Sodium nitrite

See also Sodium nitrite toxicity

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

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Cyanide toxicity	300 mg (10 mg/kg)	Methemoglobin-forming agent	IV over 5 min	Adult

See Also

• Cyanide toxicity