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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Ammonia Inhalants
Generic Name
Ammonia Inhalants
Active Ingredient
AmmoniaCategory
Other
Variants
2
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| .05 g/.33mL | INHALANT | RESPIRATORY (INHALATION) | 67777-251 |
| .045 g/.3mL | INHALANT | RESPIRATORY (INHALATION) | 46414-3333 |
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Ammonia Inhalants, you must consult a qualified healthcare professional.
Detailed information about Ammonia Inhalants
Ammonia, often formulated as Aromatic Ammonia Spirit, is a respiratory stimulant used primarily to prevent or treat fainting (syncope) by triggering a reflex inhalation through nasal mucosal irritation.
For the treatment of fainting (syncope) in adults, the standard procedure involves the inhalation of Ammonia vapors.
Ammonia must be used with extreme caution in the pediatric population.
Because the medicinal use of Ammonia involves a single, minute dose that triggers a reflex rather than requiring high systemic concentrations, dosage adjustments for renal impairment are generally not necessary for acute use. However, patients with end-stage renal disease (ESRD) already have elevated blood urea nitrogen (BUN) and potentially higher systemic ammonia levels; therefore, repeated use should be avoided.
Patients with severe hepatic impairment (e.g., Cirrhosis, Child-Pugh Class C) may have a reduced ability to process ammonia via the urea cycle. While a single inhalation is unlikely to cause systemic toxicity, healthcare providers should exercise caution in patients with hepatic encephalopathy, where even small increases in ammonia could theoretically be detrimental.
Elderly patients may have more fragile nasal mucosa and a higher prevalence of underlying cardiovascular disease. The inhalant should be held at the maximum recommended distance (6-8 inches) to avoid an overly aggressive sympathetic surge that could stress the heart.
Ammonia is for inhalation use only. It must never be swallowed, injected, or applied directly to the skin or eyes.
Ammonia is used on an 'as-needed' basis for acute symptoms. There is no schedule for this medication, and therefore, missed doses are not applicable. Do not use this medication regularly or as a preventive measure without a doctor's order.
An overdose of inhaled ammonia occurs when the vapors are inhaled too deeply, too frequently, or held too close to the nose.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or use ammonia for purposes other than those prescribed by a medical professional.
Because Ammonia is a potent chemical irritant, certain side effects are expected as part of its mechanism of action. These are usually transient and resolve shortly after the vapor is removed.
Ammonia is a powerful chemical and must be handled with care. It is intended only for the temporary relief of fainting and should never be used as a general 'pick-me-up' or to treat chronic fatigue. The most critical safety point is that Ammonia should only be used when the cause of fainting is known to be simple syncope. If a person has fainted due to a head injury, heart attack, or stroke, using ammonia could be dangerous or delay life-saving treatment.
There are currently no FDA black box warnings for Ammonia when used in medicinal inhalant forms. However, the absence of a black box warning does not imply that the drug is without risk. Its use is primarily governed by the OTC Monograph for reflex stimulants.
While Ammonia is an inhalant with minimal systemic absorption, certain combinations are strictly avoided due to the risk of severe physiological reactions:
Ammonia must NEVER be used in the following circumstances:
Ammonia is generally classified as FDA Pregnancy Category C. This means that animal reproduction studies have not been conducted, and there is no adequate and well-controlled data regarding its use in pregnant women.
It is not known whether the components of Aromatic Ammonia Spirit are excreted in human milk. However, because the systemic absorption of inhaled ammonia is extremely low and the half-life of metabolized ammonia (urea) is short, it is considered unlikely to pose a risk to a nursing infant. As a precaution, avoid using the inhalant in close proximity to the infant to prevent the baby from inhaling the vapors.
Ammonia acts as a reflex respiratory stimulant. Its primary molecular target is the sensory nerve endings of the trigeminal nerve (Cranial Nerve V) located in the nasal mucosa. Upon inhalation, the alkaline ammonia gas reacts with the moisture on the mucosal surface to form ammonium hydroxide, which briefly irritates the nerve endings.
This irritation sends an immediate afferent signal to the medulla oblongata in the brainstem. Specifically, it stimulates the inspiratory center and the vasomotor center. The result is a sudden, deep breath (reversing apnea or shallow breathing) and a transient increase in sympathetic outflow, which causes peripheral vasoconstriction and an increase in heart rate and blood pressure.
Common questions about Ammonia Inhalants
Ammonia, specifically in the form of Aromatic Ammonia Spirit, is primarily used as a respiratory stimulant to treat or prevent fainting, also known as syncope. When a person feels faint or has already lost consciousness due to a vasovagal response, the vapors are inhaled to trigger a reflex that increases breathing and heart rate. This 'shocks' the body back into an alert state by irritating the sensory nerves in the nasal passages. It is commonly found in first aid kits, dental offices, and emergency medical bags. However, it should only be used for simple fainting and not for serious conditions like head injuries or heart attacks.
The most common side effects of inhaling Ammonia include a sharp, stinging sensation in the nose, watery eyes, and immediate coughing or sneezing. These reactions are actually part of how the drug works to wake a person up. Some people may also experience a brief headache or a feeling of nausea due to the very strong and unpleasant odor. These symptoms usually disappear within a minute or two once the person is breathing fresh air. If the liquid touches the skin, it can cause redness or a mild burning sensation. Always hold the inhalant at least 4 inches away from the nose to minimize these effects.
Alcohol should be avoided if you are in a situation where Ammonia is needed. Alcohol is a central nervous system depressant and a vasodilator, meaning it relaxes blood vessels and lowers blood pressure, which are the exact opposite effects of what Ammonia is trying to achieve. Drinking alcohol can make you more prone to fainting and can dull the body's reflex response to the ammonia vapors, making the treatment less effective. Furthermore, the combination of alcohol and ammonia vapors can increase the likelihood of nausea and vomiting. If you have fainted after consuming alcohol, seek medical attention rather than relying on ammonia.
Ammonia is generally considered a Pregnancy Category C medication, meaning there is limited data on its safety in pregnant women. While a single inhalation to treat a fainting spell is unlikely to cause direct harm to the fetus, the physiological stress of fainting itself can be a concern. Pregnant women are more prone to fainting due to changes in blood circulation, and healthcare providers usually recommend lying on the left side to restore blood flow naturally. Ammonia should only be used during pregnancy if a doctor determines it is absolutely necessary. Always consult your obstetrician if you experience frequent dizzy spells or fainting during pregnancy.
Ammonia works almost instantly. Once the vapors are inhaled and reach the lining of the nose, the reflex stimulation of the brain's respiratory center happens within one to five seconds. The patient will typically take a sudden, deep gasp and regain consciousness shortly thereafter. If the person does not respond within 10 to 15 seconds of the first inhalation, the ammonia may not be effective, and there may be a more serious underlying cause for the loss of consciousness. In such cases, emergency medical services should be contacted immediately.
Yes, you can stop using Ammonia at any time because it is not a medication that is taken on a regular schedule. It is only used as an emergency 'as-needed' treatment for acute fainting episodes. There are no withdrawal symptoms or physical dependencies associated with medicinal ammonia inhalants. However, if you find that you are relying on ammonia frequently to stay alert or to manage dizzy spells, you should stop using it and see a healthcare provider. Frequent use can damage the lining of your nose and may be masking a serious heart or neurological condition that needs professional diagnosis.
Because Ammonia is only used during an emergency when someone has fainted or feels like they are about to faint, there is no such thing as a 'missed dose.' It is not a maintenance medication. You should only use it when symptoms occur and as directed by the product packaging or a healthcare professional. Do not use it more often than necessary, and do not attempt to use it as a daily supplement. If a fainting spell has passed without the use of ammonia, there is no need to take a dose afterward.
No, Ammonia used as a respiratory inhalant does not cause weight gain. The amount of the chemical that enters the body during inhalation is extremely small and is quickly processed and excreted by the liver and kidneys. It does not affect metabolism, appetite, or fat storage in any way. If you are experiencing unexplained weight gain while using any medication, you should discuss this with your doctor to identify the actual cause, which is likely unrelated to the use of ammonia inhalants.
Ammonia can generally be used if you are taking other medications, but there are some important considerations. Because it causes a brief spike in blood pressure and heart rate, it might interact poorly with certain heart medications or stimulants used for ADHD. It should never be used if you are also using other strong inhalant irritants. Since it is an inhaled reflex stimulant, it doesn't usually interfere with the absorption of pills or injections. However, you should always provide your doctor with a full list of your medications to ensure that the sympathetic 'shock' from ammonia won't interfere with your specific treatment plan.
