Editing Sodium nitrite (section)

== Uses ==

=== Industrial chemistry ===
The main use of sodium nitrite is for the industrial production of organonitrogen compounds. It is a reagent for conversion of [[amine]]s into [[diazo]] compounds, which are key precursors to many dyes, such as [[diazo dye]]s. [[Nitroso compound]]s are produced from nitrites. These are used in the rubber industry.<ref name=Ullmann/>

It is used in a variety of metallurgical applications, for [[Phosphate conversion coating|phosphatizing]] and detinning.<ref name=Ullmann/>

Sodium nitrite is an effective [[corrosion inhibitor]] and is used as an additive in industrial greases,<ref>{{cite journal | vauthors = Krakhmalev SI, Vorotnikova VA, Ten NV, Taranova NV |year=1984 |title=Determination of sodium nitrite in complex sodium oils|journal=Chemistry and Technology of Fuels and Oils |volume=20 |issue=12 |pages=612–613 |doi=10.1007/BF00726438 |s2cid=94383988}}</ref> as an aqueous solution in closed loop cooling systems, and in a molten state as a heat transfer medium.<ref>{{cite web |url=http://www.generalchemical.com/sodium-nitrite.html |title=Sodium Nitrite |publisher=General Chemical |access-date=28 September 2012 |archive-date=22 May 2013 |archive-url=https://web.archive.org/web/20130522045713/http://www.generalchemical.com/sodium-nitrite.html |url-status=dead}}</ref>

=== Food additive and preservative ===
Sodium nitrite is used to speed up the [[Curing (food preservation)|curing]] of meat,<ref name=Wilson>{{cite news |vauthors=Wilson B |date=1 March 2018 |title=Yes, bacon really is killing us |url=https://www.theguardian.com/news/2018/mar/01/bacon-cancer-processed-meats-nitrates-nitrites-sausages |url-status=live |work=[[The Guardian]] |location=London |language=en-GB |issn=0261-3077 |archive-url=https://web.archive.org/web/20210210183650/https://www.theguardian.com/news/2018/mar/01/bacon-cancer-processed-meats-nitrates-nitrites-sausages |archive-date=10 February 2021 |access-date=14 February 2021 |quote=The firms who sold nitrite powders to ham-makers spoke quite openly about how the main advantage was to increase profit margins by speeding up production.}}</ref> inhibit the germination of ''[[Clostridium botulinum]]'' spores, and also impart an attractive pink color.<ref>{{cite journal |vauthors=Lerfall J, Østerlie M |title=Use of sodium nitrite in salt-curing of Atlantic salmon (Salmo salar L.) – Impact on product quality |journal=[[Food Chemistry (journal)|Food Chemistry]] |date=February 2011 |volume=124 |issue=3 |pages=759–766 |doi=10.1016/j.foodchem.2010.06.092}}</ref><ref name="FSAINitriteInMeat">{{cite web| title = Use and Removal of Nitrite in Meat Products| url = https://www.fsai.ie/faq/use_and_removal_of_nitrite.html#prevent_botulism| access-date = 23 April 2023| archive-url = https://web.archive.org/web/20230309190327/https://www.fsai.ie/faq/use_and_removal_of_nitrite.html| archive-date = 9 March 2023}}</ref> Nitrite reacts with the meat [[myoglobin]] to cause color changes, first converting to nitrosomyoglobin (bright red), then, on heating, to nitrosohemochrome (a pink pigment).<ref>{{cite journal |vauthors=Bailey ME, Frame RW, Naumann HD |title=Cured Meat Pigments, Studies of the Photooxidation of Nitrosomyoglobin |journal=[[Journal of Agricultural and Food Chemistry]] |date=January 1964 |volume=12 |issue=1 |pages=89–93 |doi=10.1021/jf60131a026|bibcode=1964JAFC...12...89B }}</ref>

