Sodium Nitrite
Sodium Nitrite is an emergency antidote specifically used for cyanide poisoning. It works by converting hemoglobin to methemoglobin, which binds to cyanide and prevents it from inhibiting cellular respiration in tissues. This medication is typically administered in hospital emergency departments or by emergency medical services for suspected cyanide exposure from industrial accidents, smoke inhalation, or intentional ingestion.
Sodium Nitrite is an emergency antidote for cyanide poisoning that converts hemoglobin to methemoglobin to neutralize cyanide and restore cellular function.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- V03AB08
- RxNorm
- 9894
- Generic
- Sodium Nitrite
- Class
- atc-v03
- Brands
- —
- Availability
- rx
- Lactation
- unknown
- Routes
- topical
- Forms
- injection, solution
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
9 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks
regular fetal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
second trimesteruse lowest effective dose
use only if absolutely necessary for cyanide poisoning treatment
fetal heart rate monitoring and ultrasound
Use with caution and monitor for adverse effects.
pregnancy
third trimesteruse lowest effective dose
use only for emergency cyanide poisoning treatment
fetal monitoring and uterine activity assessment
Use with caution and monitor for adverse effects.
lactation
breastfeedingdiscontinue breastfeeding
avoid breastfeeding during treatment and for 24 hours after administration
monitor infant for signs of methemoglobinemia
Use of this medication in this population requires careful consideration of risks and benefits.
pediatric_age
neonates infantsavoid use
do not use in neonates and infants due to high risk of methemoglobinemia
continuous methemoglobin monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pediatric_age
children 1 month 12 yearsweight-based dosing required
use with extreme caution only for cyanide poisoning treatment
closely monitor methemoglobin levels and vital signs
Use with caution and monitor for adverse effects.
geriatric
elderly over 65reduce dose by 25-50%
use with caution due to potential decreased renal and hepatic function
monitor renal function, blood pressure, and methemoglobin levels
Use with caution and monitor for adverse effects.
renal_impairment
severe renal impairmentreduce dose and extend dosing interval
use with caution; requires dose adjustment based on renal function
monitor renal function tests and methemoglobin levels closely
Use with caution and monitor for adverse effects.
hepatic_impairment
severe hepatic impairmentreduce dose
use with caution due to impaired metabolism
monitor liver function and methemoglobin levels
Use with caution and monitor for adverse effects.
Statistics and clinical data
Primary use
Primary industrial and food industry use
Medical application
Approved medical use in emergency medicine
Toxic dose (oral)
Estimated toxic dose in adults
FDA status (medical)
Medical regulatory classification
Treatment of acute cyanide poisoning from sources including industrial chemical exposure, smoke inhalation (especially from synthetic materials), ingestion of cyanide-containing compounds, or suspected terrorist incidents involving cyanide.
Sodium Nitrite induces the formation of methemoglobin in red blood cells, which has a high binding affinity for cyanide. The cyanide preferentially binds to methemoglobin rather than cytochrome oxidase in mitochondria, effectively neutralizing its toxic effects and restoring normal cellular respiration.
Must be administered as soon as possible after cyanide exposure for maximum effectiveness; contraindicated in patients with concurrent carbon monoxide poisoning (increases methemoglobin levels dangerously); commonly used in combination with sodium thiosulfate for enhanced detoxification; requires careful monitoring of methemoglobin levels.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy