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Alkyl nitrites are a group of organic compounds with the general formula R-O-N=O, where R is any organic group. Amyl nitrite has historically been used for the treatment of angina, among other legitimate medicinal uses. Other alkyl nitrites, including butyl nitrite, isobutyl nitrite, isopropyl nitrite, ethyl nitrite, methyl nitrite as well as the disputed cyclohexyl nitrite, have been widely used for 40 years as the primary ingredients in room odorizer products and as recreational drugs. The vapours of the alkyl nitrite are inhaled directly from the bottle, inducing an almost-instant, euphoric head rush; the body's smooth muscles are relaxed. As a recreational drug, they are primarily used to enhance the sexual experience.

Basics

Cyclohexyl nitrite, butyl nitrite, isobutyl nitrite, and other light alkyl nitrites can be found as the primary ingredient in so-called 'room odorizers', 'video head cleaners', and 'leather cleaners', despite the malodorous nature of some of these compounds. Traditionally marketed in small glass bottles, they are, like amyl nitrite capsules, referred to as poppers. Nitrite-based odorizers are available in adult bookstores and shops and over the Internet, and are regulated by a variety of federal and local regulations and legal restrictions, though the status of cyclohexyl nitrite — technically not a member of the class of alkyl nitrites encompassed by the law — remains in question in the United States, as a result of the controversial Federal Analog Act. Some manufacturers include qualifying statements on their web sites such as: "All our nitrite based products are sold as room odorants, liquid incense, liquid aromas, or video head cleaner only. Although research indicates it is generally safe to do so, we do not encourage the misuse of our products as poppers. We are not responsible for the media claims that liquid aromas or poppers are said to be aphrodisiacs or sex drugs, and we do not endorse such claims. Our products do not contain amyl nitrite or butyl nitrite. They contain highly pure isobutyl nitrite, alkyl nitrites, cyclohexyl nitrite or hexyl nitrites only." Some web site dealers provide disclaimers on their sites as well.

The alkyl nitrite which has been used medicinally, amyl nitrite, was popularized in Hunter S. Thompson's Fear and Loathing in Las Vegas. Other popular nitrites include isopropyl nitrite, isobutyl nitrite, butyl nitrite and cyclohexyl nitrite.

The two main vessels for alkyl nitrites are small glass vials/bottles ("freshness jars"), or small ampules which are popped or snapped in order to release the vapors. The name snappers is sometimes used. The vials are simply uncapped, and the vapours are inhaled or allowed to permeate the room. The ampules contain small amounts of the alkyl nitrite, and are enough for only a few doses; while the vials contain enough of the alkyl nitrite for many more doses.

Legality

It is illegal to sell poppers as "inhalants" in the United States and many other jurisdictions. This is the case regardless of the formula. Most brick and mortar retailers circumvent this restriction by selling them as 'video head cleaner', 'room odourizer', 'leather cleaner', etc. Web dealers are less prone to be careful, because of their ability to hide their identity. Many websites selling 'poppers' are more explicit in their description of how the product can be misused as an inhalant.

There are occasional press accounts of raids, and even arrests associated with the sale of these products, resulting most often in confiscation of the dealer's stock and/or an accompanying fine.

Usage

Inhaling nitrites relaxes smooth muscles throughout the body, including the sphincter muscles of the anus and the vagina. This causes the blood vessels to dilate (which causes a sudden drop in blood pressure), increases heart rate, and produces a sensation of heat and excitement that can last for several minutes.

The recreational use of alkyl nitrites is typically an attempt to enhance a sexual experience. The head rush, euphoria, and sensations of relaxation that result from the blood pressure drop are often felt to increase sexual arousal and desire. At the same time, the relaxation of the sphincters of the anus and vagina can make penetration easier. Similarly, a temporary reduction in the stiffness of the erection can also make penetration easier or more comfortable, so long as an adequate degree of stiffness is retained. Some people find poppers can also moderate their gag reflex, facilitating fellatio. Others report that poppers can enhance and prolong orgasms.

