Amyl nitrite


  • Type: Antidote, anti-anginal agent
  • Dosage Forms: crushable ampules; liquid for inhalation
  • Dosage Strengths: 0.3 mL
  • Routes of Administration: inhalation
  • Common Trade Names: Component of Cyanide Antidote Package (Lilly kit)

Adult Dosing

  • Cyanide toxicity: Crush one to two ampules in gauze, cloth, or a sponge and place under patient's nose, in O2 face mask, or port access of ETT. Patient should inhale deeply for 30s, rest for 30s, and repeat for 2-3 minutes

Pediatric Dosing

  • As above

Special Populations


  • Allergy to class/drug
  • Cerebral hemorrhage, recent severe head trauma

Adverse Reactions


  • Methemoglobinemia (this is the point when used for cyanide toxicity)
  • Raised ICP
  • Rased IOP
  • Syncope


  • Orthostatic hypotension, dizziness
  • Headache
  • Flushing


  • Half-life:
  • Metabolism:
  • Excretion:

Mechanism of Action

  • Convert the iron in hemoglobin from the ferrous to the ferric form, creating methemoglobinemia. Then, the thiosulfate can become sulfate donor, allowing conversion of cyanide to readily renally excretable form


See Also