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Thiosulfuric acid
Accession Number
Small Molecule
Approved, Investigational

Thiosulfuric acid (as sodium thiosulfate) has the chemical name thiosulfuric acid, disodium salt, pentahydrate. The chemical formula is Na2S2O3•5H2O and the molecular weight is 248.17. Sodium Thiosulfate Injection is a cyanide antidote which contains one 50 mL glass vial containing a 25% solution of Sodium Thiosulfate Injection.

It has been indicated as antidote for cyanide poisoning. It is also used as adjunct agent for patients taking cisplatin chemotherapy.

Beside the above indications, sodium thiosulfate could be used as ingredient in the following: agricultural chemicals (non-pesticidal), fillers, intermediates, laboratory chemicals, oxidizing/reducing agents, process regulators, processing aids, and solids separation agents.

  • Monosulfanemonosulfonic acid
  • Sulfurothioic S-acid
Product Ingredients
IngredientUNIICASInChI Key
Sodium thiosulfateL0IYT1O31N7772-98-7AKHNMLFCWUSKQB-UHFFFAOYSA-L
Sodium thiosulfate pentahydrateHX1032V43M10102-17-7PODWXQQNRWNDGD-UHFFFAOYSA-L
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
SeacalphyxSolutionIntravenousSeaford Pharmaceuticals Inc2013-01-08Not applicableCanada
Sodium ThiosulfateInjection, solution250 mg/1mLIntravenousHope Pharmaceuticals2012-02-14Not applicableUs
Sodium Thiosulfate Inj 25% USPLiquidIntravenousDavid Bull Laboratories (Pty) Ltd.1991-12-311998-08-13Canada
Sodium Thiosulfate Injection USPSolutionIntravenousHope Pharmaceuticals2015-11-23Not applicableCanada
Sodium Thiosulfate Injection USPSolutionIntravenousPfizer Canada Ulc1998-07-13Not applicableCanada
Sodum ThiosulfateInjection, solution250 mg/1mLIntravenousAmerican Regent1990-09-302012-11-28Us
Sodum ThiosulfateInjection, solution100 mg/1mLIntravenousAmerican Regent1990-09-302012-11-28Us
Additional Data Available
  • Application Number
    Application Number

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  • Product Code
    Product Code

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Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Oligostim SoufreTabletOralDolisos Laboratoires S.A.1998-06-112007-08-01Canada
Additional Data Available
  • Application Number
    Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

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  • Product Code
    Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
Adasept Acne GelSodium thiosulfate (8 %) + Salicylic acid (2 %) + Triclosan (0.5 %)LotionTopicalOdan Laboratories Ltd1974-12-31Not applicableCanada
NithiodoteSodium thiosulfate pentahydrate (250 mg/1mL) + Sodium nitrite (30 mg/1mL)KitIntravenousHope Pharmaceuticals2011-01-14Not applicableUs
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
Sodium polysulthionate and folic acidSodium thiosulfate pentahydrate (1.8 mg/1) + Folic acid (1 mg/1) + Octasulfur (388 mg/1) + Sodium sulfate decahydrate (8 mg/1)CapsuleOralSolubiomix2016-08-242017-10-16Us
Sodium polysulthionate, 5-methyltetrahydrofolateSodium thiosulfate pentahydrate (.45 g/100g) + Levomefolic acid (.125 g/100g) + Octasulfur (97 g/100g) + Sodium sulfate decahydrate (2 g/100g)PowderOral; TopicalSolubiomix2015-07-212016-01-12Us
Sodium Polysulthionate, 5-mthfSodium thiosulfate pentahydrate (1.8 mg/1) + 5-methyltetrahydrofolic acid (.5 mg/1) + Octasulfur (388 mg/1) + Sodium sulfate decahydrate (8 mg/1)CapsuleOralSolubiomix2016-01-092016-01-12Us
Sodum ThiosulfateSodium thiosulfate pentahydrate (250 mg/1mL)Injection, solutionIntravenousAmerican Regent1990-09-302012-11-28Us
Sodum ThiosulfateSodium thiosulfate pentahydrate (100 mg/1mL)Injection, solutionIntravenousAmerican Regent1990-09-302012-11-28Us
XizflusSodium thiosulfate pentahydrate (1.8 mg/1) + 5-methyltetrahydrofolic acid (.5 mg/1) + Octasulfur (388 mg/1) + Sodium sulfate decahydrate (8 mg/1)CapsuleOralBasiem2016-01-092016-01-12Us
XizflusSodium thiosulfate pentahydrate (.45 g/100g) + 5-methyltetrahydrofolic acid (.125 g/100g) + Octasulfur (97 g/100g) + Sodium sulfate decahydrate (2 g/100g)PowderOral; TopicalBasiem2015-07-142016-01-12Us
CAS number
Average: 114.144
Monoisotopic: 113.94453531
Chemical Formula
InChI Key



