Editing Sodium nitrite (section)

=== Medication ===
{{Infobox drug
| IUPAC_name = 
| image = Natriumnitrit.png
| image_class = skin-invert-image
| alt = 
| caption = Chemical structure

<!-- Clinical data -->
| pronounce =
| tradename = 
| Drugs.com = {{Drugs.com|pro|sodium-nitrite-injection}}
| MedlinePlus = 
| pregnancy_AU = 
| 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>
| pregnancy_category= 
| routes_of_administration = 
| class = 
| 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 -->
| legal_US = Rx-only
| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV-->
| legal_status = <!-- Free text -->

<!-- Pharmacokinetic data -->
| bioavailability = 
| protein_bound = 
| metabolism = 
| metabolites =
| onset = 
| elimination_half-life = 
| duration_of_action =
| excretion =

<!-- Identifiers -->
| CAS_number = 7632-00-0 
| PubChem = 24269
| DrugBank = DB09112
| ChemSpiderID = 22689
| UNII = M0KG633D4F
| KEGG = D05865
| synonyms =

<!-- Chemical and physical data -->
| Na = 1 | N =1 | O = 2
| smiles = N(=O)[O-].[Na+]
| StdInChI = 1S/HNO2.Na/c2-1-3;/h(H,2,3);/q;+1/p-1
| StdInChIKey = LPXPTNMVRIOKMN-UHFFFAOYSA-M
}}
'''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 It is recommended only in severe cases of cyanide poisoning and has largely been replaced by use of [[hydroxocobalamin]],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>