Historically, [[salt]] has been used for the preservation of meat. The salt-preserved meat product was usually brownish-gray in color. When sodium nitrite is added with the salt, the meat develops a red, then pink color, which is associated with cured meats such as ham, bacon, hot dogs, and bologna.<ref>{{cite web|url=http://www.math.unl.edu/~jump/Center1/Labs/MeatPigmentChemistry.pdf|title="Meat Pigment Chemistry", taken from IFT Mini-Experiments in Food Science Series|access-date=28 January 2019|archive-date=3 December 2019|archive-url=https://web.archive.org/web/20191203111916/http://www.math.unl.edu/~jump/Center1/Labs/MeatPigmentChemistry.pdf|url-status=dead}}</ref>

In the early 1900s, irregular curing was commonplace. This led to further research surrounding the use of sodium nitrite as an [[Food additive|additive]] in food, standardizing the amount present in foods to minimize the amount needed while maximizing its food additive role.<ref name="Sindelar Human safety">{{cite journal | vauthors = Sindelar JJ, Milkowski AL | title = Human safety controversies surrounding nitrate and nitrite in the diet | journal = Nitric Oxide | volume = 26 | issue = 4 | pages = 259–266 | date = May 2012 | pmid = 22487433 | doi = 10.1016/j.niox.2012.03.011}}</ref> Through this research, sodium nitrite has been found to give taste and color to the meat and inhibit lipid oxidation that leads to rancidity, with varying degrees of effectiveness for controlling growth of disease-causing [[microorganisms]].<ref name="Sindelar Human safety" /> The ability of sodium nitrite to address the above-mentioned issues has led to production of meat with extended storage life and has improved desirable color and taste. According to scientists working for the meat industry,<ref>{{cite web |url=https://www.ctvnews.ca/lifestyle/science-says-are-hot-dogs-healthier-without-added-nitrites-1.3483769|title=Science Says: Are hot dogs healthier without added nitrites? {{!}} Lifestyle from CTV News|website=www.ctvnews.ca|date=30 June 2017}}</ref> nitrite has improved [[food safety]].<ref name="Sindelar Human safety" /> This view is disputed in the light of the possible carcinogenic effects caused by adding nitrites to meat.<ref name=Wilson/>

Nitrite has the [[E number]] E250. [[Potassium nitrite]] (E249) is used in the same way. It is approved for usage in the European Union,<ref>{{cite web|title=Approved additives and E numbers|url=https://www.food.gov.uk/business-guidance/approved-additives-and-e-numbers|access-date=9 January 2023|website=Food Standards Agency|language=en}}</ref><ref>{{cite web | title = Opinions of the Scientific Committee for Food on: Nitrates and Nitrite |url=http://ec.europa.eu/food/fs/sc/scf/reports/scf_reports_38.pdf| work = Food Science and Techniques | publisher = European Commission|access-date=1 April 2018}}</ref> USA,<ref>US Food and Drug Administration: {{cite web |url=https://www.fda.gov/Food/FoodIngredientsPackaging/FoodAdditives/ucm191033.htm#ftnT |archive-url=https://web.archive.org/web/20100108135705/http://www.fda.gov/Food/FoodIngredientsPackaging/FoodAdditives/ucm191033.htm#ftnT |url-status=dead |archive-date=8 January 2010 |title=Listing of Food Additives Status Part II |website=[[Food and Drug Administration]] |access-date=27 October 2011}}</ref> and Australia and New Zealand.<ref>{{cite web |title=Australia New Zealand Food Standards Code - Standard 1.2.4 - Labelling of Ingredients |url=http://www.legislation.gov.au/Details/F2011C00827/Html/Text |access-date=9 January 2023 |website=www.legislation.gov.au |language=en}}</ref>

In meat processing, sodium nitrite is never used in a pure state but always mixed with common [[salt]]. This mixture is known as nitrited salt, [[curing salt]] or nitrited curing salt. In Europe, nitrited curing salt contains between 99.1% and 99.5% common salt and between 0.5% and 0.9% nitrite. In the US, nitrited curing salt is dosed at 6.25%<ref name="Gisslen2006">{{cite book | vauthors = Gisslen W | title = Professional Cooking, College Version | chapter = Sausages and Cured Foods  | chapter-url = https://books.google.com/books?id=hxcH5o9QeywC&pg=PA827 | page = 827 | year = 2006 | location = Hoboken, New Jersey | publisher = John Wiley & Sons | isbn = 9780471663744 | access-date = 2013-08-16 }}</ref> and must be remixed with salt before use.<ref>{{cite book |vauthors=Coudray G |title=Who poisoned your bacon? |date=February 2021 |publisher=Icon Books |isbn=978-1785786112 |pages=xv |url=https://iconbooks.com/ib-title/who-poisoned-your-bacon/}}</ref>