Indicated for sequential intravenous use with sodium nitrite for the treatment of acute cyanide poisoning that is judged to be life-threatening.

Associated Conditions

In dogs, pretreatment with sodium thiosulfate to achieve a steady state level of 2 µmol/mL increased the rate of conversion of cyanide to thiocyanate over 30-fold.

Mechanism of action

As antidote: Sodium thiosulfate acts as a sulfur donor for the endogenous sulfur transferase enzyme, rhodanese. It is used together with sodium nitrite for cyanide poisiong as antidote. Cyanide has a very high affinity for iron in the ferric state. It reacts with the trivalent (ferric) iron of mitochondrial cytochrome oxidase, thereby inhibiting cellular respiration, resulting in lactic acidosis and cytotoxic hypoxia. Sodium nitrite reacts with hemoglobin to form methemoglobin, which competes with cytochrome oxidase for the cyanide ion. Cyanide binds to methemoglobin to form cyanmethemoglobin and restore the activity of cytochrome oxidase. When cyanide dissociates from methemoglobin, sodium thiosulfate facilitates its conversion by rhodanese to thiocyanate, a less toxic ion. As antineoplastic adjunct: The mechanism of action of sodium thiosulfate is still not clear, but it is thought that it forms a complex with cisplastin via covalent bond, which renders cisplastin more readily eliminated from the kidneys. It was believed also that sodium thiosulfate plays a role in the protection from nephrotoxicity caused by cisplastin, through reducing delivery of cisplatin to the kidneys and by neutralizing cisplatin in the kidneys where sodium thiosulfate is highly concentrated.

Additional Data Available
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Thiosulfate taken orally is not systemically absorbed. Most of the thiosulfate is oxidized to sulfate or is incorporated into endogenous sulphur compounds; a small proportion is excreted through the kidneys. After an intravenous injection of 1 g sodium thiosulfate in patients, the reported serum thiosulfate half-life was approximately 20 minutes. However, after an intravenous injection of a substantially higher dose of sodium thiosulfate (150 mg/kg, that is, 9 g for 60 kg body weight) in normal healthy men, the reported elimination half-life was 182 minutes.

Volume of distribution

150 mL/kg.

Protein binding

Data not found.


Data not found.

Route of elimination

Elimination is primarily renal, approximately 20-50% of exogenously administered thiosulfate is eliminated unchanged via the kidneys Antidote (to cyanide poisoning): Primarily as thiocyanate. Antineoplastic adjunct: As a nontoxic sodium thiosulfate/cisplatin complex.

Half life

Thiosulfate: 15 to 20 minutes.


1.86 ± 0.45 ml/min per kg.


Oral, rat : LD50 = >5000mg/kg

Affected organisms
  • Humans and other mammals
Not Available
Pharmacogenomic Effects/ADRs
Not Available


Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Technetium Tc-99m oxidronateThiosulfuric acid may decrease effectiveness of Technetium Tc-99m oxidronate as a diagnostic agent.
Additional Data Available
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Food Interactions
Not Available


General References
  1. MSDS [Link]
  2. Monograph [Link]
  3. product info [Link]
  4. product info [Link]
  5. database [Link]
External Links
Human Metabolome Database
KEGG Compound
PubChem Compound
PubChem Substance
AHFS Codes
  • 92:12.00 — Antidotes
  • 88:29.00* — Minerals

