Another suicide by sodium nitrite and multiple drugs: an alarming trend for “exit”?

  title={Another suicide by sodium nitrite and multiple drugs: an alarming trend for “exit”?},
  author={Carlos Dur{\~a}o and Frederico Gonçalves Pedrosa and Ricardo Jorge Dinis-Oliveira},
  journal={Forensic Science, Medicine and Pathology},
This case report describes a fatal case of sodium nitrite and multiple drug consumption. A 37-year-old female was found in bed with a plastic bottle containing sodium nitrite and a bag containing multiple drugs and a suicide note. The results of the autopsy showed completely fixed grayish livor mortis , signs of asphyxia on the lips, and facial cyanosis. This represents the second case in just a few months and highlights how relatively easy it is to buy sodium nitrite to commit suicide… 

Suicide attempt using sodium nitrite ordered on the internet: Two case reports.

Case reports of 2 patients who attempted suicide by sodium nitrite after ordering a "suicide powder" on the internet market are presented, highlighting how simple and easy it is to buy Sodium nitrite for suicidal purposes.

Sodium Nitrite Intoxication and Death: Summarizing Evidence to Facilitate Diagnosis

Sodium-nitrite-related deaths represent a challenge for forensic pathologists; therefore, it is important to promptly recognize the essential features and perform the necessary and unrepeatable examinations for the correct diagnosis of the cause of death.

Increasing use of sodium nitrite in suicides—an emerging trend

While autopsy findings were generally consistent with the literature, scene findings emphasized the accessibility of sodium nitrite to the general public as well as important analytical limitations in the evaluation of suspected cases.

Fatal methemoglobinemia in three suicidal sodium nitrite poisonings

The data from these cases indicate that levels of MetHb can vary widely in fatal cases, and should not be used as the sole criterion for determination of a death caused by sodium nitrite.

The use of sodium nitrite for deliberate self-harm, and the online suicide market: Should we care?

A case of sodium nitrite intoxication for deliberate self-harm is reported and the increasing number of such cases in recent times is discussed.

Commentary on: Dean DE, Looman KB, Topmiller RG. Fatal methemoglobinemia in three suicidal sodium nitrite poisonings. J Forensic Sci. doi: 10.1111/1556‐4029.14689. Epub 2021 Feb 17.

Responses should focus on restricting the ease access to large quantities of sodium nitrite and alert to the risk of death after exposure, and the advertisement by the Internet may contribute to disseminate this burden.



A fatal case by a suicide kit containing sodium nitrite ordered on the internet.

Fatal Sodium Nitrite Poisoning: Key Considerations for Prehospital Providers

EMS professionals should consider sodium nitrite toxicity in patients with a suspected overdose who present with a cyanotic appearance, pulse oximetry that remains around 85% despite oxygen, and dark brown blood seen on venipuncture.

Fatal methaemoglobinaemia in a dental nurse. A case of sodium nitrite poisoning.

  • W. Gowans
  • Medicine
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 1990
Methaemoglobinaemia should be considered as a diagnosis in any patient with significant central cyanosis in whom there is no obvious cardiorespiratory cause and its storage made correspondingly more secure.

Sodium nitrite food poisoning in one family

The presented cases illustrate the necessity of close cooperation between the authorities, medical staff, veterinary inspectorate, and forensic pathologists in determining the source of poisoning, the cause of death of the victim, and preventing the outbreak of poisoning among a greater number of consumers.

Severe Methemoglobinemia and Death From Intentional Sodium Nitrite Ingestions.

A case of fatal methemoglobinemia of unknown origin but presumably due to ingestion of nitrate

The post-mortem examination of the blood revealed a methemoglobin (MetHb) concentration of 78% and the concentrations of nitrate and nitrite were 1.50 and 0.76 μg/mL, respectively.

Review article: Management of cyanide poisoning

Hydroxocobalamin and sodium thiosulphate differ from alternatives in having negligible adverse effects, and on the basis of current evidence are the antidotes of choice.

Fatal methemoglobinemia caused by inadvertent contamination of a laxative solution with sodium nitrite.

We describe two cases of fatal methemoglobinemia resulting from ingestion of laxative solution inadvertently contaminated with sodium nitrite. Postmortem toxicological examination revealed

Death associated with nitrite ingestion: report of a case.

It is concluded that noth nitrite and nitrate salts may be identified in tissues from persons ingesting only nitrite salts and that a significant conversion to nitrate may result from oxidation of nitrite during the conversion of heme iron to Fe3+.

Fatal methaemoglobinaemia induced by self‐poisoning with sodium nitrite

A 76‐year‐old man collapsed and rapidly developed brady‐asystolic cardiac arrest 25 min following self‐poisoning with an unknown quantity of crystalline sodium nitrite and died despite prolonged resuscitative efforts.