Subcutaneous benzos?

[VictorZ06]

Hi All,

I'm looking for a benzo that acts fast (like valium or clonazapam wafers). Are there any benzos that are available for sub-q administration? I know there are a lot for IV/IM, but not sure about sub-q. I've been on several different kinds of benzos for a good 10+ years, I was thinking that sub-q versions might be easier on my liver. Thanks in advance for any help.

/V

 

[Tchort]

Midazolam is a very fast acting Benzodiazepine and the injectable ampoules are approved for subcutaneous administration.

Absolute bioavailability of midazolam after subcutaneous administration to healthy volunteers

Aims
Midazolam is given intravenously for induction of anaesthesia and conscious sedation and by subcutaneous infusion in patients in palliative care units. The objective of the present study was to determine the absolute bioavailability of subcutaneous midazolam and its pharmacokinetics in young, healthy, male volunteers.
Methods
Eighteen volunteers were given single doses of 0.1 mg kg−1 midazolam i.v. and s.c. after a wash-out period of 7–15 days in an open-label, randomized, cross-over study. Blood samples were collected up to 12 h post-infusion. Plasma concentrations of midazolam and of its two metabolites, 1′-OHM and 4-OHM, were assessed using an h.p.l.c.-MS method (LOQ 0.5 ng ml−1 for each analyte). Vital signs, cardiac parameters and oximetry were monitored. Local tolerance was determined and adverse events were also monitored.
Results
After s.c. infusion tmax and Cmax were 0.51 ± 0.18 h and 127.8 ± 29.3 ng ml−1 (mean ± s.d.), respectively. No statistically significant difference was detected in AUC(0,∞) after i.v. and s.c. administration. The mean (± s.d.) absolute bioavailability of subcutaneous midazolam was 0.96 (± 0.14) (CI 0.84, 1.03). Mean (± s.d.) t1/2 was similar after s.c. (3.2 (± 1.0) h) and i.v. infusion (2.9 (± 0.7) h), although a statistically significant difference was reached (P < 0.05). Mean CL and V of i.v. midazolam were 4.4 ± 1.0 ml min−1 kg−1 and 1.1 ± 0.2 l kg−1 (mean ± s.d.), respectively. Plasma concentrations of 1’-OHM were higher than those of 4-OHM. Few mild and transient adverse events were noted and there were no clinically significant effects on EEG, blood pressure and laboratory parameters.
Conclusions
This study has shown that subcutaneous midazolam has excellent bioavailability and that administration of midazolam by this route could be preferable when the intravenous route is inappropriate.
Keywords: bioavailability, intravenous, midazolam, pharmacokinetics, subcutaneous

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1874433

Any Benzodiazepine available in a sterile injectable ampoule can be injected Intramuscular, Intravenous or Subcutaneous. Diazepam, Alprazolam, etc.

Just a warning to those who seem to think facts like this are an excuse to inject crushed tablets, capsules ,etc.-

Subcutaneous, Intramuscular and even Intravenous injection of crushed pills mixed with water has lead to significant health complications including amputation, gangrene, necrotizing fasciitis, collapsed veins, endocarditis, hardened veins, etc.

At the very least expect a very serious abscess that will almost definitely become infected.

So, just to review: It is perfectly acceptable to inject sterile ampoule[/i] solutions of Benzodiazepines SC, IV or IM. It is never safe to inject pills in any fashion, ever.

 

[djsim]

Subcutaneous administration isnt going to avoid hepatic metabolism so there's no benefit in dosing in this manner. Injecting benzos is really only done clinically... there's no good reason to inject benzos since the BA for most types is really high for oral dosing (midazolam being the main exception)

 

[Captain.Heroin]

Follow Tchort's advice. Lacking a sterile ampule made for im/iv, you should stick to oral dosing.

 

[VictorZ06]

Thanks for the help guys, I really appreciate it.

I sometimes have VERY bad panic attacks, my body turns numb, I hyperventilate, and if I don't do anything about it...I pass out. Promblem is that I vomit and can't keep the orals inside me. I've had this condition since I was 14 (I'm 31 now). When I get it real bad, I'm rushed to the ER and they shoot me up with 2cc of ativan. My doc believes that my condition is a result of my father having been exposed to Agent Orange when he served in Vietnam. I know my spina bifida is associated with his exposure.

I take clonazapam regularly, 2mg 3X a day (along with seroquil). I take the waffer versions that melt under your tongue. They work a lot quicker, but I don't get the valium/ativan like effect that I get in the hospital. I tried diazapam via IM and that did help me better than the clonopin. I'm trying to avoid going to the ER every f*ckn time I have an attack.

I did not know I could take these products SQ, I got a 10ml vial (not amps) from the pharmacy a while back and I could have sworn it said to be taken only via IM/IV. But I could be wrong. I do know it was dosed at 5mg/ml. I tried it once via IV with a slin pin, but could only load 5mg at a time (as the slin pin only holds 1cc/ml), and for me that's nothing I would feel due to my high benzo tolerance.

