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  • EADD Moderators: Pissed_and_messed | Shinji Ikari

EADD Benzo Discussion V. Waking up in a Wakefield skip

LivingOnValium said:
No wonder lol. 2mg clonazepam is compareble to 40mg diazepam. A hefty dose for someone without a tolerance.

Clonazepam is equipotent to alprazolam but it lasts about 3 times longer. It's a great benzo. One of the best.
Click to expand...

Also one of the most toxic. I did a lot of research but it wasn't until I found these:

Biochemical Pharmacology Volume 140, 15 September 2017, Pages 150-160
'Identification of enzymes responsible for nitrazepam metabolism and toxicity in human'


Forensic Science International Volume 122, Issues 2–3, 1 November 2001, Pages 136-141
Flunitrazepam: an evaluation of use, abuse and toxicity

Drug and Alcohol Dependence Volume 231, 1 February 2022
Significant toxicity following an increase in poisonings with designer benzodiazepines in the Netherlands between 2010 and 2020

Benzodiazepine toxicity
Michael Kang; Michael A. Galuska; Sassan Ghassemzadeh.

I have many more references but in short, one metabolite is hepatotoxic, another teratotoxic. I did check and since all of the nitrobenzodiazepines appear to be metabolised in the same way, they all carry that risk. But I was surprised to discover that the more potent ones such as clonazepam and flunitrazepam appear to be just as toxic after acute dosing. Now I have not been able to find detailed papers on nitrazolam and flunitrazolam but assuming they follow the increased toxicity of all of the other nitrobenzodiazepines, they pose a much larger risk than, say, diazepam.

I don't know if their is a specific hepatic function to detect chronic damage, but as soon as I read the papers, I switched to clobazam.

BTW I don't make or sell clobazam. I have no conflict of interest. I just want people to be aware.
 
Fertile said:
Also one of the most toxic. I did a lot of research but it wasn't until I found these:

Biochemical Pharmacology Volume 140, 15 September 2017, Pages 150-160
'Identification of enzymes responsible for nitrazepam metabolism and toxicity in human'


Forensic Science International Volume 122, Issues 2–3, 1 November 2001, Pages 136-141
Flunitrazepam: an evaluation of use, abuse and toxicity

Drug and Alcohol Dependence Volume 231, 1 February 2022
Significant toxicity following an increase in poisonings with designer benzodiazepines in the Netherlands between 2010 and 2020

Benzodiazepine toxicity
Michael Kang; Michael A. Galuska; Sassan Ghassemzadeh.

I have many more references but in short, one metabolite is hepatotoxic, another teratotoxic. I did check and since all of the nitrobenzodiazepines appear to be metabolised in the same way, they all carry that risk. But I was surprised to discover that the more potent ones such as clonazepam and flunitrazepam appear to be just as toxic after acute dosing. Now I have not been able to find detailed papers on nitrazolam and flunitrazolam but assuming they follow the increased toxicity of all of the other nitrobenzodiazepines, they pose a much larger risk than, say, diazepam.

I don't know if their is a specific hepatic function to detect chronic damage, but as soon as I read the papers, I switched to clobazam.

BTW I don't make or sell clobazam. I have no conflict of interest. I just want people to be aware.
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I don't the toxicity is something to be really worried about. Sure it's more but it's still not significant. Clonazepam has been sold since 1975 and there haven't been any issues health wise. Also, the largest clinically used dose is 20mg/day which is absurdly high when you consider the drug's potency. If they're willing to prescribe doses like that the toxicity cannot be an issue.
 
LivingOnValium said:
I don't the toxicity is something to be really worried about. Sure it's more but it's still not significant. Clonazepam has been sold since 1975 and there haven't been any issues health wise. Also, the largest clinically used dose is 20mg/day which is absurdly high when you consider the drug's potency. If they're willing to prescribe doses like that the toxicity cannot be an issue.
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Well bother to check the reference. I don't know of ANY nation that uses 20mg/day but I'm happy to ready your reference... since you didn't provide any. That's how science works - we base factual information on the best data available.

OR..... are you selling clonazepam, perchance?
 
Fertile said:
Also one of the most toxic. I did a lot of research but it wasn't until I found these:

Biochemical Pharmacology Volume 140, 15 September 2017, Pages 150-160
'Identification of enzymes responsible for nitrazepam metabolism and toxicity in human'


Forensic Science International Volume 122, Issues 2–3, 1 November 2001, Pages 136-141
Flunitrazepam: an evaluation of use, abuse and toxicity

Drug and Alcohol Dependence Volume 231, 1 February 2022
Significant toxicity following an increase in poisonings with designer benzodiazepines in the Netherlands between 2010 and 2020

Benzodiazepine toxicity
Michael Kang; Michael A. Galuska; Sassan Ghassemzadeh.

I have many more references but in short, one metabolite is hepatotoxic, another teratotoxic. I did check and since all of the nitrobenzodiazepines appear to be metabolised in the same way, they all carry that risk. But I was surprised to discover that the more potent ones such as clonazepam and flunitrazepam appear to be just as toxic after acute dosing. Now I have not been able to find detailed papers on nitrazolam and flunitrazolam but assuming they follow the increased toxicity of all of the other nitrobenzodiazepines, they pose a much larger risk than, say, diazepam.

I don't know if their is a specific hepatic function to detect chronic damage, but as soon as I read the papers, I switched to clobazam.

BTW I don't make or sell clobazam. I have no conflict of interest. I just want people to be aware.
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Aromatic nitro compounds have this nasty tenancy to become aromatic amines and these fuck over liver cells (like the metabolite of paracetamol once all the stuff to make glutathione is used up). Aromatic nitro compound are good at decoupling oxidative phosphorylation (making useful energy from the citric acid cycle) -for fucks sake, never think dinitrophenol is a slimming drug. It's a fucking poison...
 
Fertile said:
I don't know of ANY nation that uses 20mg/day but I'm happy to ready your reference...
since you didn't provide any. That's how science works - we base factual information on the best data available.
Click to expand...

Usual Pediatric Dose for Seizure Prophylaxis​

Up to 10 years of age OR 30 kg body weight: 0.01 mg/kg/day to 0.05 mg/kg/day orally administered in 2 or 3 divided doses

  • Maintenance dose: 0.1 to 0.2 mg/kg/day

10 years or older OR 30 kg and over: 1.5 mg orally per day divided into 3 doses; this may be increased in increments of 0.5 mg to 1 mg every 3 days until seizures are adequately controlled or until side effects preclude any further increase.
  • Maximum dose: 20 mg/day

www.drugs.com

Clonazepam Dosage Guide + Max Dose, Adjustments - Drugs.com

Detailed Clonazepam dosage information for adults and children. Includes dosages for Panic Disorder and Seizure Prophylaxis; plus renal, liver and dialysis adjustments.
www.drugs.com www.drugs.com

Apparently, quite many nations use clonazepam up to 20mg/day for preventing seizures.
 
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@Fertile what are you laughing at you clown. 😂

Do you really think one should dig into research papers to find out what is a standard clinical protocol when dealing with drugs that have been on the market for almost 50 years? 🤣🤣
 
Mate - not your fault, but I PRETTY sure that value is in extreme cases when the balance of risk makes it worthwhile. If someone has severe refractive epilepsy i.e. things like barbiturates have not helped, then a senior consultant might consider such a 'heroic' dose. A dose that would only be considered in highly tolerant patients.

Also, drugs.com isn't what we mean when we say 'reference'. We mean a proper journal that details the action, side-effects and balance of risks i.e. the papers a specialist would consider when treating a patient.

Epileps 1986;27 Suppl 1:S45-52.

It's a rather long piece but it details 'the toxicity of clonazepam being the limiting factor of it's use in most cases'. Now that quotation needs to be read in context whish is why I provide references for everything.

The fact that cases of liver injury (specifically) due to chronic use (usually prescribed) of nitrobenzodiazepines is becoming apparent. That it displays acute toxicity as well was observed but until the 2017 paper (I referenced in an above post) nobody knew why.

I did post a lot of reference and a nice diagram so people could understand the specifics of it's toxic metabolites.

fast&bulbous then went further to provide detailed information on what the diagram was showing.

I'm sure someone called 'LivingOnValium' might not like to hear this. But I never told anyone to stop. I simply stated the known risks, provided reference for everything and noted that neither nitrazolam nor flunitrazolam have been studied so we don't KNOW the risks (although we can see reports of fatalities such as the 2011-2019 Dutch study). Why the more potent nitrobenzodiazepines seem to cause the same levels of hepatic injury per dose-unit (rather than by mass) I don't know, but it appears to be the case.

It's your own body and it's your own responsibility.
 
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Smuck_Hey_Dee_Hewitt said:
Plus taking into account that Bleaney is not an addict and intermittently doses Etiz. I would say that he would be pretty satisfied with 2mgs of Roche Clonaz. Far too satisfied actually .
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You are absolutely right, 2mg without tolerance is a HIGH dose. First time I ever took clonazepam, it was “just” 3mg and I got smashed. I was really surprised they even make such a strong pills, comparing that experience to diazepam which I eaten a handful without getting nearly as strong effects.

I should have added that my max dose of etizolam was above 20mg (and I thought I can function on few mg without a problem but it was affecting my performance at that small doses too, somewhat positive too tho) and I don’t really feel other benzos (but I keep the dose very low, today I started with 7.5mg oxazepam and wont take more than 10mg diaz equvivalent most days, like 2 – 3 0.25mg aplraz pills or 2 – 3 oxazepams, 1 – 2 0.5mg clonaz or 2 – 3 2.5/5mg diaz) and when I found a bit of etizolam (2 – 3mg max) after just a few days of abstinence I felt it a lot but I’m willing to admit that was nostalgia/placebo and not just tasty powder that (almost) ruined my life.
 
