When This Medicine Should Not Be Used:
Because cyanide poisoning can be life-threatening, there is no reason not to use this medicine to treat it.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• A nurse or other health provider will give you this medicine.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using nitroprusside (Nitropress®), procaine (Novocain®), or medicine to treat erectile dysfunction (such as sildenafil, tadalafil, Cialis®, or Viagra®). Tell your doctor if you are using diuretics or "water pills" for high blood pressure (such as furosemide, hydrochlorothiazide [HCTZ], torsemide, Demadex®, or Lasix®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, anemia, heart disease, low blood pressure, breathing problems (such as asthma or chronic obstructive pulmonary disease, COPD), or a genetic blood disease called glucose-6-phosphate dehydrogenase (G6PD) deficiency.
• Severe hypotension (low blood pressure) may occur with this medicine. It could be life-threatening and requires immediate medical attention. Your doctor will measure your blood pressure and keep it from going too low while you are receiving this medicine.
• This medicine may cause a rare, but serious blood problem called methemoglobinemia. Your doctor will measure how much methemoglobin is in your blood and keep it from going too high while you are receiving this medicine.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Bluish-colored lips, fingernails, or palms.
• Confusion about identity, place, and time.
• Fast, slow, pounding, or uneven heartbeat.
• Lightheadedness, dizziness, or fainting.
• Numbness or tingling sensation in your body.
• Seizures.
• Shortness of breath or troubled breathing.
• Unusual bleeding or bruising.
• Unusual tiredness or weakness.

If you notice these less serious side effects, talk with your doctor:

• Blurred vision.
• Headache.
• Increased sweating.
• Nausea, vomiting, or stomach pain.
• Salty taste in your mouth.
• Warm sensation over your body.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088