==== Color and taste ====
The appearance and taste of meat is an important component of consumer acceptance.<ref name="Sindelar Human safety" /> Sodium nitrite is responsible for the desirable red color (or shaded pink) of meat.<ref name="Sindelar Human safety" /> Very little nitrite is needed to induce this change.<ref name="Sindelar Human safety" /> It has been reported that as little as 2 to 14 parts per million (ppm) is needed to induce this desirable color change.<ref name="Sindelar One" /> However, to extend the lifespan of this color change, significantly higher levels are needed.<ref name="Sindelar One" /> The mechanism responsible for this color change is the formation of nitrosylating agents by nitrite, which has the ability to transfer [[nitric oxide]] that subsequently reacts with myoglobin to produce the cured meat color.<ref name="Sindelar One" /> The unique taste associated with cured meat is also affected by the addition of sodium nitrite.<ref name="Sindelar Human safety" /> However, the mechanism underlying this change in taste is still not fully understood.<ref name="Sindelar One" />

==== Inhibition of microbial pathogens ====
In conjunction with salt and pH levels, sodium nitrite reduces the ability of ''[[Clostridium botulinum]]'' spores to grow to the point of producing toxin.<ref name="FSAINitriteInMeat" /><ref>{{cite journal | vauthors = Lee S, Lee H, Kim S, Lee J, Ha J, Choi Y, Oh H, Choi KH, Yoon Y | title = Microbiological safety of processed meat products formulated with low nitrite concentration - A review | journal = Asian-Australasian Journal of Animal Sciences | volume = 31 | issue = 8 | pages = 1073–1077 | date = August 2018 | pmid = 29531192 | pmc = 6043430 | doi = 10.5713/ajas.17.0675 }}</ref> Some dry-cured meat products are manufactured without nitrites. For example, [[Parma ham]], which has been produced without nitrite since 1993, was reported in 2018 to have caused no cases of botulism. This is because the interior of the muscle is sterile and the surface is exposed to oxygen.<ref name=Wilson/> Other manufacture processes do not assure these conditions, and reduction of nitrite results in toxin production.<ref>{{cite journal | vauthors = Lebrun S, Van Nieuwenhuysen T, Crèvecoeur S, Vanleyssem R, Thimister J, Denayer S, Jeuge S, Daube G, Clinquart A, Fremaux B | title = Influence of reduced levels or suppression of sodium nitrite on the outgrowth and toxinogenesis of psychrotrophic Clostridium botulinum Group II type B in cooked ham | journal = International Journal of Food Microbiology | volume = 334 | pages = 108853 | date = December 2020 | pmid = 32932195 | doi = 10.1016/j.ijfoodmicro.2020.108853 }}</ref>

Sodium nitrite has shown varying degrees of effectiveness for controlling growth of other spoilage or disease causing microorganisms.<ref name="Sindelar Human safety" /> Although the inhibitory mechanisms are not well known, its effectiveness depends on several factors including residual nitrite level, [[pH]], salt concentration, reductants present and [[iron]] content.<ref name="Sindelar One">{{cite journal |vauthors=Sindelar J, Milkowski A |date=November 2011 |title=Sodium Nitrite in Processed Meat and Poultry Meats: A Review of Curing and Examining the Risk/Benefit of Its Use |url=http://www.meatscience.org/docs/default-source/publications-resources/white-papers/2011-11-amsa-nitrite-white-paper.pdf?sfvrsn=8 |journal=American Meat Science Association |volume=3 |pages=1–14}}</ref> The type of [[bacteria]] also affects sodium nitrite's effectiveness.<ref name="Sindelar One"/> It is generally agreed that sodium nitrite is not effective for controlling [[Gram-negative]] enteric pathogens such as ''[[Salmonella]]'' and ''[[Escherichia coli]]''.<ref name="Sindelar One" />