Not in to benzos but seem to have a natural tolerance to them - a friend in the NL use to pass me strips of 50mg oxazapam, I use to take two and drink on top... mildly soporific
 
Well oxazepam is a really weak benzo and I can imagine taking 100mg first time and not feeling too much of it. One of first times I did benzos it was about 50mg of diaz and I did not felt much at all beside forgetfulness (can’t remember proper word lol) but when I did 3mg of clonazepam I got smashed.

I think oxazepam is great for stopping benzos altogether tho, I stopped using diaz and other benzos and oxazepam as diazepam metabolite seems like a logical step before dropping to 0 for good, much more than cutting dose of diazepam until infinitely small, which is just plain stupid imho.
 
LivingOnValium said:
No wonder lol. 2mg clonazepam is compareble to 40mg diazepam. A hefty dose for someone without a tolerance.

Clonazepam is equipotent to alprazolam but it lasts about 3 times longer. It's a great benzo. One of the best.
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Definitely ...actually ,came to a point ,as I already stated above that I was on a daily cocktail of benzos. Two of those happened to be Clonazepam and Alprazolam at one point .
Once I had already decided to narrow it all down to 1 benzo only, namely Diazepam ,I did not do it from one day to the next - I eleminated one at a time figuring out which other one would substitute it and at what .By experimeting with various combos I found out that I could eleminate the Alprazolam by increasing my Clonazepam dose ( Both were Roche products att btw ). 0.5 mgs of Clonazepam covered a 1mg Alprazolam dose with negligible negative side effects . Again, these two were not the only substances I was on at the time ,still , I don´t think I´ve ever took Alprazolam again ever since I replaced it with Clonazepam -it´s just a well rounded benzo which addresses a lot of the angles why people decide to be on a benzo ...including tappering off of other benzos -a purpose I reckon is underestimated /or obscured by Diazepam .
Having said this, I too favour Diazepam over Clonazepam as a tool to jump off of the tranq carousel.
Somebody must have put it this way already ...still :Diazepam is to benzo addicts ,what Buprenorphine is to Gear addicts ( best short term and supervised. AA/NA meetings are of extreme importance -I can´t stress this enough - as much as I would stress doing Sports or ,at least, not procrastinating ) . One way or another ,comes to a point you only feel the side effects (for the most part ) and it´s just not worth it ...not worth losing your sense of empathy ,losing partners, losing a quick wit and barely finding the proper words to maintain a decent conversation with others etc, etc ... it´s at this point that you begin planning your way out of it all . A return to feeling human again .
Apologise by these ,at times fractured, incoherent walls of text ...back on Buprenorphine/Diazepam maintenance and trying to work things out in my head as I interact with you .
 
Smuck_Hey_Dee_Hewitt said:
Apologise by these ,at times fractured, incoherent walls of text ...back on Buprenorphine/Diazepam maintenance and trying to work things out in my head as I interact with you .
Click to expand...

pubmed.ncbi.nlm.nih.gov

Interactions on mixing diazepam with methadone or buprenorphine in maintenance patients - PubMed

Benzodiazepine use by patients in methadone and buprenorphine substitution treatment is common, despite safety concerns regarding these drug interactions. The relative safety of diazepam use by methadone- or buprenorphine-treated patients has not been systematically examined. This study aimed to...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov

Mechanisms of respiratory depression induced by the combination of buprenorphine and diazepam in rats - PubMed

Pharmacodynamic parameters and antagonist pretreatments indicate that diazepam/buprenorphine-induced respiratory depression results from a pharmacodynamic interaction between both drugs on ventilatory parameters.
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov

I could hand you a dozen references but they are sometimes easier to find than to access.

Only this morning I was reading that when combined, their metabolism alters. I haven't got sufficient reference to detail just what is going on, but that the metabolism IS altered of concern and appears to be something with ongoing research.

I don't know what doses you are on but they are prescribed and you have a medical professional ensuring the best possible outcome.

Oh, I also came across a paper that detailed methadone & diazepam. Do you want me to reference that for you?
 
Fertile said:
Mate - not your fault, but I PRETTY sure that value is in extreme cases when the balance of risk makes it worthwhile. If someone has severe refractive epilepsy i.e. things like barbiturates have not helped, then a senior consultant might consider such a 'heroic' dose. A dose that would only be considered in highly tolerant patients.

Also, drugs.com isn't what we mean when we say 'reference'. We mean a proper journal that details the action, side-effects and balance of risks i.e. the papers a specialist would consider when treating a patient.
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Of course, it's used in such large doses only in extreme cases. That's a given. No need to explain that.