Yes, Ammonia is widely available as a generic product, most commonly sold as 'Aromatic Ammonia Spirit' or 'Ammonia Inhalants.' It is an inexpensive, over-the-counter (OTC) product that is produced by many different pharmaceutical manufacturers. The generic versions are just as effective as the brand-name versions, as they all follow the same standard formula of ammonia, ammonium carbonate, alcohol, and aromatic oils. You can find these at most pharmacies, often in the first aid or emergency supplies section.
Other drugs with the same active ingredient (Ammonia)
> Warning: Stop using Ammonia and call your doctor or emergency services immediately if you experience any of the following:
Ammonia is not intended for long-term or chronic use. Prolonged or frequent exposure to ammonia vapors can lead to:
No FDA black box warnings are currently issued for Aromatic Ammonia Spirit. However, it is classified as a hazardous substance in high concentrations, and medical formulations must be used strictly according to the label instructions to avoid severe respiratory injury.
Report any unusual symptoms or persistent side effects to your healthcare provider. You may also report side effects to the FDA at 1-800-FDA-1088.
Because Ammonia is used for acute, one-time events, long-term laboratory monitoring is generally not required. However, the following should be monitored during and after use:
After an episode of fainting and the subsequent use of Ammonia, patients should not drive or operate heavy machinery until they have been cleared by a healthcare provider. The underlying cause of the fainting (e.g., cardiac arrhythmia) may recur, posing a significant safety risk.
Alcohol is a CNS depressant and a vasodilator, which can worsen the symptoms of syncope. Using Ammonia while intoxicated may result in a diminished reflex response or increased nausea and vomiting. It is generally advised to avoid alcohol if you are prone to fainting episodes.
There are no tapering requirements for Ammonia, as it is not used chronically. However, if you find yourself needing to use ammonia frequently, you must stop and consult a doctor to investigate the cause of your frequent fainting, as this may indicate a serious underlying heart or neurological condition.
> Important: Discuss all your medical conditions, especially respiratory or heart problems, with your healthcare provider before using Ammonia.
There are no known direct food interactions with inhaled Ammonia. However, patients who experience frequent fainting are often advised to monitor their salt and water intake. Dehydration can increase the risk of syncope, potentially leading to more frequent needs for ammonia.
For each interaction, the primary concern is the pharmacodynamic interaction, where the effects of the two substances on the heart, lungs, or brain either cancel each other out or combine to create an excessive, dangerous response.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, especially if you have a history of respiratory or cardiovascular disease.
Conditions requiring careful risk-benefit analysis by a healthcare provider include:
Patients who are sensitive to other nitrogenous compounds or strong chemical irritants may be more likely to have an exaggerated or adverse reaction to Ammonia. Additionally, those with 'Multiple Chemical Sensitivity' (MCS) may experience prolonged symptoms after exposure to the pungent odor of Aromatic Ammonia Spirit.
> Important: Your healthcare provider will evaluate your complete medical history, including any history of respiratory distress or heart disease, before prescribing or using Ammonia.
In patients with chronic kidney disease (CKD), the body's ability to excrete urea (the metabolite of ammonia) is diminished. While a single use for syncope is generally safe, repeated use in a patient with a GFR below 30 mL/min should be avoided to prevent any contribution to uremic symptoms.
In patients with liver failure or cirrhosis, the urea cycle is impaired. These patients are already at risk for hepatic encephalopathy due to elevated endogenous ammonia. While the amount of ammonia in a medicinal inhalant is small, it should be used with extreme caution in this population, as their 'ammonia buffer' is already compromised.
> Important: Special populations require individualized medical assessment. Always inform your doctor if you are pregnant, breastfeeding, or have chronic kidney or liver issues.
| Parameter | Value |
|---|---|
| Bioavailability | High (local mucosal), Low (systemic) |
| Protein Binding | Negligible |
| Half-life | Minutes (as NH3), Hours (as Urea) |
| Tmax | Immediate (seconds) |
| Metabolism | Hepatic (Urea Cycle) |
| Excretion | Renal (>95% as Urea) |
Ammonia is classified as a Respiratory Stimulant (Inhalant). It is distinct from systemic stimulants like caffeine or amphetamines because it does not cross the blood-brain barrier to act on the central nervous system directly; rather, it works through a peripheral sensory reflex arc.