Other food additives (such as [[Lactic acid|lactate]] and [[sorbate]]) provide similar protection against bacteria, but do not provide the desired pink color.<ref>{{cite journal | vauthors = Seward RA, Deibel RH, Lindsay RC | title = Effects of potassium sorbate and other antibotulinal agents on germination and outgrowth of Clostridium botulinum type E spores in microcultures | journal = Applied and Environmental Microbiology | volume = 44 | issue = 5 | pages = 1212–1221 | date = November 1982 | pmid = 6758699 | pmc = 242170 | doi = 10.1128/AEM.44.5.1212-1221.1982 | bibcode = 1982ApEnM..44.1212S}}</ref><ref>{{cite journal | vauthors = Sofos JN, Busta FF, Bhothipaksa K, Allen CE, Robach MC, Paquette MW |title=Effects of various concentrations of sodium nitrite and potassium sorbate on Clostridium botulinum toxin production in commercially prepared bacon |journal=Journal of Food Science |date=September 1980 |volume=45 |issue=5 |pages=1285–1292 |doi=10.1111/j.1365-2621.1980.tb06539.x}}</ref><ref>{{cite journal | vauthors = Linton M, Connolly M, Houston L, Patterson MF |title=The control of Clostridium botulinum during extended storage of pressure-treated, cooked chicken |journal=Food Control |date=March 2014 |volume=37 |pages=104–108 |doi=10.1016/j.foodcont.2013.09.042}}</ref><ref>{{cite journal | vauthors = Alnoman M, Udompijitkul P, Paredes-Sabja D, Sarker MR | title = The inhibitory effects of sorbate and benzoate against Clostridium perfringens type A isolates | journal = Food Microbiology | volume = 48 | pages = 89–98 | date = June 2015 | pmid = 25790996 | doi = 10.1016/j.fm.2014.12.007 }}</ref>

==== Inhibition of lipid peroxidation ====
Sodium nitrite is also able to effectively delay the development of oxidative [[rancidity]].<ref name="Sindelar One" /> [[Lipid peroxidation]] is considered to be a major reason for the deterioration of quality of meat products (rancidity and unappetizing flavors).<ref name="Sindelar One" /> Sodium nitrite acts as an [[antioxidant]] in a mechanism similar to the one responsible for the coloring effect.<ref name="Sindelar One" /> Nitrite reacts with [[heme]] proteins and metal ions, neutralizing [[free radicals]] by [[nitric oxide]] (one of its byproducts).<ref name="Sindelar One" /> Neutralization of these free radicals terminates the cycle of [[lipid oxidation]] that leads to rancidity.<ref name="Sindelar One" />

=== Medication ===
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| image_class = skin-invert-image
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| pregnancy_AU_comment = Exempt<ref>{{Cite web | title=Therapeutic goods exempted from pregnancy categorisation {{!}} Therapeutic Goods Administration (TGA) | url=https://www.tga.gov.au/therapeutic-goods-exempted-pregnancy-categorisation | archive-url=https://web.archive.org/web/20150622174355/https://www.tga.gov.au/therapeutic-goods-exempted-pregnancy-categorisation | access-date=2024-12-25 | archive-date=2015-06-22}}</ref>
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| ATC_prefix = V03
| ATC_suffix = AB08

| legal_AU = S4
| legal_AU_comment = <ref>{{cite web | title=Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017 | website=Therapeutic Goods Administration (TGA) | date=21 June 2022 | url=https://www.tga.gov.au/resources/publication/publications/prescription-medicines-registration-new-generic-medicines-and-biosimilar-medicines-2017 | access-date=30 March 2024}}</ref>
| legal_CA = <!-- OTC, Rx-only, Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_DE = <!-- Anlage I, II, III -->
| legal_NZ = <!-- Class A, B, C -->
| legal_UK = <!-- GSL, P, POM, CD, CD Lic, CD POM, CD No Reg POM, CD (Benz) POM, CD (Anab) POM or CD Inv POM / Class A, B, C -->
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| PubChem = 24269
| DrugBank = DB09112
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| UNII = M0KG633D4F
| KEGG = D05865
| synonyms =

