![]() ![]() Ingestion or Inhalation StudyA retrospective chart review over a period of 15 years was compiled by identifying 14 patients who had been exposed to cyanide from sources other than from fire or smoke (i.e., ingestion or inhalation). Survival in these two studies was 34 of 61 (56%) for one study, and 30 of 72 (42%) for the second. Subjects were treated with up to 15 g of hydroxocobalamin. Two additional retrospective, uncontrolled studies were carried out in subjects who had been exposed to cyanide from fire or smoke inhalation. The most common adverse events for this study were chromaturia (n=6), pink or red skin discoloration (n=4), hypertension (n=3), erythema (n=2), and increased blood pressure (n=2). 1,6įollowing the administration of hydroxocobalamin, 50 of 69 subjects with cyanide poisoning (73%) survived. The median hydroxocobalamin dose was 5 g with a range from 4 g to 15 g. The presence of cyanide poisoning, defined by a pretreatment blood cyanide concentration ≥39 µmol/L was confirmed in 42 of the 63 patients with evaluable data (67%). Subjects had to be over 15 years of age, present with soot in the mouth and expectoration (to indicate smoke exposure), and have altered neurological status. Smoke-Inhalation StudiesA prospective, uncontrolled, open-label study spanning almost 7 years was carried out in 69 subjects who had been exposed to smoke inhalation from fires. ![]() Respiratory, thoracic, and mediastinal disorders: pleural effusion.Investigations: electrocardiogram repolarization abnormality, heart rate increased.Cardiac disorders: ventricular extrasystoles. ![]() Adverse reactions reported in these studies listed by system organ class included 1: Systematic collection of adverse events was not done in all of these studies and interpretation of causality is limited due to the lack of a control group and due to circumstances of administration (e.g., use in fire victims). 1Įxperience in Known or Suspected Cyanide Poisoning VictimsA total of 245 patients received hydroxocobalamin treatment in these studies. However, 4 open-label, uncontrolled clinical studies were conducted in known or suspected cyanide poisoning victims. Hydroxocobalamin, the active ingredient in CYANOKIT, has been used in France since the 1980s, was formally licensed there in 1996, and was approved in the United States in 2006 to treat known or suspected cyanide poisoning 6,7Ĭlinical ExperienceRandomized clinical trials in humans are not possible due to ethical considerations, therefore evidence in controlled trials of the effectiveness of hydroxocobalamin for the treatment of cyanide poisoning was obtained primarily from studies in animals.CYANOKIT can be used to treat multiple sources of cyanide poisoning, including smoke inhalation and ingestion 1.If clinical suspicion of cyanide poisoning is high, CYANOKIT should be administered without delay 1 CYANOKIT for intravenous infusion is indicated for the treatment of known or suspected cyanide poisoning.If cyanide poisoning is known or suspected, treat with CYANOKIT-an FDA-approved treatment option for cyanide poisoning. 1Signs and symptoms of acute systemic cyanide poisoning may develop rapidly, depending on the route and extent of cyanide exposure. 1 The expert advice of a regional poison control center may be obtained by calling 1-80. Airway, ventilatory and circulatory support, oxygen administration, and management of seizures should not be delayed to administer CYANOKIT. Comprehensive treatment of acute cyanide intoxication requires support of vital functions. ![]()
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