My discussion with you was about the maximum daily dose, nothing else. Again, there's no need to reference a research paper when we're talking about the clinical protocol of using a drug that's been on the market for nearly 50 years. That's why i linked drugs dot com.

If you do believe the (very basic) information i provided you is fraudulent you can easily check it out from god knows how many other sources. You will get the exactly same answer every time.

Now you're just trying steer my answer to you to something it was never about while trying to sound fancy. That's such bollox.😂

edit: btw I got BSc in chemistry (Hon's) so there's no need to inform me about how to reference scientific journals

Actually, I cannot fathom what you really expected of me to do. Just for the hell of it try to find a publication in a scientific journal that determines clonazepam's maximum daily dose in clinical use.

Maybe this "reference" is suited better for your standards?

A clonazepam study guide: https://europepmc.org/article/NBK/nbk556010
 
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LivingOnValium said:
edit: btw I got BSc in chemistry (Hon's) so there's no need to inform me about how to reference scientific journals
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The number of people on this site who claim to have a certain qualification is high. But to use is as your 'get out of jail' isn't very smart. Ever wonder if other posters to this thread might actually have studied medicinal chemistry? That's 3 years sub graduate and 5 years post graduate.

But ANYONE can make such claims.

I won't name names, but VERY qualified people have posted on this thread. Did you read the references I gave you? You should know that it's a slow process and a lot of time was put into getting people the best information possible.
 
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Fertile said:
pubmed.ncbi.nlm.nih.gov

Interactions on mixing diazepam with methadone or buprenorphine in maintenance patients - PubMed

Benzodiazepine use by patients in methadone and buprenorphine substitution treatment is common, despite safety concerns regarding these drug interactions. The relative safety of diazepam use by methadone- or buprenorphine-treated patients has not been systematically examined. This study aimed to...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov

Mechanisms of respiratory depression induced by the combination of buprenorphine and diazepam in rats - PubMed

Pharmacodynamic parameters and antagonist pretreatments indicate that diazepam/buprenorphine-induced respiratory depression results from a pharmacodynamic interaction between both drugs on ventilatory parameters.
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov

I could hand you a dozen references but they are sometimes easier to find than to access.

Only this morning I was reading that when combined, their metabolism alters. I haven't got sufficient reference to detail just what is going on, but that the metabolism IS altered of concern and appears to be something with ongoing research.

I don't know what doses you are on but they are prescribed and you have a medical professional ensuring the best possible outcome.

Oh, I also came across a paper that detailed methadone & diazepam. Do you want me to reference that for you?
Click to expand...
Thanks for having forwarded these to me. I had never read these and this is obviously a topic which interests me. Not only the ones you sent me but if you look the "related articles " are also pretty engrossing. Feel free to send the other one, definitely ! Once I read these I will try to comment on what I find legit, speculative or/and dose dependent etc, based on my relative experience with this combo . Good stuff!
 
 
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Smuck_Hey_Dee_Hewitt said:
A lot of this information is new to me since I quit it all (apart from Diazepam which I use now and then when I relapse on certain other substances ) , yet , last I checked , the Clonazepam I would get was marketed by Roche - 2mgs of that would sort me right out ...perhaps even a bit too much .Entering "recreational " area at such doses depending on tolerance, obviously.
Plus taking into account that Bleaney is not an addict and intermittently doses Etiz. I would say that he would be pretty satisfied with 2mgs of Roche Clonaz. Far too satisfied actually .
Click to expand...
I'm probably understating things a bit to make myself feel better with a touch of denial about the extent of my usage. It's probably true that I'm not technically an addict; but I am dependant (by choice) if i have to be around people, which I do for work, 5 days a week, plus social things most Saturdays. But I could go a day or 2 without benzos and as long as I didn't have to leave the house and "people" especially in crowded noisy places I wouldnt have w/ds apart from extreme insomnia (I attribute this to using etizolam rather than any other form of benzo). To get to sleep I'd have to knock myself out with every single alternative sleep remedy that I know of.

I could do with another 4 months of furlough. That would be awesome. Have the whole country shut down just so I could reset my benzo tolerance lol.

From what others have said here, I suspect that Roche Clonazepam is better than Galenkia Rivotrils. THe GRs are definitely not equal to 40mg of diazepam and all other benzo doses that are meant to be equivalent, eg 4 mg of etizolam or xanax. 2mg of Galenkia Rivotril doesn't feel as effective as just under 2mg of etizolam. I'm currently doing alternate days between the 2, and feel much better on the etizolam days.

Darknet here I come.
 
You don't understand BelleRed. I don't need help. I could quit benzos immediately if I gave up work.

I need proper medications and a more suitable job.
 
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