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| smiles = N(=O)[O-].[Na+]
| StdInChI = 1S/HNO2.Na/c2-1-3;/h(H,2,3);/q;+1/p-1
| StdInChIKey = LPXPTNMVRIOKMN-UHFFFAOYSA-M
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'''Sodium nitrite''' is used as a medication together with [[Sodium thiosulfate (medical use)|sodium thiosulfate]] to treat [[cyanide poisoning]].<ref name=WHO2008/> It is recommended only in severe cases of cyanide poisoning and has largely been replaced by use of [[hydroxocobalamin]],<ref name="UK2017">{{cite web |title=Sodium Nitrite Solution for Injection - Summary of Product Characteristics (SPC) - (eMC) |url=https://www.medicines.org.uk/emc/medicine/32282 |website=www.medicines.org.uk |access-date=15 January 2017|url-status=live |archive-url=https://web.archive.org/web/20170918184748/https://www.medicines.org.uk/emc/medicine/32282 |archive-date=18 September 2017}}</ref> a form of [[vitamin B12]], but given in much higher doses than needed nutritionally.<ref>{{cite journal | vauthors = Streitz MJ, Bebarta VS, Borys DJ, Morgan DL | title = Patterns of cyanide antidote use since regulatory approval of hydroxocobalamin in the United States | journal = American Journal of Therapeutics | volume = 21 | issue = 4 | pages = 244–249 | date = July–August 2014 | pmid = 23689094 | doi = 10.1097/MJT.0b013e31824ea656 | s2cid = 21116328}}</ref>
In those who have both cyanide poisoning and [[carbon monoxide poisoning]] sodium thiosulfate by itself is usually recommended if the facility does not have sufficient [[hydroxycobalamin]].<ref>{{cite book | vauthors = Graham J, Traylor J | chapter = Cyanide Toxicity |date=2023 | chapter-url = http://www.ncbi.nlm.nih.gov/books/NBK507796/ | title = StatPearls |access-date=7 December 2023 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29939573}}</ref><ref>{{cite book |vauthors=Baren JM |title=Pediatric Emergency Medicine |date=2008 |publisher=Elsevier Health Sciences |isbn=978-1416000877 |page=1018 |url=https://books.google.com/books?id=wpvux6RS-jsC&pg=PA1018 |language=en |url-status=live |archive-url=https://web.archive.org/web/20170116172656/https://books.google.ca/books?id=wpvux6RS-jsC&pg=PA1018 |archive-date=16 January 2017 |via=[[Google Books]]}}</ref> It is given by [[intravenous infusion|slow injection into a vein]].<ref name=WHO2008>{{cite book |title=WHO Model Formulary 2008 |year=2009 |isbn=9789241547659 |vauthors=((World Health Organization)) |veditors=Stuart MC, Kouimtzi M, Hill SR |hdl=10665/44053 |author-link=World Health Organization |publisher=World Health Organization |hdl-access=free |page=65}}</ref>

{{chem2|NaNO2}} side effects are chiefly related to creation of methemoglobinemia and vasodilation. Side effects can include [[low blood pressure]], [[headache]], [[shortness of breath]], [[loss of consciousness]], and vomiting.<ref name=WHO2008/> Greater care should be taken in people with underlying heart disease.<ref name=WHO2008/> The patient's levels of [[methemoglobin]] should be regularly checked during treatment.<ref name=WHO2008/> While not well studied during pregnancy, there is some evidence of potential harm to the baby.<ref name=Pro2017/> Sodium nitrite works by creating methemoglobin, where the iron atom at the center of the heme group is in the oxidized ferric ({{chem2|Fe(3+)}}) state, which binds with cyanide with greater affinity than its binding to the [[cytochrome C oxidase]], and thus removes it from blocking the metabolic function of [[mitochondria]].<ref name=Pro2017>{{cite web |title=Sodium Nitrite Injection - FDA prescribing information, side effects and uses |url=https://www.drugs.com/pro/sodium-nitrite-injection.html |website=www.drugs.com |url-status=live |archive-url=https://web.archive.org/web/20170118044431/https://www.drugs.com/pro/sodium-nitrite-injection.html |archive-date=18 January 2017}}</ref>

