Thiosulfate side effects: what 540 FDA adverse event reports show
Drug class
Not stated in label
Label matched
Sodium Thiosulfate (Pedmark)
Who reports
540 reports · 83% serious · 78 with death outcome · 59% female
Used for
PEDMARK is indicated to reduce the risk of ototoxicity associated with cisplatin in pediatric patients 1 month of age and older with localized, non-metastatic solid tumors. Limitations of Use The safety and efficacy of PEDMARK have not been established when administered following cisplatin infusions longer than 6 hours.
What it is
Sodium thiosulfate anhydrous is an inorganic salt with a molecular formula of Na 2 S 2 O 3 and a molecular weight of 158.11 g/mol.
Boxed warning
None in the current label
Causality screen of the 5 strongest signals
What the badges mean
- Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 1 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Metabolic acidosis | 31 | 38.1 27.0–53.6ROR 40.3 · χ² 1,083 / p 1e-237 | 37.2 EB05 27.5 · IC025 +4.0 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 26.5 · 96% clinician | no trial data cached |
| Hypocalcaemia (low calcium) | 12 | 24.7 14.1–43.2ROR 25.2 · χ² 250 / p 1e-56 | 23.7 EB05 14.2 · IC025 +2.7 3/3 methods agree | Not in label — unassessed | serious PRR 15.2 | no trial data cached |
| Neurotoxicity | 9 | 20.1 10.5–38.5ROR 20.4 · χ² 145 / p 1e-33 | 18.6 EB05 9.4 · IC025 +2.2 3/3 methods agree | Not in label — unassessed | serious PRR 14.1 | no trial data cached |
| Infusion site pain | 6 | 18.3 8.2–40.5ROR 18.4 · χ² 81 / p 9e-20 | 15.0 EB05 5.5 · IC025 +1.6 3/3 methods agree | Not in label — unassessed | serious n=4 | no trial data cached |
| Sneezing | 10 | 17.4 9.4–32.1ROR 17.7 · χ² 138 / p 3e-32 | 16.0 EB05 8.1 · IC025 +2.2 3/3 methods agree | Not in label — unassessed | serious PRR 12.0 | no trial data cached |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Metabolic acidosis | 31 | 38.1 27.0–53.6ROR 40.3 · χ² 1,083 / p 1e-237 | 37.2 EB05 27.5 · IC025 +4.0 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 26.5 · 96% clinician | no trial data cached |
| Hypocalcaemia (low calcium) | 12 | 24.7 14.1–43.2ROR 25.2 · χ² 250 / p 1e-56 | 23.7 EB05 14.2 · IC025 +2.7 3/3 methods agree | Not in label — unassessed | serious PRR 15.2 | no trial data cached |
| Sneezing | 10 | 17.4 9.4–32.1ROR 17.7 · χ² 138 / p 3e-32 | 16.0 EB05 8.1 · IC025 +2.2 3/3 methods agree | Not in label — unassessed | serious PRR 12.0 | no trial data cached |
| Neurotoxicity | 9 | 20.1 10.5–38.5ROR 20.4 · χ² 145 / p 1e-33 | 18.6 EB05 9.4 · IC025 +2.2 3/3 methods agree | Not in label — unassessed | serious PRR 14.1 | no trial data cached |
| Infusion site pain | 6 | 18.3 8.2–40.5ROR 18.4 · χ² 81 / p 9e-20 | 15.0 EB05 5.5 · IC025 +1.6 3/3 methods agree | Not in label — unassessed | serious n=4 | no trial data cached |
| Nephropathy toxic | 4 | 13.9 5.3–37.0ROR 14.0 · χ² 36 / p 1e-9 | 8.5 EB05 2.8 · IC025 +0.8 3/3 methods agree | Not in label — unassessed | serious PRR 9.9 | no trial data cached |
Unlabeled candidate signals
Every screened signal with n ≥ 20 was either labeled, an indication term, or an artifact pattern — no unlabeled candidate stood out in the top signals.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Thiosulfate?
In FDA FAERS, the most frequently co-reported reaction terms for Thiosulfate are metabolic acidosis, hypocalcaemia, sneezing, neurotoxicity, infusion site pain, nephropathy toxic. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Thiosulfate have an FDA boxed warning?
No. The FDA label retrieved for Thiosulfate has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Thiosulfate causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID f98c7076-2a7b-4fd7-ab90-eed5e9137bae, effective 20251027; matched on
openfda.generic_name.exact:"SODIUM THIOSULFATE") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 6 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath
Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.