Potassium nitrate

Potassium nitrate

Product Name: Калий азотнокислый, Potassium nitrate, Kaliumnitrat, Nitrato de potasio, Nitrate de potassium, نترات البوتاسيوم, โพแทสเซียมไนเตรท, Kaliy selitrasi, Калий селитрасы, Kalium nitratı, Нитрати калий, Kalio nitratas, Kālija nitrāts, Калій нітрат, אשלגן חנקתי

Synonyms: калиевая селитра, potassium saltpeter, salpeter, nitrato potásico, salitre, nitre, نترات البوتاسيوم, เกลือดินประสิว

Used Parts: crystals.

Main Indications for the Use of Potassium nitrate: chronic pulpitis, dentin hypersensitivity, inflammatory periodontal diseases, arterial hypertension, angina pectoris, chronic heart failure, chronic bronchitis, bronchial asthma, chronic gastritis with reduced secretion, gastric and duodenal ulcers, chronic colitis, urolithiasis, hyperkalemia, hyponatremia, methemoglobinemia, cyanide poisoning.

Use of Potassium nitrate in Mixtures and Complexes: chronic periodontitis, generalized periodontitis, chronic obstructive pulmonary disease, chronic pharyngitis, gastroesophageal reflux disease, chronic pancreatitis, chronic pyelonephritis, chronic cystitis, chronic prostatitis.

Pharmacological Properties of Potassium nitrate: desensitizing, antihypertensive, antianginal, anti-inflammatory, antispasmodic, antiarrhythmic, bronchodilatory, expectorant, antiulcer, astringent, diuretic, antidotal, methemoglobin-reducing, electrolyte-correcting.

Dosage of Pharmaceutical Forms — Potassium nitrate

Powder — Potassium nitrate

Indications (Powder): dentin hypersensitivity, chronic pulpitis, chronic periodontitis, generalized periodontitis, arterial hypertension, angina pectoris, chronic heart failure, chronic bronchitis, bronchial asthma, chronic gastritis with reduced secretion, gastric ulcer, duodenal ulcer, chronic colitis, urolithiasis, methemoglobinemia, cyanide poisoning.

Standard Dosage (Powder): orally, 0.3–0.5 grams 2–3 times a day after meals, course up to 10 days.

Enhanced Dosage (Powder): orally, 0.6–0.8 grams 2–3 times a day for pronounced arterial hypertension, angina pectoris, chronic heart failure — not more than 7 days.

Maximum Dosage (Powder): orally, up to 1 gram per dose, not more than 3 grams per day, for acute cyanide poisoning or pronounced methemoglobinemia — single dose under medical supervision.

Preventive Dosage (Powder): orally, 0.2–0.3 grams once daily in courses of 5 days monthly for chronic periodontitis, chronic dentin hypersensitivity, patients over 45 years with risk factors for cardiovascular diseases.

Pediatric Dosage (Powder): orally from 12 years old with body weight from 40 kg — 0.1–0.2 grams 2 times a day, not more than 5 days; do not use with lower body weight.

Contraindications (Powder): pronounced renal failure, hyperkalemia, severe anemia, individual intolerance; scientific data on contraindications during pregnancy, lactation, and in children under 12 years are not registered.

Side Effects (Powder): nausea, diarrhea, dizziness, hypotension, cardiac arrhythmia in case of overdose.

Adjustment for Patient Body Weight: for body weight below 60 kg, reduce the dose by 25%; for weight above 90 kg, a dose increase of 15% is possible under medical supervision.

Preparation method (Powder): grind potassium nitrate crystals to a homogeneous powder in a porcelain mortar; sift through a sieve with 0.2 mm mesh; package in light-protected jars of 100 grams; use gloves and a respirator during work, avoid inhaling dust.

Storage Conditions and Shelf Life (Powder): store in a hermetically sealed container made of dark glass or metal, at a temperature of 15–25 °C, in a dry place protected from light and electromagnetic radiation. Shelf life — 5 years. After opening, use within 6 months.

Paste — Potassium nitrate

Indications (Paste): dentin hypersensitivity, chronic pulpitis, chronic periodontitis, generalized periodontitis.

Standard Dosage (Paste): apply to teeth and gums in a layer 1–2 mm thick 2 times a day after brushing teeth, leave for 3–5 minutes, then rinse with warm water; course 2–4 weeks.

Enhanced Dosage (Paste): apply 3 times a day for pronounced dentin hypersensitivity, generalized periodontitis — course not more than 14 days.

Maximum Dosage (Paste): apply 4 times a day to limited areas for acute pain in teeth, not more than 5 days.