Sodium nitrite came into medical use in the 1920s and 1930s.<ref>{{cite book |vauthors=Dart RC |title=Medical Toxicology |date=2004 |publisher=[[Lippincott Williams & Wilkins]] |isbn=9780781728454 |page=172 |url=https://books.google.com/books?id=BfdighlyGiwC&pg=PA172 |language=en |url-status=live |archive-url=https://web.archive.org/web/20170116172601/https://books.google.ca/books?id=BfdighlyGiwC&pg=PA172 |archive-date=16 January 2017 |via=[[Google Books]]}}</ref><ref>{{cite book |vauthors = Bryan NS, Loscalzo J |title=Nitrite and Nitrate in Human Health and Disease |date=2011 |publisher=Springer Science & Business Media|isbn=9781607616160 |page=226 |url=https://books.google.com/books?id=CDkkwVV4aMQC&pg=PA226 |language=en |url-status=live |archive-url=https://web.archive.org/web/20170116173748/https://books.google.ca/books?id=CDkkwVV4aMQC&pg=PA226 |archive-date=16 January 2017 |via=[[Google Books]]}}</ref> It is on the [[WHO Model List of Essential Medicines|World Health Organization's List of Essential Medicines]].<ref name="WHO21st">{{cite book |vauthors=((World Health Organization)) |title=World Health Organization model list of essential medicines: 21st list 2019 |year=2019 |hdl=10665/325771 |author-link=World Health Organization |publisher=World Health Organization |location=Geneva |id=WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO |hdl-access=free}}</ref>

=== Suicide ===
Several academic publications in 2020 and 2021 have discussed the toxicity of sodium nitrite, and an apparent recent increase in suicides using sodium nitrite which had been ordered online.<ref>{{harvp|Durão C, ''et al.'', 2020.}}; {{harvp|Durão C, ''et al.'', 2021.}}; {{harvp|Tomsia M, ''et al.'', 2021.}}; {{harvp|McCann SD, Kennedy JM, ''et al.'', 2021.}}; {{harvp|Dean DE, ''et al.'', 2021.}}; {{harvp|Hickey TB, ''et al.'', 2021.}}; {{harvp|Harvey M, ''et al.'', 2010.}}; {{harvp|McCann SD, Tweet MS, Wahl MS, 2021.}}; {{harvp|Sedhai YR, ''et al.'', 2022.}}; {{harvp|Mudan A, ''et al.'', 2020.}}</ref> The usage of sodium nitrite as a suicide method has been heavily discussed on suicide forums, primarily [[Sanctioned Suicide]].<ref name="Where the Despairing Log On, and Learn Ways to Die">{{cite news | vauthors = Twohey M |author-link=Megan Twohey|date=9 December 2021|title=Where the Despairing Log On, and Learn Ways to Die|newspaper=[[The New York Times]] |url=https://www.nytimes.com/interactive/2021/12/09/us/where-the-despairing-log-on.html|access-date=24 July 2022|url-access=subscription}}</ref>

