Frequently Asked Questions

FAQs About CYANOKIT®

  • What is CYANOKIT®?
    CYANOKIT® contains hydroxocobalamin, an antidote indicated for the treatment of known or suspected cyanide poisoning.1 Learn more about CYANOKIT®.
  • Is CYANOKIT® the same medicine as the other FDA-approved cyanide antidotes such as the Cyanide Antidote Package?
    CYANOKIT® contains a completely different drug than any other cyanide antidote approved for use in the United States. The active ingredient in CYANOKIT® is hydroxocobalamin, the hydroxylated active form of vitamin B12.1
  • How long has CYANOKIT® been available?
    CYANOKIT® was FDA-approved in the United States in 2006.28 CYANOKIT® has been used in France since 1996 to treat known or suspected cyanide poisoning.2 Marketing authorization was granted throughout the European Union in 2007.29
  • How is CYANOKIT® dosed, prepared, and administered?
    The initial dose of CYANOKIT® for adults is 5 g. Previously supplied in two 2.5-g vials, it is now provided in a single 5-g vial, which contains the complete starting dose of hydroxocobalamin. It is administered by IV infusion over 15 minutes. Depending upon the severity of the poisoning and the clinical response, a second dose of  5 g may be administered by IV infusion up to a total dose of
    10 g. The rate of infusion for a potential second dose may range from 15 minutes (for patients in extremis) to 2 hours, as clinically indicated. Learn more about CYANOKIT® preparation and administration.
  • What is the mechanism of action of CYANOKIT®?
    CYANOKIT® contains the active ingredient hydroxocobalamin, which binds with cyanide, forming nontoxic cyanocobalamin (a form of vitamin B12), that is excreted from the body.1,4
  • How is CYANOKIT® packaged?
    CYANOKIT® was previously packaged as two 2.5-g (250-mL) vials of lyophilized (freeze-dried) hydroxocobalamin with 2 sterile transfer spikes, 1 IV administration set, a quick-use reference guide, and a package insert. Now, CYANOKIT® comes in a single 5-g vial, which contains the full starting dose, along with 1 sterile transfer spike, 1 IV administration set, 1 quick-use reference guide, and a package insert.
  • Is CYANOKIT® safe to administer in cases of suspected cyanide poisoning?
    CYANOKIT® is indicated for the treatment of either known or suspected cyanide poisoning. CYANOKIT® is generally well-tolerated–even in cases of unconfirmed poisoning. 1,4,11,13

    Substantial increases in blood pressure may occur following treatment with CYANOKIT®.1

    Use caution in the management of patients with known anaphylactic reactions to hydroxocobalamin or cyanocobalamin.1

    Please see full CYANOKIT® Prescribing Information for more detail.

  • What are the most common adverse reactions with CYANOKIT®?
    The most common adverse reactions (>5%) are transient and include chromaturia (red-colored urine), erythema (skin redness), rash (acne-like), increased blood pressure, nausea, headache, decreased lymphocyte percent, and injection site reactions. Allergic reactions have been observed. Usage may interfere with some clinical laboratory evaluations.1

    Please see full CYANOKIT® Prescribing Information for more detail.

  • When would a patient be administered CYANOKIT®?
    CYANOKIT® can be given in the field or in the hospital under direction of a healthcare professional.13 CYANOKIT® is indicated for the treatment of known or suspected cyanide poisoning. If clinical suspicion of cyanide poisoning is high, CYANOKIT® should be administered without delay.1
  • Can CYANOKIT® be given to pediatric patients?
    The safety and effectiveness of CYANOKIT® have not been established in this population.

FAQs About Cyanide Poisoning

  • What are potential sources of cyanide poisoning?
    Fire smoke—cyanide can be released by virtually any material containing carbon and nitrogen when burned under high temperature and low oxygen conditions.10 It is frequently found in the smoke of closed space fires.2 Learn more about cyanide poisoning from closed-space fire smoke.

    Industrial exposure—cyanide is also widely used in many industries primarily as an intermediary in industrial processes. The frequent use of cyanide for industry increases the potential for accidental exposure.25

    Terrorist attack—because cyanide is readily available and does not require special skills for effective deployment, it has the potential for use as a terrorist weapon.26

    Learn more about the dangers of cyanide.

  • What are the potential effects of cyanide poisoning?
    Cyanide is an extremely toxic poison. 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.1 The heart and brain are particularly susceptible to cyanide poisoning due to their need for large amounts of oxygen.30

    CN poisoning may also cause central nervous system side effects including intellectual impairment, Parkinson-type effects, and personality changes.10

  • How can a cyanide poisoning diagnosis quickly be confirmed?
    Currently there is no rapid test to confirm cyanide poisoning within the limited window necessary for initiating potential lifesaving treatment.21 Find out more about recognizing the signs and symptoms of cyanide poisoning.


Indication
CYANOKIT® (hydroxocobalamin for injection) 5 g for intravenous infusion is indicated for the treatment of known or suspected cyanide poisoning. If clinical suspicion of cyanide poisoning is high, CYANOKIT® should be administered without delay.

Important Safety Information
Cyanide poisoning may result from inhalation, ingestion, or dermal exposure. Prior to administration of CYANOKIT®, smoke-inhalation victims should be assessed for: exposure to fire or smoke in an enclosed area; presence of soot around the mouth, nose, or oropharynx, and altered mental status. In addition to CYANOKIT®, treatment of cyanide poisoning must include immediate attention to airway patency, adequacy of oxygenation and hydration, cardiovascular support, and management of any seizure activity.

Use caution in the management of patients with known anaphylactic reactions to hydroxocobalamin or cyanocobalamin. Allergic reactions may include: anaphylaxis, chest tightness, edema, urticaria, pruritus, dyspnea, rash, and angioneurotic edema. Substantial increases in blood pressure may occur following CYANOKIT® therapy. Usage may interfere with some clinical laboratory evaluations. Also, because of its deep red color, hydroxocobalamin may cause hemodialysis machines to shut down due to an erroneous detection of a "blood leak." This should be considered before hemodialysis is initiated in patients treated with hydroxocobalamin. Due to potential photosensitivity, patients should avoid direct sun until erythema resolves.

CYANOKIT® is Pregnancy Category C and should be used during pregnancy only if the potential benefit justifies the potential risk. Safety and effectiveness of CYANOKIT® have not been established in pediatric patients. The most common adverse reactions (>5%) are transient and include chromaturia, erythema, rash (predominantly acneiform), increased blood pressure, nausea, headache, decreased lymphocyte percentage, and injection site reactions.

Please see single 5-g vial full Prescribing Information. Please see two 2.5-g vial full Prescribing Information.

DISCLAIMER
This Web site is intended only for First Responders and Healthcare Professionals and is subject to all applicable US laws. The product information provided in this site is intended only for residents of the United States. The products discussed herein may have different product labeling in different countries.