Preventive Dosage (Paste): apply once daily in the evening in courses of 7 days monthly for patients with chronic periodontitis and dentin hypersensitivity.

Pediatric Dosage (Paste): from 14 years old — use the same doses as adults; not recommended for children under 14 years due to lack of safety data.

Contraindications (Paste): allergic reaction to components, open ulcerative surfaces in the oral cavity; scientific data on contraindications during pregnancy and lactation are not registered.

Side Effects (Paste): local mucosal irritation, burning, altered taste perception in case of overdose or prolonged use.

Adjustment for Patient Body Weight: not required, as the product is used locally.

Preparation method (Paste): to prepare 100 grams of paste, take potassium nitrate — 5 grams, coconut oil — 60 grams, vegetable glycerin — 30 grams, xylitol — 5 grams; melt coconut oil in a water bath at a temperature not exceeding 40 °C, add potassium nitrate powder and xylitol, mix until homogeneous, add glycerin, mix thoroughly again; pack into opaque plastic tubes.

Storage Conditions and Shelf Life (Paste): store in tightly closed tubes at a temperature of 5–25 °C, in a place protected from light. Shelf life — 12 months; after opening, 60 days.

Ointment — Potassium nitrate

Indications (Ointment): chronic periodontitis, generalized periodontitis, chronic dermatitis, trophic skin ulcer, neurodermatitis, acne in the inflammatory stage.

Standard Dosage (Ointment): apply a thin layer to the affected skin area 2 times a day, course up to 14 days.

Enhanced Dosage (Ointment): apply 3 times a day for acute inflammatory processes of the skin and mucous membranes in the periodontal area or for trophic ulcers — not more than 10 days.

Maximum Dosage (Ointment): apply up to 4 times a day to limited areas for severe inflammation — not more than 5 days, under medical supervision.

Preventive Dosage (Ointment): apply once daily to the gum area or problem skin areas in courses of 5–7 days monthly for patients with chronic periodontitis or recurrent dermatitis.

Pediatric Dosage (Ointment): from 12 years old — apply once a day, course up to 5 days, with body weight from 40 kg; not recommended for younger children due to lack of safety data.

Contraindications (Ointment): allergic reaction to components, open wounds of large area, burns of II–III degree; scientific data on contraindications during pregnancy and lactation are not registered.

Side Effects (Ointment): local irritation, erythema, itching, burning in case of overdose or individual sensitivity.

Adjustment for Patient Body Weight: not required, as the product is used locally.

Preparation method (Ointment): to prepare 100 grams of ointment, take potassium nitrate — 2 grams, coconut oil — 70 grams, beeswax — 20 grams, shea butter — 8 grams; melt coconut oil and shea butter in a water bath at a temperature not exceeding 40 °C, add beeswax, bring the mixture to complete homogeneity, then add potassium nitrate powder, mix thoroughly; cool to 30 °C and pour into dark glass jars.

Storage Conditions and Shelf Life (Ointment): store in a dark, cool place at a temperature of 5–20 °C, avoiding direct light. Shelf life — 12 months; after opening, 30 days.

Cream — Potassium nitrate

Indications (Cream): chronic dermatitis, seborrheic dermatitis, acne, post-inflammatory hyperpigmentation, skin irritation after shaving, folliculitis.

Standard Dosage (Cream): apply a thin layer to clean skin 1–2 times a day, course 14–21 days.

Enhanced Dosage (Cream): apply 3 times a day for pronounced inflammation or itching — not more than 7 days.

Maximum Dosage (Cream): apply up to 4 times a day to limited areas for acute inflammation — not more than 3 days.

Preventive Dosage (Cream): apply once daily in the evening in courses of 5–7 days monthly for patients with recurrent dermatitis, tendency to skin irritation after shaving.

Pediatric Dosage (Cream): from 14 years old — same doses as adults; not recommended for children under 14 years due to lack of safety data.

Contraindications (Cream): allergic reaction to components; scientific data on contraindications during pregnancy and lactation are not registered.

Side Effects (Cream): burning, itching, local irritation in case of overdose or high individual sensitivity.

Adjustment for Patient Body Weight: not required, as the product is used locally.

Preparation method (Cream): to prepare 100 grams of cream, take potassium nitrate — 1.5 grams, coconut oil — 50 grams, almond oil — 20 grams, beeswax — 5 grams, distilled water — 23.5 grams; melt oils and wax in a water bath at a temperature not exceeding 40 °C, simultaneously heat water to the same temperature, slowly pour water into the oil phase with constant stirring until emulsified, add potassium nitrate powder, mix thoroughly until homogeneous; cool and pack into opaque tubes.

