Nitrous Oxide
Pronunciation: (NYE-trus OK-side).
- Generic name
- Nitrous oxide
- Brand names
- Nitrous Oxide INOX, Nitrous Oxide Coregas, Nitrous Oxide BOC, Nitronox, Nitrous Oxide USP, Nitrous Oxide IOL
- Drug class
- Emergency & Critical Care
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What Nitrous oxide is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Nitrous oxide works
Nitrous oxide acts primarily as a central nervous system depressant. It modulates pain and anxiety by antagonizing N-methyl-D-aspartate (NMDA) receptors and stimulating the release of endogenous opioid peptides. This results in analgesia, anxiolysis, and mild sedation. Nitrous oxide also has weak anesthetic properties and minimal effects on cardiovascular and respiratory systems at therapeutic concentrations. (1)
What Nitrous oxide is used for
Anesthesia
Anesthesia (2)
Analgesia
Analgesia (2)
Sedation
Sedation (2)
Before taking Nitrous oxide
Do not take / not appropriate for
- Absolute contraindications include pneumothorax, air embolism, bowel obstruction, recent middle ear or eye surgery, and known hypersensitivity. (Contraindication) (2)
- Nitrous oxide can expand air-filled spaces and worsen certain conditions. (Contraindication) (2)
Tell your clinician about
(2)How to take Nitrous oxide
- General Instructions: Nitrous oxide is administered by a healthcare professional, usually mixed with oxygen, via a face mask or mouthpiece. It is not self-administered outside of clinical settings.. Adult Dosing: For analgesia: Typically, a 50:50 mixture of nitrous oxide and oxygen is used. Dosage is titrated to effect and duration of the procedure.. Pediatric Dosing: Children receive similar concentrations as adults, adjusted for age, weight, and clinical need. Always administered by trained professionals.. Administration: Inhaled through a mask or mouthpiece under supervision. Onset is rapid (within minutes), and effects wear off quickly after discontinuation.. When To Stop: Administration is ended by the healthcare professional once the procedure is complete, if side effects occur, or as clinically directed.. Storage: Store compressed gas cylinders upright in a cool, dry, well-ventilated area, away from direct sunlight and heat sources. Follow local regulations for medical gas storage.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
Not applicable, as nitrous oxide is administered as needed during procedures and not on a regular dosing schedule.
Overdose
Overdose may cause severe hypoxia, loss of consciousness, or respiratory depression. If overdose is suspected, seek emergency medical attention immediately — the healthcare team will stop the nitrous oxide administration and provide oxygen as needed. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Vomiting
Incidence: Reported in the clinician-authored database; frequency not established
Dizziness
Incidence: Reported in the clinician-authored database; frequency not established
Headache
Incidence: Reported in the clinician-authored database; frequency not established
Confusion
Incidence: Reported in the clinician-authored database; frequency not established
Megaloblastic anemia
Incidence: Reported in the clinician-authored database; frequency not established
Bone marrow depression
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
Prolonged or repeated use can cause vitamin B12 deficiency and neurological complications — serious
Symptoms: Prolonged or repeated use can cause vitamin B12 deficiency and neurological complications. Not suitable for patients with certain lung or ear conditions. May cause drowsiness or impaired coordination after use. Risk of hypoxia if not administered with adequate oxygen. Potential for abuse and dependence if misused.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Absolute contraindications include pneumothorax, air embolism, bowel obstruction, recent middle ear or eye surgery, and known hypersensitivity. Use with caution in patients with vitamin B12 deficiency, neurological disorders, or impaired consciousness. Nitrous oxide can expand air-filled spaces and worsen certain conditions. Note on pregnancy: a 50:50 nitrous oxide/oxygen mixture is a well-established, widely used labor analgesia option in many countries (Canada, UK, Australia, Sweden, Finland, and others), so pregnancy itself is not a blanket caution against nitrous oxide the way the other items on this list are — nitrous oxide use in pregnancy should still be discussed with the treating clinician for the specific clinical situation, but it is not equivalent to, for example, a recent ear surgery contraindication.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Nitrous oxide has few significant drug interactions when used acutely. However, it may potentiate the effects of other sedatives or anesthetics. Chronic use may interact with drugs affecting vitamin B12 metabolism. Always inform your healthcare provider of all medications and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
A 50:50 nitrous oxide/oxygen mixture is a well-established labor analgesia option used in many countries. For non-labor procedures during pregnancy, discuss the specific situation with your healthcare provider and the treating clinician administering the gas. Vitamin B12/folate status may be checked in patients at higher risk of deficiency before repeated or prolonged exposure. (2)
Breastfeeding
Nitrous oxide is considered compatible with breastfeeding: it is essentially eliminated from the body within minutes through the lungs (serum half-life under 3 minutes), so extensive passage into milk is unlikely, and no waiting period or milk discarding is generally required. If nitrous oxide is combined with other sedative or anesthetic medications, breastfeeding timing should follow the guidance for those other medications as well — confirm with your healthcare provider. (2)
Children
Frequency: Administered continuously as needed during the procedure.. Weight Based: Not established; typically administered as a fixed concentration.. Max Daily Dose: Not applicable as dosing is continuous during the procedure.. Max Single Dose: Not applicable as dosing is continuous during the procedure.. Age Restrictions: Safety not established in children. (2)
Renal_impairment
Nitrous oxide is eliminated almost entirely unchanged through the lungs and undergoes minimal metabolism, so significant renal or hepatic dose adjustment is not typically required; specific published dose-adjustment data for severe organ impairment were not found in the sources reviewed for this page, so the administering clinician should still assess individual fitness for sedation/anesthesia. (2)
Hepatic_impairment
Nitrous oxide is eliminated almost entirely unchanged through the lungs and undergoes minimal metabolism, so significant renal or hepatic dose adjustment is not typically required; specific published dose-adjustment data for severe organ impairment were not found in the sources reviewed for this page, so the administering clinician should still assess individual fitness for sedation/anesthesia. (2)
Monitoring
(2)Storage
This is a healthcare-facility-administered medical gas; storage and handling are managed by the treating facility. Compressed gas cylinders are stored upright in a cool, dry, well-ventilated area, away from direct sunlight and heat sources, per local medical gas storage regulations.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Anesthesia
Dose summary: Administered via inhalation, typically in a concentration of 50% nitrous oxide and 50% oxygen.
