Acute Porphyria Drug Database

Monograph

N01AX13 - Nitrous Oxide
Propably not porphyrinogenic
PNP

Rationale
Nitrous oxide is rapidly eliminated unchanged via the lungs, and has no potential for CYP interactions. Common adverse reactions of nitrous oxide that can be confused with an acute porphyric attack are nausea and vomiting.
Chemical description
Nitrous oxide is a medicinal gas with the chemical formula N2O.
Therapeutic characteristics
Nitrous oxide has analgesic and sedative properties and is used in the management of mild to moderate pain and in general anaesthesia in combination with other anaesthetics. It has a rapid onset and offset of effect. Nitrous oxide is administered by inhalation, and should be combined with oxygen to prevent hypoxia. Common adverse reactions of nitrous oxide that can be confused with an acute porphyric attack are nausea and vomiting.
Metabolism and pharmacokinetics
Nitrous oxide is excreted unchanged via the lungs. Because of its low solubility in blood, it is rapidly distributed to the tissue giving a rapid onset of effect. No pharmacokinetic interactions between nitrous oxide and other drugs are observed or suspected.
Published experience
Reports of uneventful use: Barone 2001: used uneventfully by 1 patient with AIP. Brown 2002: used uneventfully by 1 patient with VP. Famewo 1985: used uneventfully by 1 patient with AIP. McGovern 2007: used uneventfully by two children with latent AIP. Minoda 1997: used uneventfully by 1 patient with VP: Sarantopoulos 2000: used uneventfully by 1 patient with HCP. Shipton 1984: used uneventfully by 1 patient with VP. Yamamori 1996: used uneventfully by 1 patient with HCP

References

# Citation details PMID
*Scientific articles
1. CD. Uneventful propofol anesthesia in a patient with coexisting hereditary coproporphyria and hereditary angioneurotic edema.
Anesthesiology. 2000 Feb;92(2):607-9.
2. Shipton EA, Roelofse JAAnaesthesia in a patient with variegate porphyria undergoing coronary bypass surgery. A case report.
S Afr Med J. 1984 Jan 14;65(2):53-4.
3. The tolerability of newer immunosuppressive medications in a patient with acute intermittent porphyria.
Barone GW, Gurley BJ,et al. J Clin Pharmacol. 2001 Jan;41(1):113-5
4. Nitrous oxide and the inhalation anesthetics.
Becker DE, Rosenberg M. Anesth Prog. 2008 Winter;55(4):124-30
5. The management of porphyria in dental practice.
Brown GJ, Welbury RR. Br Dent J. 2002 Aug 10;193(3):145-6.
12213008
6. Induction of anaesthesia with etomidate in a patient with acute intermittent porphyria.
Famewo CE. Can Anaesth Soc J. 1985 Mar;32(2):171-3.
7. The dental management of five paediatric patients with a history of acute intermittent porphyria.
McGovern E, Fleming P, et al. Eur Arch Paediatr Dent. 2007 Dec;8(4):215-8.
18076854
8. Anesthetic management of a patient with variegate porphyria. J Anesth 1997;11:307-308.
Minoda Y, Oshimine KY, et al.
28921072
9. Uneventful propofol anesthesia in a patient with coexisting hereditary coproporphyria and hereditary angioneurotic edema.
Sarantopoulos CD, Bratanow NC, et al. Anesthesiology. 2000 Feb;92(2):607-9.
10. Safety of isoflurane and epidural anesthesia in a patient with hereditary coproporphyria. J Anesth 1996 10:80-82
Yamamori Y, Sumi M, et al.
*Summary of Product Characteristics
11. Norwegian medicines agency. Summary of Product Characteristics (SPC). Niontix.