Storage Conditions and Shelf Life (Cream): store in hermetically sealed tubes at a temperature of 5–20 °C, in a place protected from light. Shelf life — 9 months; after opening, 45 days.

Toxicity and Biosafety — Potassium nitrate

The LD₅₀ with oral administration in rabbits is 1901 mg/kg, in rats — 3750 mg/kg. Inhalation of dust or prolonged internal intake may lead to the development of methemoglobinemia, hypotension, and cardiac arrhythmias. Contact with mucous membranes causes irritation. Chronic exposure is associated with the risk of electrolyte imbalance, kidney and gastrointestinal tract disorders. To prevent toxic effects, it is necessary to strictly adhere to dosages and avoid long-term uncontrolled use.

Reference: https://www.atsdr.cdc.gov/toxp...

Pharmacodynamics of Potassium nitrate

Potassium nitrate is an inorganic compound that exerts a multi-level physiological effect on the human body with systemic and local application. Its pharmacological effects are due to the ability of the nitrate anion and potassium cation to participate in the regulation of ion exchange, vascular tone, and nerve impulse transmission. At the systemic level, the drug exerts a vasodilating effect due to the conversion of nitrates to nitric oxide in biological tissues. This leads to the activation of guanylate cyclase, an increase in cGMP concentration, and relaxation of vascular smooth muscle. In parallel, it participates in maintaining normal potassium-sodium balance, regulating the excitability of cell membranes, especially in nervous and muscle tissues.

The effect on the nervous system is manifested through the stabilization of the resting potential of neurons and a decrease in the pathological excitability of peripheral nerve endings. This mechanism is used for local action on tooth enamel and dentin, where the drug reduces sensitivity by blocking the transmission of pain impulses in dentinal tubules. In the tissues of the cardiovascular system, the potassium ion supports the optimal function of ion channels, influencing myocardial automaticity and conductivity.

In the respiratory system, the nitrate anion indirectly promotes bronchodilation, due to the general vasodilating effect and a decrease in smooth muscle tone. In the gastrointestinal tract, it can alter local blood flow and modulate the motor activity of smooth muscles, which is associated with the activation of guanylate cyclase in the intestinal walls. At the level of the skin and mucous membranes, potassium nitrate exhibits a local irritant, anti-inflammatory, and mild antiseptic effect, probably related to changes in the osmotic properties of the environment and inhibition of the growth of some microorganisms.

The immunomodulatory effect is indirect and is associated with improved microcirculation, which increases the access of immune cells to areas of inflammation. At the cellular level, the potassium ion is necessary for the operation of Na⁺/K⁺-ATPase, and the nitrate ion under physiological conditions can serve as a substrate for the synthesis of nitric oxide by endogenous enzymes. Local application of forms with potassium nitrate provides a high local concentration of the active substance without significant systemic effects, which reduces the risk of toxic effects.

Reference: https://www.atsdr.cdc.gov/toxp...

Pharmacokinetics of Potassium nitrate

With oral administration, potassium nitrate rapidly dissociates in the gastrointestinal tract to form potassium and nitrate ions, which are absorbed mainly in the small intestine via passive diffusion and active transport. Distribution in the body occurs with the bloodstream, with potassium actively entering the cells of all tissues, including muscles, nervous tissue, myocardium, and vascular epithelium, while the nitrate ion circulates in the plasma and partially accumulates in the salivary and gastric glands.

With local application (transdermally or through mucous membranes), absorption is minimal, but if the skin or mucosal barrier is damaged, entry into the systemic circulation is possible. In pastes, ointments, or creams, systemic exposure is limited due to the low penetrating ability through intact epidermis. With nasal or inhalation administration, absorption of the nitrate ion can occur through the capillary network of the respiratory tract mucosa.

Metabolism of nitrates in the body includes partial reduction to nitrites under the action of the microflora of the oral cavity and gastrointestinal tract, and then — enzymatic conversion to nitric oxide in various tissues. The potassium ion is not metabolized and is used in cellular processes or excreted. The main route of excretion for both potassium and nitrate is the kidneys, where the ions are excreted in the urine. A small amount of nitrates may be excreted in sweat and saliva.

With chronic use, moderate accumulation of nitrates in the salivary glands and plasma is possible, but with adherence to regulated doses, this effect is not clinically significant. The liver participates in the metabolism of nitrates at the stage of nitric oxide formation, but no direct deposition of the substance in hepatocytes is observed. In patients with impaired renal function, excretion may be slowed, which requires correction of the dosage regimen with systemic administration.

