Amyl Nitrite

1 What is Amyl Nitrite?

Generic: Amyl Nitrite (Inhalation Route)

Inhalational amyl nitrite is available in generic form. 

Amyl nitrite is a rapidly acting vasodilator administered by inhalation which is preferably used in the treatment of angina and cyanide poisoning. It is a clear, yellowish liquid having a peculiar ethereal, fruity odor. 

It is volatile, even at low temperatures, and is flammable. Indeed, it works solely by relaxing smooth muscles of blood vessels (capacitance vessels) resulting in increased blood and oxygen supply to the heart by reducing its workload. 

However, amyl nitrite is also used for other conditions including congestive cardiac failure and acute ischemic syndrome or myocardial infarction as determined by your doctor. 

This drug has been used by some people to improve sex or to cause an intense rush, euphoria, and a sensation of excitement but such uses in this way are not recommended. Besides, amyl nitrite is responsible for some unwanted adverse effects if too much is inhaled. 

In general, this medicine is known as 'poppers' and it is often used for certain non-medical purposes because of illegal availability on the street.

2 What to Know Before Using

If you are about to start a drug therapy, the risk-benefit ratio of taking the drug should be considered carefully. This is a decision that your doctor will make with your active participation. 

There are some important factors such as drug interactions, metabolic impairment, hypersensitivity reaction, pregnancy, lactation etc. which may alter the desired therapeutic effects of such medications. 

Sometimes the presence of other health disorders affects the beneficial effects of this medicine and even may cause serious toxic effects. 

Make sure you mention your doctor if you have any other health problems or medical disorders, especially:

  • Known organic nitrate intolerance
  • Severe anemia
  • High intracranial pressure
  • History of recent head injury or cerebral hemorrhage
  • Raised intraocular pressure i.e. glaucoma
  • Migraine 

Certain drugs should not be used simultaneously when you are receiving amyl nitrite or other nitrites. It is always recommended to consult with your doctor if you are in need of some other medicines for another health disorder so that you can avoid unwanted serious effects. 

Additionally, taking amyl nitrite after drinking alcohol may worsen the side effects and may cause severe hypotension and cardiovascular collapse.

Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of amyl nitrite in extreme age groups. 

Moreover, animal reproduction studies reveal that amyl nitrite (amyl nitrite inhalant) is responsible for harmful effects to the fetus. Thus, this drug should not be administered to a pregnant woman but potential benefits may warrant the use of such medications despite potential risks. 

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3 Proper Usage

Medicines should be used following the directions given by your doctor. The frequency of your daily drug administration and the duration of drug therapy depend on the particular medical problem for which you are taking the medicine. That’s why; the therapeutic dose may vary with patient’s condition or requirement. 

0.3ml is supplied in a specialized capsule covered with thin glass which can be easily crushed. The small glass ampoule of amyl nitrite is advised to hold away from the face, and then you need to crush it between the fingers to release its vapor. 

ts effect appears immediately within 30 seconds and lasts for approximately 3-5 minutes. The vapors should be inhaled by holding the capsule under the patient’s nose in seated or lying down position. 2 to 6 inhalations of the vapors from the capsule are usually enough to produce therapeutic effects. 

The dose can be repeated at 3 to 5 minutes interval if needed. But you should not inhale excessive amounts of the drug beyond maximum therapeutic dose.

Patients with history of recent angina attack or myocardial infarction are advised to keep this medicine with them so that they can improve the further symptoms. 

Such medications should be kept out of the reach of children and it is advised to dispose an outdated medicine by an appropriate way.

4 Precautions to Take

Tolerance to amyl nitrite may develop with repeated use of the drug for prolonged periods of time. The risk of development of tolerance can be minimized by beginning with the smallest effective dose and alternating the drug with another coronary vasodilator. 

Transient episodes of dizziness, weakness, or other signs of cerebral ischemia or syncope are reported in certain individuals due to development postural hypotension following inhalation of amyl nitrite, particularly if the patient is standing immobile. 

Some measures facilitating venous return such as deep breathing and movement of extremities are found helpful to reduce such incidences. In addition, this medicine should not be used in those individuals who are metabolically impaired or methemoglobin reductase deficient because of increased risk of methemoglobinemia.

5 Potential Side Effects

There are some unwanted side effects associated with each drug that usually do not need medical attention. These side effects usually go away during the treatment episode as your body adjusts to the medicine. 

Your healthcare professional may advise you about the ways how to prevent or reduce those unwanted adverse effects. A patient should check with his/her healthcare professional if any of the following side effects continue:

  • Mild transitory headache, dizziness and flushing of the face are the common adverse effects with the use of inhalant amyl nitrite. 
  • Syncope, involuntary defecation and urination, hypotension, tachycardia, pale, skin, restlessness, generalized weakness, fainting and lightheadedness, vomiting and nausea may also occur in susceptible patients. 
  • Excessively administration in high doses may cause methemoglobinemia in certain individuals.
  • Such nitrites are often abused for sexual stimulation, with tolerance and headache as a common side effect.
  • It may cause permanent hearing loss, as well as chronic tremors and slurred speech.
  • Continued use can also result in mental disturbance, ongoing hallucinations, chronic memory loss, and emotional instability,
  • Long term use of such medications may cause permanent damage to the brain, bones, heart, kidneys and liver.
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