Clinical Trials

Clinical Trials
0RecruitingTreatmentMalignant Abdominal Neoplasm / Malignant Pelvic Neoplasm / Recurrent Colon Carcinoma / Recurrent Desmoplastic Small Round Cell Tumor / Recurrent Fallopian Tube Carcinoma / Recurrent Gastric Carcinoma / Recurrent Liposarcoma / Recurrent Malignant Mesothelioma / Recurrent Ovarian Carcinoma / Recurrent Primary Peritoneal Carcinoma / Recurrent Rectal Carcinoma / Recurrent Rhabdomyosarcoma / Recurrent Sarcoma / Refractory Colon Carcinoma / Refractory Desmoplastic Small Round Cell Tumor / Refractory Fallopian Tube Carcinoma / Refractory Gastric Carcinoma / Refractory Liposarcoma / Refractory Malignant Mesothelioma / Refractory Ovarian Carcinoma / Refractory Primary Peritoneal Carcinoma / Refractory Rectal Carcinoma / Refractory Rhabdomyosarcoma / Refractory Sarcoma / Resectable Liposarcoma / Resectable Malignant Mesothelioma / Resectable Sarcoma1
1CompletedTreatmentMalignant Pleural Mesothelioma (MPM)1
1CompletedTreatmentMalignant Pleural Mesothelioma (MPM) / Pleural Mesotheliomas1
1Not Yet RecruitingOtherHealthy Volunteers1
1TerminatedTreatmentBone Marrow Suppression / Brain and Central Nervous System Tumors / Drug/Agent Toxicity by Tissue/Organ / Long-Term Effects Secondary to Cancer Therapy in Children1
1, 2CompletedTreatmentAcute Coronary Syndromes (ACS)1
1, 2RecruitingTreatmentAdult Anaplastic Oligodendroglioma / Adult Mixed Glioma / Adult Oligodendroglioma / Oligoastrocytoma / Recurrent Adult Brain Neoplasm1
1, 2RecruitingTreatmentCentral Nervous System Lymphoma1
1, 2SuspendedTreatmentAdult Central Nervous System Germ Cell Tumor / Adult Embryonal Tumor With Multilayered Rosettes, C19MC-Altered / Adult Ependymoblastoma / Adult Medulloblastoma / Adult Pineoblastoma / Adult Supratentorial Embryonal Tumor, Not Otherwise Specified / Adult Supratentorial Primitive Neuroectodermal Tumor / Atypical Teratoid/Rhabdoid Tumor / Central Nervous System Embryonal Tumor / Childhood Atypical Teratoid/Rhabdoid Tumor / Childhood Central Nervous System Germ Cell Tumor / Childhood Embryonal Tumor With Multilayered Rosettes, C19MC-Altered / Childhood Ependymoblastoma / Germ Cell Tumors / Medulloepithelioma / Ototoxicity / Recurrent Adult Brain Neoplasm / Recurrent Childhood Central Nervous System Embryonal Neoplasm / Recurrent Childhood Malignant Germ Cell Tumor / Recurrent Childhood Medulloblastoma / Recurrent Childhood Pineoblastoma / Recurrent Childhood Supratentorial Embryonal Tumor, Not Otherwise Specified / Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor1
1, 2WithdrawnTreatmentBrain and Central Nervous System Tumors / Breast Cancer / Cognitive/Functional Effects / Drug/Agent Toxicity by Tissue/Organ / Psychosocial Effects of Cancer and Its Treatment1
2Active Not RecruitingTreatmentGastrointestinal Cancers1
2CompletedTreatmentAdrenocortical Carcinoma / Peritoneal Carcinomatosis1
2CompletedTreatmentCalcific Tendinitis of the Rotator Cuff1
2CompletedTreatmentCalcifications, Vascular / Coronary Calcification1
2CompletedTreatmentCalcinosis / Dermatomyositis Associated Superficial Calcinosis / Superficial Calcinosis1
2CompletedTreatmentMalignant Pleural Mesothelioma (MPM) / Pleural Mesotheliomas1
2RecruitingPreventionHeart Failure / Myocardial Infarction1
2RecruitingTreatmentAdrenocortical Carcinoma / Peritoneal Carcinomatosis1
2RecruitingTreatmentDermatomyositis / Idiopathic Inflammatory Myopathies / Juvenile Dermatomyositis1
2RecruitingTreatmentEsophagogastric Junction / Gastric Adenocarcinoma / Malignant Neoplasm of Stomach1
2TerminatedDiagnosticMalignant Pleural Mesothelioma (MPM) / Pleural Mesotheliomas1
2TerminatedSupportive CareAdverse Effects / DDP / Head and Neck Carcinoma1
2TerminatedTreatmentBrain and Central Nervous System Tumors / Drug/Agent Toxicity by Tissue/Organ / Malignant Lymphomas / Thrombocytopenia1
2WithdrawnTreatmentCutaneous calcification1
3CompletedSupportive CareChildhood Germ Cell Tumor / Extragonadal Germ Cell Tumor / Liver Cancer / Neoplasms, Brain / Neuroblastomas / Ototoxicity / Ovarian Cancer / Sarcomas / Tumors of the Central Nervous System1
3TerminatedTreatmentCalcific Uremic Arteriolopathy (CUA) / Calciphylaxis1
3Unknown StatusTreatmentLiver Cancer / Ototoxicity1
4RecruitingTreatmentCutaneous calcification1
Not AvailableAvailableNot AvailableCisplatin-Induced Hearing Loss in Children Who Had Standard-risk Hepatoblastoma1
Not AvailableCompletedTreatmentCardiovascular Heart Disease / Complication of Hemodialysis1
Not AvailableCompletedTreatmentKidney Stones1
Not AvailableCompletedTreatmentRenal Failure1
Not AvailableRecruitingNot AvailableCalciphylaxis / Renal Insufficiency,Chronic1
Not AvailableTerminatedPreventionMalignancies1


