For pediatric cyanide exposure, what is the Cyanokit dose?

• A. 70 mg/kg
• B. 5 g
• C. 10 g
• D. 35 mg/kg

Answer: (A)

Dosing in children is weight-based because kids vary in size, body composition, and how they process drugs. Hydroxocobalamin works by binding cyanide to form cyanocobalamin, which is then eliminated by the body, so giving the right amount relative to body weight ensures effective detoxification without overdosing.

For pediatric patients, the recommended single dose is 70 mg per kilogram given intravenously over about 15 minutes, with a maximum per-dose limit of 5 g. If symptoms persist or there’s ongoing exposure, a second dose can be given after about 4 hours, up to a total of 10 g. This makes 70 mg/kg the best answer because it reflects the pediatric weight-based dosing, whereas fixed amounts like 5 g or 10 g don’t account for a child’s smaller size, and 35 mg/kg isn’t a standard dosing figure.