Renal context: Nitrous oxide is eliminated almost entirely unchanged through the lungs with minimal metabolism, so it is not cleared renally; no specific renal dose-adjustment scheme was found in the sources reviewed, and the administering clinician should still assess individual fitness for sedation/anesthesia. (1)
Hepatic guidance
Nitrous oxide undergoes minimal hepatic metabolism and is eliminated almost entirely unchanged through the lungs, so it is not cleared hepatically; no specific hepatic dose-adjustment scheme was found in the sources reviewed.
Frequently asked questions
What is nitrous oxide used for?
Nitrous oxide is used for pain relief and mild sedation during dental work, minor surgical procedures, labor, and emergency care. It helps reduce anxiety and discomfort while allowing patients to remain awake.
How quickly does nitrous oxide work?
Nitrous oxide acts within minutes of inhalation, providing rapid pain relief and relaxation. Its effects also wear off quickly after the gas is stopped.
Is nitrous oxide safe for children?
Yes, when administered by trained professionals, nitrous oxide is considered safe for children for short procedures. Dosing is carefully adjusted for age and size.
Can I drive after receiving nitrous oxide?
You should not drive or operate machinery immediately after receiving nitrous oxide. Wait until you are fully alert and your healthcare provider confirms it is safe.
Are there long-term risks with nitrous oxide?
Short-term use is generally safe. However, repeated or prolonged exposure can cause vitamin B12 deficiency and neurological problems. Recreational misuse is dangerous.
Can pregnant women use nitrous oxide?
Nitrous oxide may be used with caution during labor for pain relief, but only under medical supervision. Discuss risks and benefits with your healthcare provider.
What should I tell my doctor before receiving nitrous oxide?
Inform your doctor about any lung, ear, neurological, or vitamin B12 deficiency conditions, as well as all medications and supplements you are taking.
What happens if I take too much Nitrous oxide?
Taking too much Nitrous oxide can lead to severe side effects such as hypoxia, respiratory depression, and loss of consciousness. In extreme cases, it can be life-threatening. If you suspect an overdose, seek immediate emergency medical attention. Prompt intervention is crucial to manage symptoms and prevent serious complications.
Can I drink alcohol while taking Nitrous oxide?
It is strongly advised to avoid alcohol consumption while receiving Nitrous oxide. Both substances are central nervous system depressants, and combining them can significantly amplify their sedative effects, leading to increased drowsiness, dizziness, impaired coordination, and potentially dangerous respiratory depression. Always consult your healthcare provider about alcohol use with any medication.
Is Nitrous oxide safe during pregnancy?
A 50:50 nitrous oxide/oxygen mixture is a well-established, widely used option for labor pain relief in many countries. For non-labor procedures during pregnancy, the potential risks and benefits should be evaluated by your healthcare team for your specific situation. It is important to inform your doctor if you are pregnant or planning to become pregnant before receiving nitrous oxide.
What is the mechanism of action of Nitrous oxide?
Nitrous oxide acts primarily as a central nervous system depressant. It modulates pain and anxiety by antagonizing N-methyl-D-aspartate (NMDA) receptors and stimulating the release of endogenous opioid peptides. This results in analgesia, anxiolysis, and mild sedation. Nitrous oxide also has weak anesthetic properties and minimal effects on cardiovascular and respiratory systems at therapeutic concentrations. (1)
What is the generic name of Nitrous Oxide?
The generic name is Nitrous oxide. It is sold under brand names including Nitrous Oxide INOX, Nitrous Oxide Coregas, Nitrous Oxide BOC, Nitronox, Nitrous Oxide USP, Nitrous Oxide IOL.
What class of drug is Nitrous oxide?
Nitrous Oxide is classed as: Emergency & Critical Care.
References
- Nitrous oxide medicine recordMedGuideGlobal · Global (internal clinical summary) · accessed 2026-08-06 · source 1
- Use of Nitrous Oxide in Labor and Possible Interaction with Systemic Opioids or Sedatives-HypnoticsAmerican College of Obstetricians and Gynecologists · United States · dated 2021-07 · accessed 2026-08-06 · source 2
- Safety and Utility of Nitrous Oxide for Labor AnalgesiaAnesthesia Patient Safety Foundation · United States · accessed 2026-08-06 · source 3
- Nitrous oxide use while BreastfeedingDrugs.com / InfantRisk Center · United States · accessed 2026-08-06 · source 4
- NITROUS OXIDE GAS [LINDE GAS & EQUIPMENT INC.] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 5
- NITROUS OXIDE — FDA approval record (Drugs@FDA NDA205704)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 6
- Nitrous oxide — RxNorm normalized drug concept (RXCUI 7486)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 7
Brand names by country
Single-ingredient Nitrous oxide names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Nitrous Oxide Oxygen Mix500 mL/L · roberts oxygen company, inc.
- Oxygen992 mL/L · all gas & welding supplies co., inc.