While anecdotal evidence reveals that both men and women can find the experience of using poppers pleasurable, this experience is not universal. Some people report that the smell of second-hand poppers (which delivers a relatively small dose) can cause head-aches and nausea. Others feel the reduction in erection stiffness can interfere with sexual performance. Some men find that poppers can interfere with their ability to attain or maintain an erection. These undesirable effects occur for most people as exposure increases, reducing the likelihood of a dangerous overdose.

The use of poppers was popularized in Radley Metzger's 1972 cult classic film Score. In the film, a bisexual woman glides them under the nose of a heterosexual woman in an attempt to loosen her vagina for seduction. During the 1970's and 1980's, the mainstream media often wrote about poppers with stories similar to this front page Wall Street Journal article. They were discussed again in the mainstream news at the turn of the century when the danger of combining nitrites with sildenafil (Viagra) or other impotence drugs became known. (e.g. Viagra May Cause Heart Attack Deaths In Younger Men With No Heart Problems, Study Finds), and again on the anniversary of the first quarter century of the AIDS epidemic, in a feature article in the June 5, 2006 edition of New York magazine (AIDS in New York: A Biography).

Alkyl nitrites are often assumed to be used exclusively or primarily by homosexual men, but usage is reportedly popular among heterosexual men and women as well. This can be compared with the propaganda directed at Ecstasy in an attempt to discourage use by the majority.

Nitrite users tend to be adults rather than adolescents.

Some nitrite users combine them with other recreational drugs to enhance the effects. For example, combining ecstasy with poppers reportedly produces an intense rush of euphoria and physical pleasure. Since the rise of Disco in the mid-1970s and of Acid House music in the late 1980s, nitrite inhalants have been a large part of the disco scene and rave culture, used on the dance floor to heighten the experience of music and lights.

Chemistry

Alkyl nitrites can be synthesized from primary alcohols according to the following reaction process:

R-OH + NaNO₂ + H₂SO₄ ==> R-ONO + NaHSO₄ + H₂O

It has been reported (US Patent 4,638,094) that alkyl nitrites are also a precursor for MDP2P, a phenylacetone used in the production of MDMA, more commonly known as "ecstasy." The basic reaction process is shown below:

MeONO in corresponding alcohol + safrole + PdCl₂ ==> MDP2P

Health hazards

This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. Find sources: "Poppers" – news · newspapers · books · scholar · JSTOR (Learn how and when to remove this message)

The possible hazards of nitrite use have been a contentious issue since the mid-1970’s. Over the next decade, however, no allegation would be more hotly debated, or more serious, than that of a possible link between nitrites and AIDS, or AIDS-related illnesses such as Kaposi's sarcoma.

After a 1983 meeting between the Centers for Disease Control's principal AIDS investigator, James Curran, and Joseph Miller, the president of Great Lakes Products, Inc. (a then-major manufacturer of popular nitrite brands such as Rush, who sought the meeting with Dr. Curran in order to discuss a possible poppers-AIDS connection -- before HIV was discovered), Miller reported in a press release that poppers had been exonerated by the Center for Disease Control. Dr. Curran later pointed out in a September 27, 1983 letter to Miller that he had been misinterpreted in the press release. Curran stated that: “Other health hazards from misuse of these drugs have been documented. Your press release and advertisements in the Advocate are misleading and misrepresent the CDC findings and their implications... While it is unlikely that nitrites will be implicated as the primary cause of AIDS, their role as a co-factor in some of the illnesses found in this syndrome has not been ruled out. I must insist that you discontinue the misuse and misinterpretation of CDC findings.”

