![]() ![]() In the absence of rapid and adequate treatment, exposure to a high dose of cyanide can result in death within minutes due to the inhibition of cytochrome oxidase resulting in arrest of cellular respiration. Hydroxocobalamin Mechanism of actionĬyanide is an extremely toxic poison. Evidence-based medicine for Chemical Defense - including efficacy and safety A. Hydroxocobalamin is indicated as an antidote in patients with known or suspected cyanide poisoning. Chemical Defense therapeutic area(s) - including key possible uses Name of Chemical Defense therapeutic agent/device The most common adverse reactions (>5%) include transient chromaturia, erythema, oxalate crystals in urine, rash, increased blood pressure, nausea, headache and infusion site reactions.1.Breastfeeding is not recommended during treatment with CYANOKIT.In animal studies, hydroxocobalamin administered to pregnant rats and rabbits during the period of organogenesis caused skeletal and soft tissue abnormalities, including alterations in the central nervous system, at exposures similar to human exposures at the therapeutic dose. There are risks to the pregnant woman and fetus associated with untreated cyanide poisoning. Available data from cases reported in the published literature and postmarketing surveillance with CYANOKIT use in pregnant women are insufficient to identify a drug-associated risk for major birth defects, miscarriage, or adverse maternal and fetal outcomes.While it is not known if the skin redness predisposes to photosensitivity, patients should be advised to avoid direct sun while their skin remains discolored. It therefore has potential to cause photosensitivity. Hydroxocobalamin absorbs visible light in the UV spectrum.This should be considered before hemodialysis is initiated in patients treated with hydroxocobalamin. Because of its deep red color, hydroxocobalamin may cause hemodialysis machines to shut down due to an erroneous detection of a “blood leak”.While determination of blood cyanide concentration is not required for management of cyanide poisoning and should not delay treatment with CYANOKIT, collecting a pretreatment blood sample may be useful for documenting cyanide poisoning as sampling post-CYANOKIT use may be inaccurate.Be aware of this when reporting and interpreting laboratory results. Because of its deep red color, hydroxocobalamin has been found to interfere with colorimetric determination of certain laboratory parameters (e.g., clinical chemistry, hematology, coagulation, and urine parameters).Substantial increases in blood pressure may occur following CYANOKIT therapy. ![]() Monitor renal function for 7 days following CYANOKIT therapy.
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