I'll give Midazolam a shot. How is it dosed comapred to daizapam, clonazapam, or alprazolam? (pardon my spelling on some of these substances). What would the equivilent dose be with midazolam?

Again, thanks for you help guys. I really appreciate it!

/V

 

[Captain.Heroin]

My doc believes that my condition is a result of my father having been exposed to Agent Orange when he served in Vietnam. I know my spina bifida is associated with his exposure.

Wow, I am really sorry to hear that.

I know what it's like to have anxiety so bad you vomit, I used to wake up every day and vomit due to anxiety.

I'm trying to avoid going to the ER every f*ckn time I have an attack.

That is most understandable.

I'll give Midazolam a shot. How is it dosed comapred to daizapam, clonazapam, or alprazolam? (pardon my spelling on some of these substances). What would the equivilent dose be with midazolam?

Midazolam is a really powerful benzo from what others have said. I would really like to try it. It'll probably be more powerful than alprazolam, which is more powerful than diazepam and clonazepam.

I knew someone who posted a lot in the Suboxone Mega Thread v2, and he took 40mg diazepam every day. He said he'd have to break 15mg of midazolam in half because half of a midazolam tab would have him fucked up (despite his 40mg/diazepam daily dose).

Again, thanks for you help guys. I really appreciate it!

/V

No problem. I hope it works out for you.

You might want to stick to IV administration if at all possible (quickest onset), is there a reason why you're specifically looking into SI?

 

[PinK~cloud]

steroids!!!!!!!!!!11111

but seriously midazolam is the shit. i've had it subcutaneous preprocedure before, due to the fact that i have tiny tiny veins and they kept bruising me. worked wonderfully.

 

[min0taur]

bump
I've got Dormicum 5mg/1ml ampules with NO tolerance to benzos. How do I go about this w/o violating probation or ending up dead?

 

[Unknown]

^^^
You are violating probation even by having them without a license or prescription. Since drug testing talk isnt allowed here, we cant talk about that aspect.

Just be sterile about it. Have you IVed anything before?

 

[megawoof]

i use midzalom at night to go to sleep mine come in 3ml amps equal to 15mg its water soluble i take 1n half of the amp and with in mins im totally out for 5 to 6 hours its great for sleeping but not for aniety as it pure for sleeping or pre med

 

[min0taur]

^^^
You are violating probation even by having them without a license or prescription. Since drug testing talk isnt allowed here, we cant talk about that aspect.

Just be sterile about it. Have you IVed anything before?

Actually I was talking about it making me do stupid shit and waking up in jail.

Yeah I IV drugs. . . I'm worried that parenteral midazolam might be impossible to guage the dose when one has no benzo tolerance. Maybe a quarter of a mg is good for starters? Half?

 

[phatass]

as long as they're vials and not pills, i think* you can SC then, but i'm no sure.. i think IM is safer

 

[min0taur]

hell, if they're in vials then any route of admin is fine: intramuscular, intravenious, subcutaneous, intracardiac, lol
would .5 mg IM be too much?

 

[Deadhead420]

I don't get it... if you wanna use a needle why not IV and get 100% bioavailibilty and the fastest onset

 

[Unknown]

Benzos are extremely lipid soluble, so I dont see a reason to IM/SC this class of drugs if you are able to take them orally.

 

[djsim]

^ I'd IV midazolam if I had a vial of it The few times I've had IV shots of that (at hospital after car accident) I had that realisation "wow, this is why people do drugs"

 

[djsim]

hell, if they're in vials then any route of admin is fine: intramuscular, intravenious, subcutaneous, intracardiac, lol
would .5 mg IM be too much?

No shit, is getting high worth going back to jail? I know it's hard to qualify addiction in those terms, but seriously, if you don't start trying to do so, won't you just be in and out of jail? My vote is to not even bother.... I could never rationalise months (or even days!) in jail for a few hrs of getting high

 

[Unknown]

hell, if they're in vials then any route of admin is fine: intramuscular, intravenious, subcutaneous, intracardiac, lol
would .5 mg IM be too much?

Intracardiac injection should NEVER be done by someone who doesn't know what their doing. It would be very pointless, and probably dangerous to use this ROA with benzos, or anything not approved for IC injection.

^ I'd IV midazolam if I had a vial of it The few times I've had IV shots of that (at hospital after car accident) I had that realisation "wow, this is why people do drugs"

oO, I never said IV was pointless. IV versed is the best shit I have ever received.

 

[min0taur]

my point is: if it comes in sealed ampules meant for injection, then put the needle where ever you want. So SC administration is fine.

 

[min0taur]

Actually I was talking about it making me do stupid shit and waking up in jail.

Yeah I IV drugs. . . I'm worried that parenteral midazolam might be impossible to guage the dose when one has no benzo tolerance. Maybe a quarter of a mg is good for starters? Half?

I tried .5mg: nothing. 1mg: slight codeine buzz w/o euphoria. 2mg: still disappointed.
Shit, midazolam ain't as strong as I thought. I read somewhere on here that tooth extraction procedure maxes out at 2mg. guess it has to be mainlined to get the spectacular fx everyone raves about.
....or maybe I'm some kind of natural benzo Hercules?