Sodium nitroprusside-associated cyanide toxicity in adult patients – fact or fiction? A critical review of the evidence and clinical relevance

Alissa Lockwood1, John Patka2, Marina Rabinovich2, Katleen Wyatt2, Prasad Abraham21Department of Pharmacy, Parkland Health System, Dallas, TX, USA; 2Department of Pharmacy and Drug Information, Grady Health System, Atlanta, GA, USAAbstract: Since its US Food and Drug Administration (FDA) approval in 1974, sodium nitroprusside (SNP) has been fraught with controversy in regards to its safety. Over the years, a growing concern related to SNPs propensity to cause cyanide (CN) toxicity culminated into a series of case reports that led the FDA to develop a black-box warning with dose limitations of