Sodium Thiosulfate

Routes	Forms	Strengths	Brand Names	Manufacturer
Crystals*

* available by nonproprietary name

Sodium Thiosulfate Combinations

Routes	Forms	Strengths	Brand Names	Manufacturer
Topical	Lotion	25% with Salicylic Acid 1%	Versiclear® Lotion (with isopropyl alcohol 10% and propylene glycol)	Hope

Selected Revisions June 2008, © Copyright, January 1959, American Society of Health-System Pharmacists, Inc. 7272 Wisconsin Avenue, Bethesda, MD 20814.