FDA Updates List of Nitrous Oxide Inhalant Products That Pose Serious Health Risks

Michigan alone has seen a more than 500% increase in reports of nitrous oxide inhalation injuries over the past five years.

Federal regulators have added several nitrous oxide delivery systems to a growing list of products that should not be inhaled recreationally, citing increased risks of serious injury and death.

The U.S. Food and Drug Administration (FDA) issued a nitrous oxide advisory update on June 4, expanding its March warning about the dangers of inhaling nitrous oxide. The update follows a rise in reports of serious adverse events linked to recreational use of the gas.

Nitrous oxide is a colorless, odorless gas commonly used for pain management during dental procedures and as a food propellant in products like whipped cream. However, in recent years, there has been a growing trend of individuals inhaling nitrous oxide recreationally to experience brief episodes of euphoria or relaxation.

The products are sold under various different brand names, and commonly referred to as “whippets” or “laughing gas.” As a result of the increasing popularity of inhaling nitrous oxide, the canisters are now widely available at smoke shops and a number of online retailers, sometimes even in flavored varieties like strawberry and watermelon.

Adverse events linked to the recreational use of these products has led to a number of nitrous oxide lawsuits being filed in recent months against manufacturers and retailers, who have been accused of promoting and designing unsafe products that they knew could bring harm to individuals.

Many lawsuits describe common patterns of early exposure through social media or retail sales, misleading safety messaging, and devastating long-term effects from repeated inhalation, such as nerve damage, cognitive decline and addiction.

“Inhaling nitrous oxide can result in a range of symptoms and serious health problems, from abnormal blood counts, asphyxiation, blood clots, frostbite, headache, impaired bowel and bladder function, lightheadedness, limb weakness, loss of consciousness, numbness, palpitations, paralysis, psychiatric disturbances (delusions, hallucinations, paranoia, depression), tingling, trouble walking, vitamin B12 deficiency, and in some cases, death,” the FDA warns. “For some individuals who regularly inhale nitrous oxide, this habit can lead to prolonged neurological effects, including spinal cord or brain damage, even after stopping use.”

This week, the FDA released an updated list of products the advisory applies to, which now includes ExoticWhip, FastGas and NITROX. However, the agency also indicates the warning is not limited to just these products. It includes:

According to the FDA, these products have been sold through Amazon.com, Ebay, Walmart and at gas stations, smoke shops and vape shops nationwide.

The agency noted that reports of injuries have come in through its own reporting systems, the media and state agencies.

Nitrous Oxide Injuries on the Rise in Michigan

On the same day as the update, the state of Michigan’s Department of Health and Human Services issued a press release warning of a “dramatic increase” in emergency healthcare incidents involving nitrous oxide use.

Calls regarding adverse nitrous oxide effects increased by 533% from 2019 to 2024, according to the state. Emergency department visits linked to the problem increased even more, growing by 757% from 2019 to 2023, according to the warning.

“The drug landscape is constantly changing and the increases in nitrous oxide misuse are concerning, given the widespread availability of the product and the increase in multiple substance use,” Dr. Natasha Bagdasarian, Michigan DHHS’s chief medical executive, said in the press release. “It is crucial that individuals who use nitrous oxide are aware of the risks of chronic use and take steps to reduce its harms.”

The state’s nitrous oxide problems were detailed in April in the U.S. Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report. In the report, the CDC warned that there is no reliable screening test for nitrous oxide, making increased clinical awareness and a detailed history of the patient’s recreational drug history key for accurate and timely diagnosis of nitrous oxide-related injuries.

The FDA warns consumers to contact a doctor if they recently used nitrous oxide gas products or are experiencing any symptoms. Side effects should also be reported to the FDA’s Human Foods safety reporting program.

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