Not Available
Not Available
Dosage forms
Injection, solutionIntravenous100 mg/1mL
Injection, solutionIntravenous250 mg/1mL
PowderOral; Topical
Not Available
Patent NumberPediatric ExtensionApprovedExpires (estimated)
Additional Data Available
  • Filed On
    Filed On

    The date on which a patent was filed with the relevant government.

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Not Available
Experimental Properties
Not Available
Predicted Properties
pKa (Strongest Acidic)11.35ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count3ChemAxon
Hydrogen Donor Count2ChemAxon
Polar Surface Area57.53 Å2ChemAxon
Rotatable Bond Count0ChemAxon
Refractivity21.76 m3·mol-1ChemAxon
Polarizability8.51 Å3ChemAxon
Number of Rings0ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
Not Available


Mass Spec (NIST)
Not Available
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSsplash10-03di-2900000000-cfd5e2fee5605aa6f365
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSsplash10-03di-1900000000-14f35b6955762fa5ef9c
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSsplash10-01pk-9300000000-6d71fc2acfdc5c953636
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSsplash10-03di-0900000000-4fefeb50f8b5131bb095
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSsplash10-03di-1900000000-25562aa85ac0e34c2f5b
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSsplash10-03di-1900000000-c55a98b5b4d32b24a3cd


This compound belongs to the class of inorganic compounds known as non-metal thiosulfates. These are inorganic non-metallic compounds containing a thiosulfate as its largest oxoanion.
Inorganic compounds
Super Class
Homogeneous non-metal compounds
Non-metal oxoanionic compounds
Sub Class
Non-metal thiosulfates
Direct Parent
Non-metal thiosulfates
Alternative Parents
Inorganic sulfides / Inorganic oxides
Non-metal thiosulfate / Inorganic oxide / Inorganic sulfide
Molecular Framework
Not Available
External Descriptors
thiosulfuric acid (CHEBI:29279)


Pharmacological action
General Function
Thiosulfate sulfurtransferase activity
Specific Function
Formation of iron-sulfur complexes, cyanide detoxification or modification of sulfur-containing enzymes. Other thiol compounds, besides cyanide, can act as sulfur ion acceptors. Also has weak merca...
Gene Name
Uniprot ID
Uniprot Name
Thiosulfate sulfurtransferase
Molecular Weight
33428.69 Da

Drug created on November 30, 2015 12:10 / Updated on January 25, 2020 15:09