Butyl Nitrite and Methemoglobinemia

Excerpt

To the editor: A recent extensive study of the toxic potential of amyl, butyl, and isobutyl nitrite concluded that these are "among the safest medications listed in the U.S. Pharmacopoeia", a conclusion based on the relatively low levels of methemoglobin (5% to 8%) arising from inhalation of these esters (1). We wish to qualify this impression by reporting a case of near-fatal methemoglobinemia as a consequence of ingestion of butyl nitrite.

The patient was a 28-year-old chronic drug abuser who became stuporous within an hour of ingesting a 0.4-ounce bottle of butyl nitrite. The empty bottle was displayed to physicians