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The Drug-Induced Cardiotoxicity Website and App

Frequency - Incidence

Incidence of cardiac adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for cardiac adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

XXIII.a

Methemoglobinemia

May associate with hemolytic anemia. See PMID 18477042

Publications

Valenzuela M, Phan T, Samones E, Dukes WS

Do Not Drink Poppers: A Case Report of Near Fatal Methemoglobinemia After Ingestion of Alkyl Nitrite.

Cureus. 2025;17(1):e77190

Alkhateeb W, Luthra G, Almatroud L, Saleh A, Landa E

From Poppers to Peril: Recreational Nitrite-Induced Methemoglobinemia.

Cureus. 2024;16(8):e67435

Idries IY, Khristoforov V, Duddala S, Duong YV, Zaman M

Out of the Blue: Methemoglobinemia Associated With the Use of Amyl Nitrite in Rush Poppers for Erectile Stimulation.

Cureus. 2023;15(6):e41201

Barrangou-Poueys-Darlas M, Gerardin M, Deheul S, Istvan M, Guerlais M, Fan, Jolliet P, Dejoie T, Victorri-Vigneau C

Poppers Use and High Methaemoglobinaemia: 'Dangerous Liaisons'.

Pharmaceuticals (Basel, Switzerland). 2021;14(10)

Elshikh AH, Kango G, Baalbaki M, Lankowsky J, Bawa A

Amyl Nitrite-Induced Hemolytic Anemia: Acute Therapy and Prevention.

Cureus. 2021;13(7):e16099

Tello DM, Doodnauth AV, Patel KH, Gutierrez D, Dubey GR

Poppers-Induced Methemoglobinemia: A Curious Case of the Blues.

Cureus. 2021;13(5):e15276

Hunter L, Gordge L, Dargan PI, Wood DM

Methaemoglobinaemia associated with the use of cocaine and volatile nitrites as recreational drugs: a review.

British journal of clinical pharmacology. 2011;72(1):18-26

Lin CH, Fang CC, Lee CC, Ko PC, Chen WJ

Near-fatal methemoglobinemia after recreational inhalation of amyl nitrite aerosolized with a compressed gas blower.

Journal of the Formosan Medical Association = Taiwan yi zhi. 2005;104(11):856-9

Jansen T, Barnung S, Mortensen CR, Jansen EC

Isobutyl-nitrite-induced methemoglobinemia; treatment with an exchange blood transfusion during hyperbaric oxygenation.

Acta anaesthesiologica Scandinavica. 2003;47(10):1300-1

Modarai B, Kapadia YK, Kerins M, Terris J

Methylene blue: a treatment for severe methaemoglobinaemia secondary to misuse of amyl nitrite.

Emergency medicine journal : EMJ. 2002;19(3):270-1

Retornaz F, Retornaz K, Seux V, Cortes E, Auffray J, Soubeyrand J

[Recurrent methemoglobinemia: look for repeated use of poppers].

La Revue de medecine interne. 2001;22(4):401-2

Stambach T, Haire K, Soni N, Booth J

Saturday night blue--a case of near fatal poisoning from the abuse of amyl nitrite.

Journal of accident & emergency medicine. 1997;14(5):339-40

Bradberry SM, Whittington RM, Parry DA, Vale JA

Fatal methemoglobinemia due to inhalation of isobutyl nitrite.

Journal of toxicology. Clinical toxicology. 1994;32(2):179-84

Edwards RJ, Ujma J

Extreme methaemoglobinaemia secondary to recreational use of amyl nitrite.

Journal of accident & emergency medicine. 1995;12(2):138-42

Shesser R, Dixon D, Allen Y, Mitchell J, Edelstein S

Fatal methemoglobinemia from butyl nitrite ingestion.

Annals of internal medicine. 1980;92(1):131-32

Dixon DS, Reisch RF, Santinga PH

Fatal methemoglobinemia resulting from ingestion of isobutyl nitrite, a "room odorizer" widely used for recreational purposes.

Journal of forensic sciences. 1981;26(3):587-93

O'Toole JB 3rd, Robbins GB, Dixon DS

Ingestion of isobutyl nitrite, a recreational chemical of abuse, causing fatal methemoglobinemia.

Journal of forensic sciences. 1987;32(6):1811-2

Yamaguchi K, Futami G, Kiyokawa T, Ishii T, Murphy JR, Takatsuki K

Adult T cell leukemia/lymphoma. Perspectives on the treatment.

Annals of the New York Academy of Sciences. 1991;636:165-70