Two years later, in 1985, after a demand from Hank Wilson, creator of the 'Committee to Monitor Poppers', that Dr. Curran take an anti-poppers stand, Dr. Curran responded to the one-man committee by telling Wilson that "Current data does not warrant an anti-poppers campaign". -- May 6,1985 letter to the Committee to Monitor Poppers

Upon the discovery of HIV and the definitive research that showed HIV to be the cause of AIDS, poppers were eliminated as the cause of AIDS. However,the possible role of popper use as a risk factor in HIV infection continues to be explored. It is thought by some that even the insignificant immunosuppressive effect of poppers, may increase susceptibility to HIV infection and also HHV-8 infection, or that they may affect sexual behavior increasing risk for infection, though there is little data to support these theories.

It has also been speculated by some that because Kaposi's sarcoma occurred in homosexual AIDS-patients 20 times more often than in non-homosexual AIDS-patients, some cofactor must be involved beyond the virus HIV itself. Poppers were suggested as a candidate for that cofactor, though studies have been contradictory.

The large MACS study in 1987 concluded that no such connection with poppers existed. However, a later 1993 MACS publication PMID 8356966 found nitrite inhalant use a significant risk factor for KS. In 2002, Casper PMID 11920325, found that poppers use was an independent risk factor for HHV-8 seroconversion. In 2000, Pauk et al. PMID 11070101 found amyl nitrite use an independent risk factor for HHV-8 infection.In 2006,Casper et al. found a strong and dose dependent relation between popper use and HHV-8 infection in the EXPLORE study.(Casper et al.,"HIV Serodiscordant sex partners and the prevalence of HHV-8 infection among HIV negative men who have sex with men:Baseline data from the EXPLORE Study." Sexually Transmitted Infections June 1 2006 Vol. 82 Issue 3: 229-235. It is now generally accepted that HHV-8, a member of the herpes family, is a co-factor for or the cause of Kaposi's sarcoma. Research continues to explore risks for the transmission of HHV-8 and the progression to Kaposi's sarcoma. Research findings have been inconsistent, Haverkos and Drotman, PMID 7744258 cite 5 published studies finding a correlation between KS and poppers use and point out that differences in research methodologies may account for some of the discrepancies.

An argument continues today that, there are a number of possible negative health effects caused by poppers. For example, that high doses of Nitrites may cause methemoglobinemia, particularly in individuals predisposed towards such a condition.. However, as the authors point out, it would take 'excessively high doses of poppers, administered chronically', to possibly cause methemogtlobinaemia (and that methemogtlobinaemia is readily reversible with the administration of methylene blue). Or that use with Viagra can cause heart failure (though there is no indication in the literature that such heart failure has ever occurred), and individuals with anaemia or heart, breathing or blood pressure conditions may be at risk of complications. It’s also suggested that since pressure in the eye and cranium is increased, individuals with glaucoma or traumatic head injuries may have an added risk of negative short or long term effects.

According to the National Institute on Drug Abuse, use of poppers is associated with unsafe sexual practices that increase the risk of contracting and spreading infectious diseases such as HIV/AIDS and hepatitis., though it's notable that nitrites are not alone in being associated with unsafe sexual practices. Included along with nitrite use would be alcohol use, marijuana use, among other drug use, and that use of nitrites may only be a marker for high-risk behavior in general.

Impure alkyl nitrites can burn the skin on contact. All alkyl nitrites can be fatal if swallowed or injected. It has also been reported by some users of an association with mild to extreme headaches.

There has also been significant input from researchers and governmental officials in the USA and other countries, that poppers do not pose a significant hazard to users . Some experts, including Thomas P Lowry, MD, went even further. In a research paper published in the Journal of Psychoactive Drugs; Jan-Jun, 1982; Vol. 14(2): 77-79, Dr. Lowry not only addressed the issue of potential hazards of poppers, but also discussed their use as aphrodisiacs, thereby combining a discussion of effects and sociological aspects.

Over the past quarter century, prominent AIDS researchers and activists, such as Paul Varnell and Bruce Voeller (the scientist who gave AIDS its name) made their concerns known about what they believed to be misrepresentations about poppers.

