Table 4.

Treatment of cyanide poisoning as recommended by TOXBASE⁹

Severity	Treatment
Mild	12.5 g sodium thiosulfate IV over 10 min
Moderate	12.5 g sodium thiosulfate IV over 10 min OR 200 mL of 25 mg/mL hydroxocobalamin IV over 15 min OR 20 mL of 1.5% dicobalt edetate solution (300 mg) IV over 1 min followed immediately by 50 mL of 50% dextrose
Severe	20 mL of 1.5% dicobalt edetate solution (300 mg) IV over 1 min followed immediately by 50 mL of 50% dextrose. If only partial response or patient relapses after recovery, repeat dose OR 200 mL of 25 mg/mL hydroxocobalamin IV over 15 min. A second dose of 5 g can be given over 15 min to 2 hours depending on patient stability and poisoning severity OR If neither of the above available, give 10 mL of 3% sodium nitrite solution IV over 5–20 min AND 12.5 g of sodium thiosulfate IV over 10 min. A further dose of sodium thiosulfate can be given if necessary

IV, intravenous.