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Confusion Between Nitrites & Nitrates
by Erowid & Torsten
v 1.0, March 2001

In many articles and information sources, both online and off, there is a confusion between the terms Nitrite (with an "i") and Nitrate (with an "a"). Nitrite = NO2 , Nitrate = NO3. Both nitrites and nitrates are used as medicines to treat heart problems including angina, chest pains, and as emergency medicine during heart attacks.

Amyl-, Butyl-, and Isobutyl-Nitrite are used recreationally and are referred to as "poppers". They are known for causing a brief head rush, skin flushing, and muscle relaxation. They are sometimes labelled as "video head cleaners" in order to get past the legal restrictions for inahalants, but it's questionable whether they are actually useful as such. Nitrites are packaged and sold as heart medicines in small glass ampules inside cloth. The ampule is broken and the vapors inhaled as emergency remedies for heart / angina attacks.

Amyl nitrite (AM-il NYE-trite) is related to the nitrate medicines and is used by inhalation to relieve the pain of angina attacks. It works by relaxing blood vessels and increasing the supply of blood and oxygen to the heart while reducing its workload.
Nitrates on the other hand are not used recreationally and are not "Poppers". They are sold in tablet form and are administered sublingually as a heart medication.

From Dr Mani's Heart Disease Online:
Nitrates are a group of drugs that act on blood vessels and dilate them. By relaxing smooth muscle in the vessel wall, they produce an increase in diameter which in turn increases the volume of blood flowing through them.

Both of these chemicals act similarly, relaxing muscles and reducing blood pressure. According to several sources, Amyl-Nitrite was first discovered in 1844 and its blood-vessel relaxing properties were discovered quickly thereafter. Later, Nitroglycerin was discovered to have similar effects and became one of the most common heart medication prescribed in the 20th Century, replacing Amyl-Nitrite because it had fewer side effects and was easier to administer.

Many doctors, web sources, and drug reference sheets such as Material Safety Data Sheets (MSDS) confuse Nitrites and Nitrates. One recent issue where the two have been confused is in news reports that heart patients died after taking Viagra with oral nitrate heart medication. Whether or not inhalant nitrites and Viagra are also a dangerous combination has not necessarily been established. Much of medical literature I have seen refers to amyl-nitrite as 'amyl-nitrate'. The interactions between nitrates and Viagra are well known and thus amyl-nitrite is automatically lumped into the same group. Although there is good reason to think the blood-pressure lowering effects of nitrites could interact dangerously with Viagra, other blood-pressure lowering medications are not considered dangerous in combination with Viagra. Fatalities from combining the two are primarily a matter of men who take nitrate heart medications to treat already existing severe cardio-vascular problems and who then also take Viagra, so its difficult to extrapolate reliably to healthy fun-seekers. Caution is obviously advisable.

It should also be noted that in recent years, amyl-nitrite has been replaced substantially by butyl- and isobutyl-nitrite because the corresponding alcohol is easier to acquire for manufacture and also because it smells somewhat less unpleasant (a sweet solvent smell rather than a sweaty socks / locker room solvent smell). Some countries have also specifically banned Over The Counter (OTC) sale of amyl-nitrite because of its recreational use, but have not yet blocked the sale of butyl- and isobutyl-nitrite.