The antidotal action of sodium nitrite and sodium thiosulfate against cyanide poisoning

J Clin Pharmacol. 1992 Apr;32(4):368-75. doi: 10.1002/j.1552-4604.1992.tb03849.x.


The combination of sodium thiosulfate and sodium nitrite has been used in the United States since the 1930s as the primary antidote for cyanide intoxication. Although this combination was shown to exhibit much greater efficacy than either ingredient alone, the two compounds could not be used prophylactically because each exhibits a number of side effects. This review discusses the pharmacodynamics, pharmacokinetics, and toxicology of the individual agents, and their combination.

Publication types

  • Review

MeSH terms

  • Animals
  • Antidotes / adverse effects
  • Antidotes / pharmacokinetics
  • Antidotes / therapeutic use*
  • Biological Availability
  • Cyanides / pharmacokinetics
  • Cyanides / poisoning*
  • Drug Therapy, Combination
  • Humans
  • Poisoning / drug therapy
  • Sodium Nitrite / adverse effects
  • Sodium Nitrite / pharmacokinetics
  • Sodium Nitrite / therapeutic use*
  • Thiosulfates / adverse effects
  • Thiosulfates / pharmacokinetics
  • Thiosulfates / therapeutic use*


  • Antidotes
  • Cyanides
  • Thiosulfates
  • sodium thiosulfate
  • Sodium Nitrite