Sodium nitrite was also the focal-point of the ''McCarthy et al. v [[Amazon (company)|Amazon]]'' lawsuit alleging that Amazon knowingly assisted in the deaths of healthy children by selling them "suicide kits" as Amazon's "[[recommendation engine|frequently bought together]]" feature recommended buying sodium nitrite, an [[antiemetic]], and a suicide instruction book together.<ref>{{cite news|title=Amazon 'suicide kits' have led to teen deaths, according to new lawsuit|url=https://arstechnica.com/tech-policy/2022/10/amazon-suicide-kits-have-led-to-teen-deaths-according-to-new-lawsuit/| vauthors = Belanger A |work=[[Ars Technica]]|date=7 October 2022|access-date=26 August 2023}}</ref> This lawsuit was dismissed in June 2023.<ref>{{cite news | vauthors = Stempel J |date=28 June 2023 |title=Judge dismisses lawsuit claiming Amazon sold 'suicide kits' to teenagers |language=en |work=Reuters |url=https://www.reuters.com/legal/judge-dismisses-lawsuit-claiming-amazon-sold-suicide-kits-teenagers-2023-06-28/ |access-date=3 November 2023}}</ref> The online marketplace eBay has globally prohibited the sale of sodium nitrite since 2019.<ref>{{cite web|url=https://www.judiciary.uk/wp-content/uploads/2020/12/2020-0246-Response-from-Ebay-UK-Ltd-Redacted.pdf|date=8 January 2021|title=Re Jason Thompson (deceased) – Sodium Nitrite|author=Director, eBay (UK) Limited|via=[[Judiciaries of the United Kingdom]]|access-date=26 August 2023}}</ref> A [[Canadian]] distributor of sodium nitrite was prosecuted in 2023 for assisting suicide.<ref>{{cite news|url=https://toronto.ctvnews.ca/here-s-why-the-world-will-be-watching-kenneth-law-s-court-battle-1.6493596|title=Here's why the world will be watching Kenneth Law's court battle| vauthors = Murphy A |publisher=[[CFTO-DT|CTV Toronto]]|date=25 July 2023|access-date=26 August 2023}}</ref><ref>{{cite news|url=https://www.bbc.com/news/world-us-canada-66609884|title=88 UK deaths linked to Canada 'poison seller'| vauthors = Crawford A |publisher=[[BBC News]]|date=25 August 2023|access-date=26 August 2023}}</ref> That same year, legislation was introduced in the United States with the aim of deeming sodium nitrite products with a sodium nitrite concentration of greater than 10% by volume to be banned consumer products under the [[Consumer Product Safety Act]].<ref>{{cite web |title=Chemical Used in Suicides Faces Sales Ban Under Proposed Law |url=https://news.bloomberglaw.com/us-law-week/chemical-used-in-suicides-faces-sales-ban-under-proposed-law |access-date=3 November 2023 |website=news.bloomberglaw.com |language=en}}</ref>

In cases of suspected suicide involving sodium nitrite, it is critical that [[First responder|responding individuals]] administer immediate intravenous [[methylene blue]].<ref>{{cite journal | vauthors = Sheehy MH, Way JL |date=1 November 1974 |title=Nitrite intoxication: Protection with methylene blue and oxygen |url=https://dx.doi.org/10.1016/0041-008X%2874%2990093-3 |journal=Toxicology and Applied Pharmacology |volume=30 |issue=2 |pages=221–226 |doi=10.1016/0041-008X(74)90093-3 |bibcode=1974ToxAP..30..221S |issn=0041-008X|url-access=subscription }}</ref><ref name=":0">{{cite journal | vauthors = Ehlers P, Bryant SM | title = Immediate methylene blue is critical for sodium nitrite ingestions | journal = The American Journal of Emergency Medicine | volume = 68 | pages = 186 | date = June 2023 | pmid = 37120398 | doi = 10.1016/j.ajem.2023.04.034 | s2cid = 258324908}}</ref><ref>{{cite web | vauthors = Su M, McRae M |date=8 September 2022 |title=2022 Health Advisory #22 Poisonings and Death Related to Intentional Sodium Nitrite Ingestions |url=https://www.nyc.gov/assets/doh/downloads/pdf/han/advisory/2022/sodium-nitrate-ingestion-poisonings.pdf |access-date=4 November 2023 |website=[[New York City Department of Health and Mental Hygiene]]}}</ref> Methylene blue is the antidote to the [[methemoglobinemia]] caused by intentional ingestion of sodium nitrite as a suicide agent.<ref>{{cite journal | vauthors = Lee GW, Lee JB |date=16 December 2013 |title=Antidote for acquired methemoglobinemia: methylene blue |url=https://synapse.koreamed.org/articles/1042644 |journal=Journal of the Korean Medical Association |volume=56 |issue=12 |pages=1084–1090 |doi=10.5124/jkma.2013.56.12.1084|doi-access=free}}</ref>