Medical uses

Alkyl nitrites are clinically utilized as a vasodilator in order to treat angina, and as part of the treatment regimen for cyanide poisoning. Most Certified first responders and Emergency departments in the United States maintain a supply of Amyl Nitrite for such use.

Street names

Street names for these products are often brand names from manufacturers; for example, Rush and Locker Room.

• RUSH
• Locker Room
• Poppers
• Snappers
• Bolt

External links

• Toronto Canada Harm Reduction, information on poppers from a harm reduction perspective
• Poppers at DanceSafe UK, poison control and harm reduction information
• Psychosexual Aspects of the Volatile Nitrites, by Thomas Lowry, MD
• Sex Talk, a homosexual social perspective on poppers
• The Art of Scientific Scrutiny: Investigating the Poppers-AIDS Hypothesis, by Christine Weber
• Confusion Between Nitrites & Nitrates, at Erowid

References

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Alkyl nitrites were shown to be immunosuppressive, mutagenic and carcinogenic in animals and immunosuppressive in humans(Dax,1991). Though generally it is considered that the dose used on animals greatly exceed doses used by humans.

• Tran DC et al.,"Effects of repeated in vivo inhalant nitrite

exposure on genes expression in mouse liver and lungs." Nitric Oxide 2006 Jun;14(4):279-289. "In conclusion, multiple exposure to inhalant nitrite appeared to cause alterations in the expression of a number of genes relating to cancer and angiogenesis,.."

• Mbullaiteye Sam et al.,"Risk factors for human herpesvirus 8 seropositivity in the AIDS Cancer Cohort Study." Journal of Clinical Virology Volume 35, Issue 4, April 2006, Pages 442-449.
• Chin-Hong PV et al.,"Age-related prevalance of anal cancer precursors in homosexual men: the EXPLORE study." J Natl Cancer Inst. 2005 Jun 15;97(12):896-905.
• Casper et al.,(2006) "HIV Serodiscordant sex partners and the prevalence of HHV-8 infection among HIV negative men who have sex with men: baseline data from the EXPLORE study." Sexually Transmitted Infections 2006:Vol 82 Issue 3: 229-235.
• Tran DC, Brazeau DA, Nickerson PA, Fung HL (2005), Effects of repeated in vivo inhalant nitrite exposure on gene expression in mouse liver and lungs., Nitric Oxide. PMID 16288974

"Exposure to inhalant organic nitrites (drugs of abuse commonly known as "poppers") has been reported to enhance tumor growth in mice, but the mechanism is not fully defined. In conclusion, multiple exposures to inhalant nitrite appeared to cause alteration in the expression of a number of genes relating to cancer and angiogenesis, including VEGF. These studies demonstrate that in vivo exposure to inhalant nitrites results in changes in the angiogenesis cascade."

• Soderberg LS, et al. (2004) "Production of macrophages IL-1beta was inhibited both at the levels of transcription and maturation caspase-1 following inhalation exposure to isobutyl nitrite." Toxicology Letters 2004 Aug 30; 152(1):47-56. PMID 15294346.
• Ponnappan U, et al. (2004)"Inhaled isobutyl nitrite inhibited macrophage inducible nitric oxide by blocking NFKappaB signalling and promoting degradation of inducible nitric oxide synthase-2." Int. Immunopharmacology 2004 August; 4(8):1075-82. PMID 15222982.
• Tran D et al. (2003) "Inflammatory macrophage nuclear factor-kb and proteasome activity are inhibited following exposure to inhaled isobutyl nitrite." Journal of Leukocyte Biology. Vol 69,April 2001:639-644.
• Casper et al. (2002) "Correlates of prevalent and incident KS-associated herpesvirus infection in men who have sex with men." Journal of Infectious Diseases 2002 April 1; 185(7):990-993.Epub 2002Mar. 11. PMID 11920325.

