Amyl Nitrite

(BAN, USAN, rINN)
Amyl Nitrite Chemical formula

💊 Chemical information

Amyli Nitris; Amylis Nitris; Amylium Nitrosum; Amylnitrit; Amyylinitriitti; Azotito de Amilo; Isoamyl Nitrite; Isopentyl Nitrite; Nitrito de amilo; Pentanolis Nitris.
Chemical formula: C5H11NO2 = 117.1.
ATC — V03AB22.
ATC Vet — QV03AB22.

Pharmacopoeias.

In Jpn and US.

USP 31

(Amyl Nitrite). A mixture of the nitrite esters of 3-methyl-1-butanol and 2-methyl-1-butanol. A clear, yellowish liquid having a peculiar, ethereal, fruity odour. It is very flammable. It is volatile even at low temperatures. B.p. about 96°. Practically insoluble in water; miscible with alcohol and with ether. Store in a cool place in airtight containers. Protect from light.

Stability.

Amyl nitrite is liable to decompose with evolution of nitrogen, particularly if it has become acid in reaction.

💊 Adverse Effects, Treatment, and Precautions

Amyl nitrite inhalation commonly causes flushing, headache, and dizziness; nausea and vomiting, hypotension, restlessness, and tachycardia may also occur. Overdosage may result in cyanosis, syncope, dyspnoea, and muscular weakness, due to vasodilatation and methaemoglobinaemia. Methylthioninium chloride may be required for severe methaemoglobinaemia but should not be used if cyanide poisoning is suspected since cyanide may be displaced. Amyl nitrite may increase intra-ocular and intracranial pressure and should be used with caution in patients with glaucoma, recent head trauma, or cerebral haemorrhage.

Abuse.

Volatile nitrites (commonly known as ‘poppers’), including amyl, butyl, or isobutyl nitrite, have been abused in the belief that they expand creativity, stimulate music appreciation, promote a sense of abandon in dancing, and intensify sexual experience.1,2 Inhalation causes headache, tachycardia, syncope, acute psychosis, increased intra-ocular pressure, transient hemiparesis, methaemoglobinaemia, coma, and, rarely, sudden death. Haemolytic anaemia has also been reported;3-5 in some subjects, Heinz body formation has been detected.3 Methaemoglobinaemia may be severe,6 and has also been reported after ingestion of volatile nitrites.7-10 Symptoms are similar to those of hypoxia9 and may be reversed by methylthioninium chloride.6-10 Amyl nitrite inhalation has led to severe and extensive contact dermatitis around the face with secondary spread elsewhere on the body.11
1. Sigell LT, et al. Popping and snorting volatile nitrites: a current fad for getting high. Am J Psychiatry 1978; 135: 1216–18
2. Lockwood B. Poppers: volatile nitrite inhalants. Pharm J 1996; 257: 154–5
3. Romeril KR, Concannon AJ. Heinz body haemolytic anaemia after sniffing volatile nitrites. Med J Aust 1981; 1: 302–3
4. Brandes JC, et al. Amyl nitrite-induced hemolytic anemia. Am J Med 1989; 86: 252–4
5. Graves TD, Mitchell S. Acute haemolytic anaemia after inhalation of amyl nitrite. J R Soc Med 2003; 96: 594–5
6. Modarai B, et al. Methylene blue: a treatment for severe methaemoglobinaemia secondary to misuse of amyl nitrite. Emerg Med J 2002; 19: 270–1
7. Laaban JP, et al. Amyl nitrite poppers and methemoglobulinemia. Ann Intern Med 1985; 103: 804–5
8. Osterloh J, Olson K. Toxicities of alkyl nitrites. Ann Intern Med 1986; 104: 727
9. Pierce JMT, Nielsen MS. Acute acquired methaemoglobinaemia after amyl nitrite poisoning. BMJ 1989; 298: 1566
10. Forsyth RJ, Moulden A. Methaemoglobinaemia after ingestion of amyl nitrite. Arch Dis Child 1991; 66: 152
11. Bos JD, et al. Allergic contact dermatitis to amyl nitrite (‘poppers’). Contact Dermatitis 1985; 12: 109.

Handling and storage.

Amyl nitrite is very flammable and must not be used where it may be ignited.

💊 Uses and Administration

Amyl nitrite is rapidly absorbed on inhalation and has been used in the immediate treatment of patients with definite cyanide poisoning to induce the formation of methaemoglobin, which combines with the cyanide to form non-toxic cyanmethaemoglobin. The value of such treatment has been questioned since only low levels of methaemoglobin are formed, but other mechanisms may also be important. A suggested procedure has been to give amyl nitrite by inhalation for up to 30 seconds every minute until other measures can be instituted. It has also been suggested for use in the management of hydrogen sulfide poisoning. Amyl nitrite has an action similar to that of glyceryl trinitrate and used to be given by inhalation for the relief of acute attacks of angina pectoris but is seldom used now.

Homoeopathy.

Amyl nitrite has been used in homoeopathic medicines under the following names: Amyl nitrosum; Am. nit.

💊 Preparations

USP 31: Amyl Nitrite Inhalant. Proprietary PreparationsMulti-ingredient: Austria: Percucor†; S.Afr.: Tripac-Cyano; USA: Cyanide Antidote Package; Emergent-Ez.
Published October 14, 2018.