Sodium nitrite (medical use)

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Sodium nitrite
Chemical structure
Clinical data
AHFS/Drugs.comFDA Professional Drug Information
ATC code
Legal status
Legal status
Identifiers
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
Chemical and physical data
FormulaNaNO2
Molar mass68.9953
3D model (JSmol)
  • N(=O)[O-].[Na+]
  • InChI=1S/HNO2.Na/c2-1-3;/h(H,2,3);/q;+1/p-1
  • Key:LPXPTNMVRIOKMN-UHFFFAOYSA-M

Sodium nitrite is used as a medication together with sodium thiosulfate to treat cyanide poisoning.[2] It is only recommended in severe cases of cyanide poisoning.[3] In those who have both cyanide poisoning and carbon monoxide poisoning sodium thiosulfate by itself is usually recommended.[4] It is given by slow injection into a vein.[2]

Side effects can include low blood pressure, headache, shortness of breath, loss of consciousness, and vomiting.[2] Greater care should be taken in people with underlying heart disease.[2] People's levels of methemoglobin should be regularly checked during treatment.[2] While not well studied during pregnancy, there is some evidence of potential harm to the baby.[5] Sodium nitrite is believed to work by creating methemoglobin that then binds with cyanide and thus removes it from the mitochondria.[5]

Sodium nitrite came into medical use in the 1920s and 1930s.[6][7] It is on the World Health Organization's List of Essential Medicines.[8] The cost in the United States together with sodium thiosulfate is about US$110.[9]

References

  1. ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 Oct 2023.
  2. ^ a b c d e World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 65. hdl:10665/44053. ISBN 9789241547659.
  3. ^ "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.
  4. ^ Baren, Jill M. (2008). Pediatric Emergency Medicine. Elsevier Health Sciences. p. 1018. ISBN 978-1416000877. Archived from the original on 2017-01-16.
  5. ^ a b "Sodium Nitrite Injection - FDA prescribing information, side effects and uses". www.drugs.com. Archived from the original on 2017-01-18.
  6. ^ Dart, Richard C. (2004). Medical Toxicology. Lippincott Williams & Wilkins. p. 172. ISBN 9780781728454. Archived from the original on 2017-01-16.
  7. ^ 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.
  8. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  9. ^ 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. doi:10.4103/0976-500x.110875. PMC 3669589. PMID 23761707.{{cite journal}}: CS1 maint: unflagged free DOI (link)
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