"These results demonstrate that in vivo exposure to an inhalant nitrite results in altered tissue expression of vascular endothelial growth factor (VEGF) and its receptors, suggesting that some of its toxicological effects may be mediated partly through a mechanism involving angiogenesis." PMID 14521929.

• Ponnappan U, Soderberg LS. (2001). Inflammatory macrophage nuclear factor-kappaB and proteasome activity are inhibited following exposure to inhaled isobutyl nitrite.. PMID 11310851

"A series of 14 daily, 45-min exposures of mice to 900-ppm isobutyl nitrite in an inhalation chamber reduced the number of peritoneal exudate macrophages (PEM) by 35% and the number of resident peritoneal macrophages (RPM) by 18%. Although the tumoricidal activity of RPM was not affected by the inhalant, the cytotoxicity of PEM was reduced by 26%. The induction of nitric oxide (NO) and the inducible NO synthase (iNOS) protein in PEM were inhibited by the inhalant to a similar extent. Inhibition of NF-kappaB activation in PEM from mice exposed to the inhalant corresponded to reduced degradation of the NF-kappaB inhibitor, IkappaB alpha. Proteasome-associated, enzymatic activity was compromised in PEM from inhalant-exposed mice, suggesting that inhaled isobutyl nitrite compromised macrophage, tumoricidal activity by inhibiting proteasomal degradation of the NF-kappaB inhibitor, IkappaB alpha."

• Pauk et al.(2000). "Mucosal shedding of human herpesvirus 8 in men." New England Journal of Medicine; 2000 Nov 9;343(19):1369-77. PMID 11070101.
• Kielbasa W. et al.,(2000)." Nitrite inhalation in rats elevates tissue NOS III expression and alters tyronsine nitration and phosphorylation." Biochemical and Biophysical Research Communications; 2000 (275): 335-342. PMID 10964667.
• Guo G et al. (2000). "Acute exposure to the abused inhalant, isobutyl nitrite, reduced t cell responsiveness and spleen cellularity." Toxicology Letters 116:151-158. PMID 10906432.
• James JS. (1999). Poppers: large cancer increase and immune suppression in animal tests, AIDS Treat News 317. PMID 11366993

"A study on mice injected with cancer cells and then exposed to isobutyl nitrite (poppers) revealed that inhalant-treated mice developed tumors more readily and rapidly than control mice. The control mice were also injected with cancer cells, but only breathed air. Related studies found that poppers suppress certain immune functions involved in killing tumor cells. These studies suggest that further research of persons with HIV/AIDS who use poppers is needed to determine if they are at a high risk for developing malignancies."

• Soderberg LS. (1999). Increased tumor growth in mice exposed to inhaled isobutyl nitrite., Toxicol Lett. PMID 10048747

"To determine if exposure to nitrite inhalants could alter tumor growth, syngeneic PYB6 tumor cells were injected into groups of mice. Exposure of these mice to inhaled isobutyl nitrite increased both the tumor incidence and the tumor growth rate by almost 4-fold. Following only five daily exposures to the inhalant, the induction of specific T cell mediated cytotoxicity was inhibited by 36%. Similar inhalation exposures inhibited the tumoricidal activity of activated macrophages by 86%. The data suggest that exposure to abuser levels of a nitrite inhalant compromised tumor surveillance mechanisms."

• Soderberg LS. (1998). Immunomodulation by nitrite inhalants may predispose abusers to AIDS and Kaposi's sarcoma., J Neuroimmunol. PMID 9610684

"Inhalation exposure to the nitrites produce a nonspecific cytotoxicity, depleting many cells of the immune system. Apparently distinct from this cytotoxicity, inhalation of the nitrites impairs a variety of immune mechanisms, affecting both humoral and cell-mediated immunity. Thus, nitrite inhalants may impair immune resistance to infection and actively promote viral replication and tumor growth."

• The poppers-HIV connection. (1999). Focus. PMID 11366670

"In addition, research has found that popper use suppresses natural killer (NK) cell function, which increases vulnerability to infectious agents, produces sustained alterations in the immune system, and may be a Kaposi's sarcoma (KS) cofactor. The combined data implicate that the use of poppers may well pose as a significant risk factor for seroconversion."

