Products
Amyl nitrite is commercially available in the form of ampoules (Amyle Nitrite Inhalant USP). The product, available in many countries, is imported from abroad and is not officially approved as a drug. Amyl nitrite is included in the Federal Office of Public Health‘s antidote list and must be stocked in hospitals for the treatment of cyanide poisoning.
Structure and properties
Amyl nitrite (C5H11NO2, Mr = 117.1 g/mol) is an alkyl derivative of nitrous acid. It exists as a clear, yellowish liquid with a peculiar fruit ether-like odor and a burning taste. It is volatile and highly flammable even at low temperature. Amyl nitrite is practically insoluble in water and miscible with ethanol and ether.
Effects
Amyl nitrite (ATC V03AB22) is a vasodilator. It is most effective on vascular smooth muscle. The drug is absorbed into the bloodstream in the lungs and exerts its effects rapidly (within one minute in angina). It has a short duration of action in the range of a few minutes. Amyl nitrite leads to the formation of methemoglobin, which binds cyanide.
Indications
As an antidote in cyanide poisoning. For rapid symptom relief in angina.
Abuse
Amyl nitrite is used for sexual stimulation (“poppers”) and other purposes because of its vasodilatory, psychotropic, aphrodisiac, euphoric, and depressant properties. Due to the potential for severe adverse effects, we strongly advise against its misuse.
Dosage
According to the FOPH antidote list. The drug is administered as an inhalation while sitting or lying down, usually on a handkerchief for inhalation.
Contraindications
Amyl nitrite is contraindicated in hypersensitivity, during pregnancy, glaucoma, and head trauma. For complete precautions, see the drug label.
Interactions
Amyl nitrite should not be combined with alcohol, phosphodiesterase-5 inhibitors such as sildenafil (Viagra), and other vasodilators because a dangerous drop in blood pressure may result.
Adverse effects
Possible adverse effects include low blood pressure, headache, dizziness, rapid heartbeat, brief loss of consciousness, redness of the face (flush), a feeling of warmth, the development of methemoglobinemia, nausea, and vomiting. Repeated use leads to tolerance.
