Patient description: The patient is a 34-year-old African American man with the known history of Sickle cell disease comes to the clinic with severe bone pain. The patient had severe pain in his lower back that radiated to both thighs scored 9 out of 10. The patient has had positive history of sickle cell crises since childhood. He also had the same symptoms in past two weeks treated with oxycodone which was not beneficial to his pain. His PCP sent him to the emergency department to receive intra venous pain modulators. The patient is afebrile within the normal blood pressure. No splenomegaly was detected in the physical exam. He has no positive history of drug allergy. He won't smoke or uses any illicit drugs. The lab study is as bellow: Hgb: 8 g/dl WBC: 10000 /mm3 Plt: 300000 /ml MCV: 106 fL Hemoglobine electrophoresis: 91% HbS 6%HbF 3%HbA2 AST: 22 U/L ALT: 43 U/L Alk P: 53 U/L Ferritin: 1200 ng/ml

Clinical trial eligibility criteria: eligible ages (years): 8.0-23.0,  Sickle Cell Disease Subjects meeting all of the following will be considered for admission to the study: 1. Male or female subject aged between 8 and 23 years of age; only patients up to the age of 23 will be studied at Childrens Hospital Los Angeles 2. Electrophoretic diagnosis of sickle cell disease; 3. Sudden onset of acute pain involving >=1 sites typical of vaso-occlusive crisis (Vaso-occlusive crisis is defined as acute, severe pain in the extremities, chest, abdomen, or back that can not be explained by other complications of sickle cell disease or by a cause other than sickle cell disease.); 4. Severe pain requiring parenteral analgesics and hospitalization. 5. Informed consent obtained from a legal representative or from subjects 18 years of age or older before enrollment; 6. Being willing and able to be followed for at least 30 days for evaluation  Subjects presenting with any of the following will not be included in the study: 1. Clinically significant bleeding; 2. Current drug abuse or participation in methadone program; 3. Episode of pain requiring hospitalization within 2 weeks prior to current admission; 4. Other complications of sickle cell disease including cerebrovascular accident, pulmonary hypertension, or seizure; 5. Pregnancy (confirmed by a serum human chorionic gonadotropin pregnancy test) or breast feeding; 6. Blood pressure less than 25th percentile for the subject's age and sex on admission or at the time of screening; 7. Methemoglobinemia >3%; 8. Anemia with hemoglobin level less than 6 g/dL; 9. Red blood cell G6PD deficiency, by laboratory testing prior to enrollment; 10. History of allergy to nitrites or allergy to other substances characterized by dyspnea and cyanosis; 11. Treatment with allopurinol, a medication that could interfere with nitrite metabolism, within the past 30 days before screening; 12. Treatment with any investigational drug within the past 30 days; 13. Significant acute or chronic concomitant diseases (including renal, hepatic, cardiovascular, pulmonary, or oncologic disease, sepsis, pulmonary edema, pulmonary embolism) that would be inconsistent with survival for at least 6 months; 14. Any subject judged by the clinical investigator or study manager to be inappropriate for the study