• James JS (1999). Poppers: more evidence of suppressed immunity., AIDS Treat News, 325. PMID 11366577.

"Evidence from studies in mice shows that exposure to isobutyl nitrite suppresses the immune system. This immune suppression allows for bacterial growth in the lungs and livers of infected mice and can inhibit the ability of mediastinal lymph nodes to respond to antigen-specific stimulation. The mechanism for immune suppression may be a reduction in CD4+ and CD8+ T cell populations in the mediastinal lymph nodes following pulmonary infection with Listeria monocytogenes."

• Soderberg LS et al.,(1996)."Elevated TNF-and inducible nitric oxide production by alveolar macrophages after exposure to a nitrite inhalant." Journal of Leukocyte Biology; 1996;60:459-464. PMID 8864129.
• Soderberg LS et al.,(1996)."Leukopenia and altered hematopoietic activity in mice exposed to the abused inhalant,isobutyl nitrite." Experimental Hematology; 1996,June; 24(7):848-853. PMID 8647236.
• Soderberg LS et al.,(1996)."Acute inhalation exposure to isobutyl nitrite causes non specific blood cell destruction." Experimental Hematology;1996, April(5):592-596.PMID 8605963.
• Soderberg LS. et al.,(1996). "Inhaled isobutyl nitrite produced lung inflammation with increased macrophage TNF- and nitric oxide production." Adv Exp Med Biol;1996; 402:187-189. PMID 8787659.
• Haverkos and Drotman (1995)."Measuring nitrite exposure in gay men: implications for elucidating the etiology of AIDS-related Kaposi's sarcoma." Genetica, 1995;95(1-3)157-64.PMID 7744258.
• Ostrow,David G. et al.,(1995). "A Case Control study of human immunodeficiency virus type 1 seroconversion and risk related behaviors in the Chicago MACS/CCS Cohort, 1984-1992.MACS. Coping and Change Study." American Journal of Epidemiology, Oct 15, 1995; 142(8)875-883. PMID 7572964.
• Soderberg LS (1994). "T cell functions are impaired by inhaled isobutyl nitrite through a t-independent mechanism." Toxicology Letters; 1994, 70:319-329. PMID 8284799.
• Soderberg LS (1991). "Exposure to inhaled isobutyl nitrite reduces t cell blastogenesis and antibody responsiveness." Fundamental and Applied Toxicology; 1991; 17:821-824. PMID 1778367.
• Dax,Elizabeth et al.,(1991). "Amyl Nitrite Alters Human In Vitro Immune Function," Immunopharmacology and Immunotoxicity Vpl. 13(4):557-587. PMID 1685501."The changes in lymphocyte function observed in this study suggest that volatile nitrite inhalation results in a cycle of modest immunosuppression followed by gradual recovery after cessation of drug inhalation. NK(natural killer)activity was most noticeably effected and was the slowest to recover."
• Soderberg LS et al., (1991)."Exposure to abused inhalant, isobutyl nitrite, compromise both antibody and cell-mediated immunity." Adv Exp Med Biol., 1991; 228: 265-8. PMID 1835258.
• Dunkel, V. et al.(1989) "Mutagenicity of Some Alkyl Nitrites Used As Recreational Drugs." Environmental and Molecular Mutagenesis. 14:115-122.: "To evaluate further the genotoxic activity of these chemical, six nitrites, including those commonly used by homosexuals for sexual gratification, were selected for testing in the mouse lymphoma TK+/-and Salmonella typhimurium mutagenicity assays. One chemical, n-amyl nitritem, was negative in the mouse lymphoma assay, while other five chemicals,n-butyl, isobutyl, iso-amyl, sec-butyl, and n-propyl nitrite were positive. All six compounds were positive for the Salmonella assay." PMID 2569972.
• Harry W. Haverkos, M.D., John A. Dougherty, Ph.D. (1988). Health Hazards of Nitrite Inhalants, NIDA Research Monograph 83
• Sidney Mirvish et al., "Mutagenicity of Iso-Butyl Nitrite Vapor in Ames Test and Some Relevant Chemical Properties, Including the Reaction of Iso-Butyl Nitrite with Phosphate", Environmental and Molecular Mutagenesis, 1993;21:247-252.
• Khaled M. et al. (1986)"Inactivation of B-12 and Folate Coenzymes by Butyl Nitrite as Observed by NMR: Implications on One-Carbon Transfer Mechanism." Biochemical and Biophysical Research Communications. Vol.135 No.1:201-207.: "The significance of this experiment is the loss of the one-carbon fragment, namely the 5N-methyl group, with the subsequent destruction of the coenzyme. Frequent butyl nitrite inhalation entails therefore the risk of B12 and/or folate deficiency with consequent impairment of the immune function." PMID 3954771.
• Lauritsen, John and Hank Wilson. (1986) Death Rush: Poppers and AIDS, Pagan Press. Contains an extensive bibliography on nitrite inhalants and possible relationships to Kaposi's sarcoma and AIDS. This book is currently out of print, but may be downloaded in zip format as part of the appendix to the following paper: .
• Newell GR, Adams SC, Mansell PW, Hersh EM (1984). Toxicity, immunosuppressive effects and carcinogenic potential of volatile nitrites: possible relationship to Kaposi's sarcoma., Pharmacotherapy. PMID 6150466

