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NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER

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About the medicine

How to use NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

Nitrous Oxide Medicinal Gas Liquid Messer 98% v/v, Medicinal Gas in Fixed Cryogenic Container

Nitrous Oxide

Read the entire package leaflet carefully before starting to use the medicine, as it contains important information for you

  • Keep this package leaflet, as you may need to read it again
  • If you have any questions, consult your doctor or pharmacist
  • If you experience side effects, consult your doctor or pharmacist, even if they are not listed in this package leaflet. See section 4

Contents of the Package Leaflet:

  1. What is Nitrous Oxide Medicinal Messer and what is it used for
  2. What you need to know before starting treatment with Nitrous Oxide Medicinal Messer
  3. How to use Nitrous Oxide Medicinal Messer
  4. Possible side effects
  5. Storage of Nitrous Oxide Medicinal Messer
  6. Package Contents and Additional Information

1. What is Nitrous Oxide Medicinal Messer and what is it used for

Nitrous Oxide Medicinal Messer is a medicinal gas liquid

What is it used for?

Treatment with nitrous oxide is indicated in the following cases:

  • As an adjunct to general anesthesia, in combination with all anesthetic agents administered intravenously or by inhalation
  • As an adjunct to analgesia in the operating room or delivery room
Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before starting treatment with Nitrous Oxide Medicinal Messer

Do not use Nitrous Oxide Medicinal Messer:

  • If you need ventilation with pure oxygen
  • If you have undrained air embolisms, particularly intracranial or pneumothorax, bullous emphysema
  • Do not use it for more than 24 hours continuously

Warnings and Precautions

  • If you have heart failure, monitor your blood pressure to avoid hypotension
  • If you are going to undergo ear surgery or surgery in adjacent air-filled areas

Using Nitrous Oxide Medicinal Messer with other medicines

Tell your doctor if you are taking, or have recently taken, any other medicine, including those obtained without a prescription

Nitrous oxide enhances the hypnotic effects of intravenous or inhaled anesthetics (thiopental, benzodiazepines, morphinics, halogenated), so the dosage of these should be reduced. You should also inform your doctor if you are taking medicines containing methotrexate (e.g., for rheumatoid arthritis)

Pregnancy, Breastfeeding, and Fertility

Pregnancy

During pregnancy, the concentration of nitrous oxide in the inhaled mixture should not exceed 50%

Obstetric Anesthesia:

Due to the rapid transfer across the placental barrier, it is recommended to interrupt the administration of nitrous oxide if the time between induction of anesthesia and fetal extraction exceeds 20 minutes

Avoid using nitrous oxide in case of fetal distress

Obstetric Analgesia:

The use of nitrous oxide for this indication can only be done if a safety flowmeter is available to prevent the administration of nitrous oxide at a concentration greater than 50%

Breastfeeding

Consult your doctor before using the medicine

Driving and Using Machines

It is recommended not to drive vehicles and not to use machines during the 24 hours following anesthesia with nitrous oxide

3. How to use Nitrous Oxide Medicinal Messer

Nitrous oxide medicinal is intended for exclusive hospital use

Nitrous oxide should only be administered in the operating room or delivery room

Your doctor will determine the necessary dose of nitrous oxide and it will be administered through a system suitable for your needs, ensuring the supply of the correct amount of oxygen

If you use more Nitrous Oxide Medicinal Messer than you should:

In case of overdose, there is a risk of cyanosis and hypoxia. The administration of nitrous oxide medicinal should be interrupted and the patient ventilated (air and oxygen)

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible Side Effects

Like all medicines, this medicine can cause side effects, although not everyone gets them

The assessment of side effects is based on the following frequencies:

  • Very common: may affect more than 1 in 10 people
  • Common: may affect up to 1 in 10 people
  • Uncommon: may affect up to 1 in 100 people
  • Rare: may affect up to 1 in 1,000 people
  • Very rare: may affect up to 1 in 10,000 people
  • Unknown: cannot be estimated from the available data

Common

  • Nausea and vomiting
  • Dizziness and feeling of intoxication

Uncommon

  • Middle ear disorders
  • Temporary increase in pressure and/or volume of the body's air cavities, normal or pathological
  • Ocular hypertension
  • Bradycardia
  • Vertigo
  • Euphoria, agitation

Rare

  • Anxiety, hallucinations (psychodysleptic effects may occur in the absence of combination with another anesthetic), somnolence

Very Rare

  • Malignant hyperthermia
  • Frequency not knownSevere hematological disorders (megaloblastic anemia, agranulocytopenia, leukopenia) have been described for treatments lasting more than 24 hours
  • Arrhythmia, heart failure
  • Epilepsy, increased intracranial pressure
  • Psychotic disorder, confusion, euphoric mood state
  • Pneumothorax
  • Headache, myelopathy, subacute combined degeneration of the spinal cord, polyneuropathy, generalized convulsions
  • Respiratory depression
  • Addiction

Reporting Side Effects

If you experience any side effects, consult your doctor or pharmacist, even if they are not listed in this package leaflet. You can also report them directly through the Spanish Medicines Agency's website: www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medicine

5. Storage of Nitrous Oxide Medicinal Messer

Keep this medicine out of the sight and reach of children

Do not use Nitrous Oxide Medicinal Messer after the expiration date

Cryogenic containers:

