Alternate Name(s):
Tetramethylthionine chloride trihydrate
Classification:
Antidote
Original Date:
March 2007
Indications:
- Antidote for cyanide poisoning and drug induced methemoglobinemia.
- As a dye in diagnostic procedures.
Reconstitution and Stability:
- Available as 1% solution (10 mg/mL).
- Store at room temperature.
Compatibility:
Solution Compatible: 0.9% NaCl
Incompatible: Do not dilute with other IV solutions
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct |
YES, by physician ONLY
Undiluted or diluted in NS Inject over 5 minutes |
| IV Intermittent Infusion | NO |
| IV Continuous Infusion | NO |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
- Usual IV dose is 1-2 mg/kg injected over several minutes.
- Alternatively, an IV dose of 25-50 mg/m2 has been administered.
- Dose may be repeated in one hour if necessary.
Potential hazards of parenteral administration:
- Inject slowly to minimize formation of additional methemoglobinemia.
- May cause nausea, vomiting, abdominal and chest pain, dizziness, headache, profuse sweating, confusion and hypertension.
- With very high doses methemoglobinemia and hemolysis may occur.
Notes:
- Monitoring: methemoglobin levels, blood pressure, serum bilirubin (unconjugated) and anemia.
- Use with caution in patients with glucose-6-phosphate dehydrogenase deficiency.
- Contraindicated in severe renal impairment.
- Do not inject subcutaneously or intrathecally as necrotic abscesses (subQ) and neural damage (I.T.) including paraplegia have occurred.