Reference: https://pubchem.ncbi.nlm.nih.g...

Mechanisms of Action and Scientific Rationale — Potassium nitrate

The pharmacological action of potassium nitrate is due to the complex influence of the potassium cation and nitrate anion on physiological processes. The nitrate ion in biological systems is reduced to the nitrite anion, which in tissues, under the action of enzymes and redox reactions, is converted to nitric oxide (NO). Nitric oxide is a universal signaling molecule that activates soluble guanylate cyclase, which increases the level of cyclic guanosine monophosphate (cGMP) in smooth muscle cells, leading to their relaxation. This pathway affects the vascular endothelium, smooth muscles of the bronchi, gastrointestinal tract, and urinary tract. The potassium cation maintains the resting potential of cell membranes and participates in the regulation of ion channels, influencing the excitability of neurons, cardiomyocytes, and myocytes. The effect on nerve impulse transmission is associated with modulation of Na⁺/K⁺-ATPase activity, which stabilizes signal conduction along nerve fibers. Additionally, the nitrate ion may exert an indirect antioxidant effect through modulation of the activity of endogenous antioxidant systems and reduction of reactive oxygen species production. In the immune system, nitric oxide can regulate the activity of macrophages, neutrophils, and lymphocytes, and also influence the secretion of cytokines, including pro-inflammatory ones. With local application, potassium nitrate can cause osmotic changes that inhibit the growth of a number of microorganisms by altering their living conditions.

References: https://pubchem.ncbi.nlm.nih.g... https://www.sciencedirect.com/science/article/abs/pii/S000281777484033X

Synergy of Potassium nitrate

Experimental data and pharmacological reviews indicate synergistic interactions of potassium nitrate with a number of natural and synthetic compounds. Combined use with plants containing flavonoids (e.g., Camellia sinensis) may enhance the antioxidant potential due to additional inhibition of lipid peroxidation and activation of superoxide dismutase enzymes. In combination with substances capable of donating nitric oxide, such as arginine-containing extracts (Panax ginseng, Allium sativum), potentiation of the vasodilating and modulating effect on endothelial function is observed, which is associated with a total increase in NO availability and activation of guanylate cyclase. Interaction with polyphenolic compounds contained in Glycyrrhiza glabra may exert a protective effect on mucous membranes due to combined antioxidant and anti-inflammatory effects, mediated by a decrease in the expression of pro-inflammatory cytokines through the NF-κB cascade. When combined with magnesium salts or extracts of plants rich in magnesium (Urtica dioica), additive relaxation of smooth muscle occurs, which may be associated with modulation of calcium channels and a synergistic effect on voltage-dependent ion flows.

References: https://pubmed.ncbi.nlm.nih.go... https://www.sciencedirect.com/science/article/abs/pii/S0378874103002187

Geography of Use and Folk Medicine — Potassium nitrate

Potassium nitrate has been known in the ethnomedical and cultural tradition of various regions of the world as a substance with multifunctional use. Historically, its production and use have been recorded in China, India, the countries of the Middle East, Europe, and in a number of African regions. In China, mentions of nitrate crystals are found in texts of the Tang Dynasty (7th–10th centuries), where they were used in alchemical recipes and as a component of agents for improving physical endurance. In the Ayurveda of India, potassium nitrate was used in the form of a powder mixed with plant components and was used for medical and ritual purposes. In the Islamic medical tradition of the Middle Ages (Ibn Sina, Al-Biruni), it is described as a substance with cooling and cleansing properties, used externally and internally as part of complex mixtures.

In the countries of Southeast Asia, especially Thailand and Burma, potassium nitrate was traditionally used as a preservative for food products, as well as a component of external compositions for treating the skin and for ritual cleansing of the home. In Europe during the Renaissance and early Modern period, the substance was part of the so-called "saltpeter" plasters and poultices used in rural medicine, and was used in alchemical experiments.

In African regions (for example, among the peoples of the Sahel), potassium nitrate was used in traditional leather processing, and in some rituals — as a symbol of purification and protection. In Slavic folk practice in the 19th century, it was mentioned in rural herbal books as a component in powdered mixtures used for household disinfection and protection against the "evil eye," which reflects its inclusion in magical-ritual contexts.

Non-medical uses included use in the production of gunpowder, which in itself had important cultural and historical significance for many peoples, as it linked the substance to military and hunting traditions. In a number of cultures, potassium nitrate symbolized purification, strength, and protection, which was manifested in rituals of fumigation or sprinkling of certain areas of the dwelling to ward off evil spirits.