Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about nitrous oxide. It does not contain all the available information.
It does not take the place of talking to your doctor, anaesthetist, surgeon or dentist.
All medicines have risks and benefits. Your doctor or dentist has weighed the risks of you using nitrous oxide against the benefits they expect it will have for you.
If you have any concerns about using nitrous oxide, ask your doctor or dentist.
Keep this leaflet with you, you may want to read it again.
What Nitrous oxide is used for
Nitrous oxide is a gas used for general anaesthesia or pain relief.
It is usually given with another anaesthetic gas and oxygen during surgery via a tube placed down your throat by an anaesthetist or given with oxygen via a mask by your doctor or dentist.
Nitrous oxide works by causing unconsciousness (deep sleep) before and during surgery and by relieving pain for certain procedures.
Your doctor may prescribe nitrous oxide for another purpose. Ask your doctor if you have any questions about why nitrous oxide has been prescribed for you.
This medicine is available only with a doctor’s prescription.
Before you use Nitrous oxide
When you must not use it
Do not use nitrous oxide if:
- You have an allergy to nitrous oxide or any other component in the gas or have had an allergic reaction in the past.
- You have a condition where air is entrapped within your body and it might expand when given nitrous oxide (eg bowel obstruction, blocked middle ear, following a recent dive). Ask your doctor for full details of these conditions.
- You have been using it for a prolonged period without proper monitoring of your blood.
- Do not use nitrous oxide without the necessary amount of oxygen.
- You are intoxicated.
- You have recently had any surgery on our eyes or ears where injections of gas have been used.
Do not use nitrous oxide if the cylinder is damaged or shows signs of tampering or it has degraded.
Before you start to use it
You must tell your doctor or dentist if:
- You are allergic to any other medicines, foods, dyes or preservatives.
- You have had a reaction to nitrous oxide or any other general anaesthetic or pain relief medication in the past.
- You have had a general anaesthetic or surgery in the past.
- You have or have had any other health problems or medical conditions, including:
- A condition known as malignant hyperthermia or a family history of it.
- Low blood pressure
- Low vitamin B12 levels
- Problems with addiction to medicines
- Bone marrow problems including various cells in the blood
- Neurological diseases
- Conditions in which air is entrapped within the body
- You are pregnant or intend to become pregnant.
Your doctor or dentist will discuss the risks and benefits of using nitrous oxide when pregnant.
- You are breastfeeding or wish to breastfeed.
Your doctor or dentist will discuss the risks and benefits of using nitrous oxide when breastfeeding.
- Care should be taken when using nitrous oxide as it is stored under high pressure in gas cylinders. Contact with eyes or skin may result in cold burns.
There are also safe working exposure levels and important storage instructions. Please discuss these with your doctor if you have any questions.
- You have had long term usage or been chronically exposed to nitrous oxide.
- You have had eye surgery within the last four weeks and a gas was used in your eye during the procedure.
Taking other medicines
Tell your doctor or dentist if you are taking any other medicines, including medicines you buy without a prescription from a pharmacy, supermarket or health food shop.
Some commonly used medicines that may interfere with nitrous oxide include:
- Pain relievers
- Anaesthetics
- Methotrexate
- Medicines which may affect your nervous system
- Medicines which may interfere with Vitamin B12 and/or folate metabolism
These medicines may be affected by nitrous oxide or may affect how well it works. You may need to take different amounts of your medicine or you may need to take different medicines.
Some medicines may affect the way others work. Ask what to do when using nitrous oxide with other medicines.
Your doctor may have more information on medicines to avoid while using nitrous oxide.
If you have not told your doctor about any of the above, tell them before you start using nitrous oxide.
How to use Nitrous oxide
Nitrous oxide should only be used under the supervision of your doctor or dentist.
How much to use and how to use it
The amount of nitrous oxide given to you will be decided by your doctor or dentist, depending on the amount of pain relief or sleep required. It is usually given to you by breathing it through a mask or by a tube placed down your throat during surgery.
If you are elderly or have lung problems, you may need a lower amount of nitrous oxide.
Follow all directions given to you by your doctor or dentist carefully.
These directions may differ from the information contained in this leaflet.
If you do not understand the instructions, ask your doctor for help.
How long to use it
Your doctor will decide for how long you need to use nitrous oxide.
If you use too much (overdose)
As nitrous oxide is most likely to be given to you in hospital under the direction of your doctor, it is very unlikely you will receive an overdose.
However, if this happened, quick action can be taken to maintain your breathing and replace the nitrous oxide with more oxygen.
If you have any questions then ask your doctor.
After you have used Nitrous oxide
Things you must not do
Following a general anaesthetic:
Do not drive or operate machinery for at least 24 hours after using nitrous oxide.
General anaesthetics may cause a slight decrease in intellectual function and alertness for 2 to 3 days in some people.
Ask your doctor when it is safe for you to drive, operate machinery or perform activities following the use of nitrous oxide.
Following analgesia:
Ask your doctor or dentist when it is safe for you to drive, operate machinery or perform activities following the use of nitrous oxide.
Side effects
Tell your doctor or dentist as soon as possible if you do not feel well while you are using nitrous oxide.
Nitrous oxide may have unwanted side effects in some people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Ask your doctor any questions you may have.
Rare cases of respiratory depression in newborns have been observed, when using nitrous oxide close to delivery, newborns should be supervised for possible side effects.
Tell your doctor or dentist if you notice any of the following and they worry you:
- Nausea, vomiting
- Headache, dizziness, drowsiness
These side effects are usually mild.
Tell your doctor or dentist immediately if you notice any of the following:
- Confusion, excitation and depression of the central nervous system
- Breathing problems
- Anxiety, agitation, disorientation, hallucination
- Heart problems
- Pins and needles, changes in sensation
- Blood disorders,
- Seizures
- Abdominal pain, bloating
- Addiction
- Impaired vision
- Ear pain
- Vitamin B12 deficiency
These are serious side effects.
You may need urgent medical attention. Serious side effects are rare. Other side effects may occur as a result of your operation or other medications and anaesthetics received so check with your doctor or dentist if you have any concerns.
If any of the above occur, tell your doctor or dentist immediately or go to casualty at your nearest hospital.
Other side effects not listed above may also occur in some patients.
Tell your doctor or dentist if you notice anything else that is making you feel unwell.
Ask your doctor or dentist if you don’t understand anything in this list.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
After using Nitrous oxide
Storage
Nitrous oxide is stored at ambient temperature in cylinders by your doctor or hospital under specific instructions.
Disposal
All cylinders are the property of the manufacturer as indicated on the label. All cylinders are returnable to the manufacturer
Product Description
What it looks like
Nitrous oxide is a clear, colourless, slightly sweet smelling, non-irritating gas supplied in a cylinder with a white body and a ultramarine shoulder.
Single cylinders are available in Cylinder sizes C (1.0 m3), D (3.4 m3), E (8.6 m3) and G (17.3 m3).
Manifolded packs are available in 4, 6, 8, 12 & E10 size cylinder configurations.
Air Liquide Healthcare can create packages to suit a customer’s specific needs.
Ingredients
Active Ingredient
Nitrous oxide- 98% v/v min
Sponsor
Air Liquide Healthcare Pty Ltd
Level 4, Suite 4
247 Coward Street
Mascot, NSW 2020
Australian Registration Number
AUST R 32747 (Compressed Medical Nitrous Oxide)
This leaflet was prepared on November 2022.
Published by MIMS March 2023