  • Must be located outdoors in a clean area, without flammable materials, reserved for the storage of medicinal gases
  • It is forbidden to smoke, grease equipment, and make fire in the area where the cryogenic containers are located
  • Do not park in the area of the cryogenic containers
  • Monitor the risk of asphyxiation
  • Cryogenic containers must be protected from the risk of shock, particularly filling, emptying, and safety elements (valves, manometers), heat sources or ignition, temperatures above 50°C, and combustible materials
  • The pressure inside the distribution pipes from the cryogenic container must not exceed 10 bar

6. Package Contents and Additional Information

Composition of Nitrous Oxide Medicinal Messer

The active ingredient is Nitrous Oxide, with a concentration greater than 98% v/v

It does not contain any excipients

Appearance of the Product and Package Contents

Cryogenic containers have different average capacities with the following volumes:

  • A fixed cryogenic container of 3000 liters contains 3447 kg
  • A fixed cryogenic container of 4000 liters contains 4340 kg
  • A fixed cryogenic container of 7000 liters contains 7300 kg
  • A fixed cryogenic container of 10000 liters contains 10470 kg
  • A fixed cryogenic container of 21000 liters contains 21660 kg

Marketing Authorization Holder and Manufacturer

Messer Ibérica de Gases S.A.U

Autovía Tarragona-Salou, Km 3.8

43480 Vilaseca (Tarragona)

Spain

Manufacturer

Ijsfabriek Strombeek N.V

Broeckstraat 70 B-1860

Meise

Belgium

Date of the Last Revision of this Package Leaflet: March 2025

Detailed information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es

…………………………………………………………………………………………………

This information is intended only for healthcare professionals:

Nitrous oxide is reserved for exclusive medical use

Nitrous oxide medicinal must be used exclusively in a mixture with medicinal oxygen; the oxygen concentration (FiO2) must never be less than 21%

To avoid accidents, the following guidelines must be respected:

  • The projection of liquid could cause severe cryogenic burns (very cold). In case of burns, rinse abundantly with water
  • Ventilate the area of use if possible
  • Check the good condition of the materials before use
  • Perform any manipulation of nitrous oxide containers wearing clean, adapted gloves and safety glasses, without any grease
  • Never touch the cold or frosty parts of the material
  • Handle the material with clean, grease-free hands
  • Use a specific connector for nitrous oxide
  • Use connection hoses to wall outlets with specific connections for nitrous oxide medicinal
  • Do not use an intermediate connector that allows connecting two devices that do not fit
  • Check the compatibility of materials in contact with nitrous oxide medicinal beforehand, in particular, use connection gaskets to the manoreducer intended for this gas. Check the condition of the gaskets
  • Do not smoke, do not approach a flame, and do not grease

IMPORTANT:

  • Never introduce this gas into a device that may contain combustible bodies, particularly fatty bodies
  • Never clean the containers that contain this gas, valves, gaskets, closing devices, as well as circuits, with combustible products, particularly fatty bodies
  • Do not apply greasy substances (vaseline, ointments, etc.) to the face of patients
  • Do not use aerosol generators (hair spray, deodorants, etc.), solvents (alcohol, gasoline, etc.) on the material or in its vicinity
  • When the ambient temperature is low, the flow may decrease, even interrupt, due to insufficient pressure
  • Avoid using nitrous oxide medicinal at a temperature below 0°C to avoid a drop in pressure in case of intensive use
  • Never use nitrous oxide medicinal for leak tests, for powering pneumatic equipment, and for blowing pipes
  • The average exposure limit value (over 8 hours) to nitrous oxide is set at 25 ppm for exposure of personnel

Systematically ventilate the area of use, evacuating the exhaled gases to the outside and avoiding places where they could accumulate. It is advisable, before any use, to ensure the possibility of evacuating gases in case of an accident or unexpected leak

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Discuss questions about NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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General medicine 11 years exp.

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

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Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Nuno Tavares Lopes

Family medicine 18 years exp.

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

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Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

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Anastasiia Hladkykh

Psychiatry 15 years exp.

Dr Anastasiia Hladkykh is a physician-psychotherapist and psychologist with over 14 years of experience working with individuals struggling with various types of addictions and their families. She provides online consultations for adults, combining medical knowledge with deep psychological support and practical tools.

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Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

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In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

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Frequently Asked Questions

Is a prescription required for NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER?
NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER?
The active ingredient in NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER is nitrous oxide. This information helps identify medicines with the same composition but different brand names.
Who manufactures NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER?
NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER is manufactured by Messer Iberica De Gases, S.A.U.. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to NITROUS OXIDE MESSER 98% V/V MEDICINAL LIQUEFIED GAS IN FIXED CRYOGENIC CONTAINER?
Other medicines with the same active substance (nitrous oxide) include NITROUS OXIDE MEDICINAL AIR LIQUIDE 98% V/V MEDICINAL CRYOGENIC GAS, NITROUS OXIDE MEDICAL METAL CARBIDES 98.0% V/V LIQUEFIED MEDICINAL GAS IN FIXED CRYOGENIC CONTAINER, NITROUS OXIDE FOR MEDICAL USE, 98.0% V/V LIQUEFIED MEDICINAL GAS IN GAS CYLINDER. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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