Sodium nitrite

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Administration

  • Type: Antidote
  • Dosage Forms:
  • Routes of Administration: IV
  • Common Trade Names:

Adult Dosing

  • Symptomatic cyanide toxicity: 300 mg of sodium nitrite (10 mL of 3% solution) IV over 3–5 minutes. If no response after 30min, give additional half-dose

Pediatric Dosing

Sodium nitrite (Pediatric Dosing)

Hb Level (g/dL) Dose of 3% sodium nitrite (mL/kg)
7 0.19
8 0.22
9 0.25
10 0.27
11 0.30
12 0.33
13 0.36
14 0.39
Max dose should not exceed 10mL
Do not give faster than 5mL/min (to avoid hypotension)

Special Populations

  • Pregnancy Rating: No assigned FDA category; may impair oxygen delivery to fetus
  • Lactation risk:
  • Renal dosing:
  • Hepatic dosing:

Contraindications

  • Allergy to class/drug
  • Significant preexisting methemoglobinemia (>40%)
  • Severe hypotension (relative)
  • Concurrent carbon monoxide toxicity (relative)

Adverse Reactions

Serious

  • Hypotension (especially with rapid IV push); may be exacerbated by alcohol and other vasodilatory agents
  • Severe, potentially fatal, methemoglobinemia
  • Tachycardia

Common

  • Headache
  • Facial flushing, dizziness, sweating
  • Nausea, vomiting

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:

Mechanism of Action

  • Oxidizes hemoglobin to methemoglobin, which binds free cyanide. Vasodilation may also enhance endothelial cyanide detoxification

Comments

See Also

References