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Hydroxocobalamin

Presentation

5g vial

Note: Not interchangeable with the 1mg vial

*SAS*

Role

Management of severe cyanide toxicity, evidenced by altered level of consciousness, seizures, hypotension, significant acidosis.

Hydroxocobalamin (Cyanokit)
  • ALERT – Consultation with a clinical toxicologist is recommended through the local toxicology service or Poisons Information Centre 13 11 26 prior to administration of hydroxocobalamin for cyanide poisoning.

Dose

5g IV (child: 70mg/kg) over 15mins

Can be repeated once at 30min if inadequate response.

Stocking recommendations

Tertiary centre Regional centre Rural centre Remote centre

0 – 2 kits

0 kits 0 kits 0 kits

Rationale

Given the availability of a reasonable alternative (sodium thiosulfate) and the prohibitive cost, these recommendations reflect a pragmatic approach to antidote stocking. 2 kits will cover the dosing recommendations listed above should a repeat dose be needed.

Disclaimer

Fact sheet developed by Queensland Poisons Information Centre, Updated: July 2020.

This fact sheet is about the use of these antidotes in Australia, and may not apply to other countries. Children’s Health Queensland Hospital and Health Service cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this fact sheet.

CHQ