Sodium nitrite (medical use)

Sodium nitrite is used as a medication together with sodium thiosulfate to treat cyanide poisoning.[1] It is only recommended in severe cases of cyanide poisoning.[2] In those who have both cyanide poisoning and carbon monoxide poisoning sodium thiosulfate by itself is usually recommended.[3] It is given by slow injection into a vein.[1]

Sodium nitrite
Chemical structure
Clinical data
AHFS/Drugs.comFDA Professional Drug Information
Pregnancy
category
  • US: C (Risk not ruled out)
    ATC code
    Identifiers
    CAS Number
    PubChem CID
    DrugBank
    ChemSpider
    UNII
    KEGG
    Chemical and physical data
    FormulaNaNO2
    Molar mass68.9953
    3D model (JSmol)

    Side effects can include low blood pressure, headache, shortness of breath, loss of consciousness, and vomiting.[1] Greater care should be taken in people with underlying heart disease.[1] People's levels of methemoglobin should be regularly checked during treatment.[1] While not well studied during pregnancy, there is some evidence of potential harm to the baby.[4] Sodium nitrite is believed to work by creating methemoglobin that then binds with cyanide and thus removes it from the mitochondria.[4]

    Sodium nitrite came into medical use in the 1920s and 1930s.[5][6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] The cost in the United States together with sodium thiosulfate is about 110 USD.[8]

    References
    1. WHO Model Formulary 2008 (PDF). World Health Organization. 2009. p. 65. ISBN 9789241547659. Archived (PDF) from the original on 13 December 2016. Retrieved 8 January 2017.
    2. "Sodium Nitrite Solution for Injection - Summary of Product Characteristics (SPC) - (eMC)". www.medicines.org.uk. Archived from the original on 18 September 2017. Retrieved 15 January 2017.
    3. Baren, Jill M. (2008). Pediatric Emergency Medicine. Elsevier Health Sciences. p. 1018. ISBN 978-1416000877. Archived from the original on 2017-01-16.
    4. "Sodium Nitrite Injection - FDA prescribing information, side effects and uses". www.drugs.com. Archived from the original on 2017-01-18.
    5. Dart, Richard C. (2004). Medical Toxicology. Lippincott Williams & Wilkins. p. 172. ISBN 9780781728454. Archived from the original on 2017-01-16.
    6. Bryan, Nathan S.; Loscalzo, Joseph (2011). Nitrite and Nitrate in Human Health and Disease. Springer Science & Business Media. p. 226. ISBN 9781607616160. Archived from the original on 2017-01-16.
    7. "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
    8. Gasco, L; Rosbolt, MB; Bebarta, VS (April 2013). "Insufficient stocking of cyanide antidotes in US hospitals that provide emergency care". Journal of Pharmacology & Pharmacotherapeutics. 4 (2): 95–102. PMID 23761707.
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