Sodium Thiosulfate

[Linda Gross]

Hello all. With case reports on the successful use of Na thiosulfate for calciphylaxis mounting, so too is the usage of this agent. Wondering about other centres and how they handle this drug.  Is it formulary? Who pays for it? Are there any restrictions on use (eg. is confirmation of calciphylaxis via skin biopsy required) or do you have an algorithm that must be followed?  Any info you can pass along would be greatly appreciated.

[Ian McDormand]

It is formulary within the Nova Scotia Health Authority.

Prior to us going to 2 HAs in NS, we had it on our formulary in our former DHA. We don’t require any confirmation of calciphylaxis. Physician diagnosis is sufficient.

The cost comes out of the RDU budget.  There is no cost to the patient until they are switched to po.  The compounded oral formulation is an exception status benefit under NS Pharmacare program.

[Stephanie Gilbreath]

Does anyone have an algorithm to follow when sodium thiosulfate is ordered (eg. when appropriate, given for how long, etc.)? Costs are rising with diagnoses rising (for whatever reason) so the HD department wants us to put some limits on the ordering. Thanks!

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