I've actually looked into this pretty heavily, mostly as a backup in case my SN didn't arrive (it did, thankfully). So if anyone's curious about the viability of other nitrite salts, here's a breakdown. Bear with me, this is going to be a bit of an info dump.
All nitrite based compounds share the same fundamental mechanism: the nitrite ion (NO₂⁻) causes methemoglobinemia, which prevents haemoglobin from carrying oxygen, leading to hypoxia and ultimately death. In theory, any nitrite salt like sodium nitrite, potassium nitrite, calcium nitrite, lithium nitrite, or even barium nitrite
could work, so long as it delivers a high enough concentration of nitrite into the bloodstream.
But the rest of the molecule matters, too. The accompanying cation (like barium, calcium, or lithium) changes the toxicity profile, solubility, and absorption, and those things are
crucial.
Barium Nitrite [Ba(NO₂)₂]:
This one is technically capable of delivering NO₂⁻, but it's a terrible candidate. Barium salts are acutely poisonous even in small amounts. They disrupt potassium channels in your cells, which causes muscle paralysis, cardiac arrhythmias, nausea, vomiting, and in some cases convulsions. You'd be dealing with
two modes of poisoning at once: nitrite-induced hypoxia
and barium toxicity. That might sound like double insurance, but in reality, it likely means a far more distressing and uncontrolled death. It's
chemically viable, but absolutely not peaceful. In fact, barium chloride (a closely related compound) is historically used as a rat poison.
Calcium Nitrite [Ca(NO₂)₂]:
Calcium is naturally present in the body and relatively safe, so this compound is
theoretically safer than barium. Calcium nitrite is used in things like concrete corrosion inhibitors and sometimes in agriculture. But it's less soluble in water than sodium nitrite, which makes dosing trickier. You'd need more of it to achieve the same effect, and because there's almost no clinical data on oral ingestion in large doses, the human toxicity profile is pretty much unknown. It's not ruled out, but it's untested, unpredictable, and riskier than SN.
Lithium Nitrite [LiNO₂]:
This one is interesting. Lithium also delivers NO₂⁻, but the lithium ion is pharmacologically active. It's a psychiatric drug, after all. In overdose, lithium can cause tremors, confusion, kidney failure, seizures, and coma, and the toxicity is slow building. So if you're taking enough lithium nitrite to get the methemoglobinemia effect, you're probably also introducing lithium toxicity, which can delay or interfere with the process. It's kind of like trying to juggle two poisons and hoping they sync up. The nitrite would be doing the main job, but lithium's side effects could make the process less reliable. Again, no real world human reports to go off—just theoretical chemistry. I think this would be the best if I were to choose.
So while alternatives
can deliver nitrite ions, they all come with baggage. SN remains the preferred method because:
- It's highly soluble, meaning it dissolves easily into a uniform dose.
- The sodium ion is safe in the amounts used.
- There are dozens of documented cases, both successful and interrupted, that have helped build a known profile of how it behaves in the body.
The PPH only lists alternatives to show what's chemically possible, not necessarily what's safe or predictable. In practice, SN has the cleanest toxicological profile, the most accessibility, and the clearest dosing strategy.