"These products have been found to be profoundly immunosuppressive for human lymphocytes in vitro, and their by-products when metabolized into N-nitroso compounds have been known to be highly carcinogenic in many animal species."

• Lotzova, Eva et al.,(1984). "Depression of murine natural killer cell cytotoxicity by isobutyl nitrite." Cancer Immunology and Immunotherapy; 1984;17:130-34. PMID 6235910.
• Hersh E.M., Reuben J.M., Bogerd H., Rosenblum M., Bielski M., Mansell P.W.A., Rios A., Newell G.R., Sonnenfeld G. (1983), Effect of the recreational agent isobutyl nitrite on human peripheral blood leukocyte and on in vitro interferon production. Cancer Res 43, 1365
• Jorgensen K.A., Lawesson S.O. (1982), Amyl nitrite and Kaposi's sarcoma in homosexual men. N. Engl. J. Med. 307, 893
• Mirvish S.S., Ramm M.D., Bobcock D.M. (1988), Indications from animal and chemical experiments of a carcinogenic role for isobutyl nitrite. In: Health Hazards of Nitrite Inhalants (Haverkos H.W. Dougherty J.A., eds.) NIDA Res Monogr 83, National Institute on Drug Abuse, Washington DC, P 39
• Newell G.R., Mansell P.W., Spitz M.R., Reuben J.M., Hersh E.M. Volatile Nitrites Use and Adverse Effects Related to the Current Epidemic of the Acquired Immune Deficiency Syndrome. Am. J. Med. 78:811,1985.
• Harry Haverkos et al., "Disease manifestation among homosexual men with acquired immunodeficiency syndrome: A possible role of nitrites in Kaposi's sarcoma, Sexually Transmitted Diseases, October-December 1985. Harry Haverkos and John Dougherty, editors; Health Hazards of Nitrite Inhalants, NIDA Research Monograph 83, 1988
• I. Quinto, "The Mutagenicity of Alkylnitrites in the Salmonella Test" (translation from the Italian), Bolletino Societa Italiana Biologia Sperimentale, 56:816-820, 1980.
• "A Critical Review of the Bibliography/References listed above regarding Anti-Popper Research" — Lisa Ringold, PhD pharmacology

• Antianginals
• Antidotes
• Alkyl nitrites
• Schedule VI controlled substances
• Drugs of abuse
• Pharmacologic agents