Similar drugs
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Tradenames and packages
From some sources, we get a list of packages (United Kingdom, Ireland, Estonia). Other sources contain more or less "clean" versions of the trade name (Denmark, Finland, Iceland, Lithuania, Norway). What you see here is the raw data we get from each country, so there will appear to be duplicates. The bold names are the searchable terms. The gray names that follow are all mapped to the bolded term.
Note: The cleaning is done automatically by a proprietary algorithm, and it may produce errors. We strive to improve it continuously.
Netherlands
Distikstofoxide · Distikstofoxide medicinaal Air Liquide, medicinaal gas, vloeibaar gemaakt 100% v/v · Distikstofoxide medicinaal AIR PRODUCTS, 100% v/v, medicinaal gas, vloeibaar gemaakt · Distikstofoxide medicinaal SOL, medicinaal gas, vloeibaar gemaakt 100% v/v · Distikstofoxide Westfalen 100% v/v vloeibaar gemaakt gas · Lachgas · Lachgas Messer 100% v/v medicinaal gas, vloeibaar gemaakt · Niontix · Niontix, medicinaal gas, vloeibaar gemaakt, 100% v/v
Belgium
Dinitrox · Dinitrox 100 % gas médic. (liquifié) récip. cryogén. Mobile cadre bouteilles · Kalinox bouteille · Niontix · Niontix 100 % v/v gas médic. (liquifié) bouteille · Protoxyde d'Azote · Protoxyde d'Azote Médical Ijsfabriek Strombeek 100 % v/v gas médic. (liquifié) récip. cryogén. Mobile cadre bouteilles bouteille · Protoxyde d'azote Médical, Air Liquide Santé International 100 % gas médic. (liquifié) bouteille · Protoxyde d'Azote Medicinal Sol 100 % v/v gas médic. (liquifié) bouteille · Protoxyde d'azote Messer 100 % v/v gas médic. (liquifié) cadre bouteilles bouteille · Protoxyde d'Azote Médicinal · Protoxyde d'Azote Médicinal Air Products 100 % v/v gas médic. (liquifié) récip. cryogén. Mobile cadre bouteilles bouteille · Protoxyde d'Azote Médicinal Messer Belgium 100 % gas médic. (liquifié) cadre bouteilles bouteille
United Kingdom
Nitrous Oxide · Medical Nitrous Oxide cylinders 1800litres size E · Medical Nitrous Oxide cylinders 3600litres size F · Medical Nitrous Oxide cylinders 9000litres size G · Medical Nitrous Oxide cylinders 900litres size D · Medical Nitrous Oxide cylinders size D · Medical Nitrous Oxide cylinders size E · Medical Nitrous Oxide cylinders size F · Medical Nitrous Oxide cylinders size G · Nitrous oxide cylinders 1800litres size E · Nitrous oxide cylinders 3600litres size F · Nitrous oxide cylinders 9000litres size G · Nitrous oxide cylinders 900litres size D · Nitrous oxide cylinders size C · Nitrous oxide cylinders size D · Nitrous oxide cylinders size E · Nitrous oxide cylinders size F · Nitrous oxide cylinders size G · Nitrous oxide cylinders size J
Denmark
Dinitrogenoxid · Medicinsk Dinitrogenoxid "Air Liquide" 100 % · Medicinsk dinitrogenoxid "Nippon Gases Scan" 100% · Medicinsk Dinitrogenoxid "Strandmøllen" · Niontix
Norway
Medisinsk lystgass Air Liquide · Medisinsk lystgass Nippon Gases Scandinavia · Niontix
Poland
Podtlenek azotu AIR PRODUCTS · Podtlenek Azotu Medyczny Air Liquide · Podtlenek Azotu Medyczny SPAWMET · Podtlenek azotu Messer · Podtlenek azotu N2O · Podtlenek azotu SIAD
Luxembourg
KALINOX · KALINOX 170 BAR · Niontix · Protoxyde d'azote · Protoxyde d'azote Médical, Air liquide Santé International · Protoxyde d'azote Médicinal SOL 100% v/v
Iceland
Lyfjatvíköfnunarefnisoxíð · Lyfjatvíköfnunarefnisoxíð Strandmøllen · Niontix
Finland
Lääkkeellinen Ilokaasu Awo · Niontix
Latvia
Niontix · Slapekla oksiduls · Mediciniskais slapekla oksiduls Elme Messer L
Serbia
Azot suboksid · Azot suboksid SOL · diazotoksid · Medicinski diazotoksid
 
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