Method Gothbird's SN Protocol

[gothbird]

I don't know your location, but there are online international pharmacies you can use to reliably source antiemetics. The payment is kinda funky (can't use credit cards due to the pharmacies existing in a gray area), but they are reliable and ship real products.

Can't get hard stuff like benzos, but meto, propranolol, digoxin are all available. Many will claim you need a prescription but will still ship without a prescription.

Trans people who have to diy their meds use these sites regularly. You can research all this on Reddit with some digging if you're interested. Typically any sub that requires an expensive or hard to get medication (like tretinoin) is a also a good place to look

This is SUPER helpful. Thank you. I'll do some digging!

 

[gothbird]

Already locked it down. Thank you SO much @quietwoods Looks like the protocol will be changing if they arrive!

 

[sydel sushi]

I'm using omeprazole mostly because I can't get antiemetics. Just to be clear though, it's not a replacement for an antiemetic. It's a PPI, meaning it reduces stomach acid over time. So, yeah. It's not going to stop my nausea or prevent vomiting, but it can help keep the stomach environment less hostile, especially because I'll have fasted.

You can take it the day of without a loading period because it still reduces acid secretion after one dose, but it's more effective if you take it consistently for a few days. That said, in a pinch, one dose is better than none.

Because I have nothing else, omeprazole + fasting + cold water + no gag reflex is about as stable a setup as I'm going to get regarding vomit prevention haha.

I see. I am able to source domperidone (maybe even meto, but i am a bit worried abt the side effects), but I also have a history of acid reflux so I'm considering taking some sort of antacid to maybe prevent the Super Nausea™ that might happen. Thank you for answering!

 

[gothbird]

I see. I am able to source domperidone (maybe even meto, but i am a bit worried abt the side effects), but I also have a history of acid reflux so I'm considering taking some sort of antacid to maybe prevent the Super Nausea™ that might happen. Thank you for answering!

If you can get domperidone, that's a solid choice. It doesn't cross the blood brain barrier, so it avoids the neurological side effects that meto sometimes causes (like restlessness or extrapyramidal symptoms). Most people tolerate it well at 10–20ish mg, taken about 30 to 60 minutes before.

Antacids can help with acid reflux, but be cautious with which kind you take. Avoid anything with high sodium bicarbonate content right before SN because it can interfere with stomach acidity and slow absorption. If you're using something like famotidine (pepcid I think it's called to most people?) or omeprazole, those are fine to take in the days leading up to ease your baseline reflux, but avoid taking them right before the SN dose. (I also have acid reflux issues haha)

Domperidone + fasting + cold water mix = best chance of avoiding vomiting. Don't overdo fluids after dosing and sip if needed, but no chugging.

Hope that helps!

 

[Romanticize]

Hello. I didnt read all the answers (just the OP) and overall the plan is very good and well thought but I have some remarks:
1) biggest downside is no meto, but ondansetron is viable replacement. Ondansetron doesnt work that long, why take it so early and many doses?
2) No fasting?! Big minus.
3) You have Oxy and Zopiclone. I would take more oxy and more zopiclone (especially zopiclone). Oxy i dont know your tolerance and if you vomit after opioids, but 5mg is tiny tiny dose, almost sub perceptible. I would go for at least 20-40mg oxy and 20-30mg+ zopiclone.
4) I would drop ibuprofen or paracetamol completely. Neither paracetamol nor ibuprofen is effective against the pain or toxicity caused by SN overdose.
The symptoms arise from hypoxia and chemical damage, not from inflammation or prostaglandins, which these drugs target.

 

[quietwoods]

4) I would drop ibuprofen or paracetamol completely. Neither paracetamol nor ibuprofen is effective against the pain or toxicity caused by SN overdose.
The symptoms arise from hypoxia and chemical damage, not from inflammation or prostaglandins, which these drugs target.

It's for the headache caused by low blood pressure from the SN. Recommended by the PPH and medical doctors in MAiD.
At least I thought it was recommended by the PPH, double-checking, it's not there. Intriguing

 

[Romanticize]

Ibuprofen and paracetamol are not effective for pain caused by low blood pressure, including during sodium nitrite overdose. The discomfort in these cases comes from hypoxia, poor tissue perfusion, and ischemia – not from inflammation or fever, which is what these drugs target. While they might slightly dull general discomfort, they don't relieve the root cause like pressure in the head, cramps, or suffocating sensations from oxygen deprivation.

People often take paracetamol/ibuprofen for headaches, so they think, "maybe it helps here too."
But SN-related or low-BP headaches are from lack of oxygen or pressure→ different mechanism = no relief.

In fact, NSAIDs like ibuprofen can even be harmful in low-BP states by reducing kidney perfusion. So in SN overdose or hypotension, paracetamol and ibuprofen are basically useless for the actual pain.

Its just my research and opinion, if you think in your case they would be helpful (even acting like a placebo), go for them. They are not bad or harmful in SN protocol.

 

[gothbird]

Hello. I didnt read all the answers (just the OP) and overall the plan is very good and well thought but I have some remarks:
1) biggest downside is no meto, but ondansetron is viable replacement. Ondansetron doesnt work that long, why take it so early and many doses?
2) No fasting?! Big minus.
3) You have Oxy and Zopiclone. I would take more oxy and more zopiclone (especially zopiclone). Oxy i dont know your tolerance and if you vomit after opioids, but 5mg is tiny tiny dose, almost sub perceptible. I would go for at least 20-40mg oxy and 20-30mg+ zopiclone.
4) I would drop ibuprofen or paracetamol completely. Neither paracetamol nor ibuprofen is effective against the pain or toxicity caused by SN overdose.
The symptoms arise from hypoxia and chemical damage, not from inflammation or prostaglandins, which these drugs target.

Ibuprofen and paracetamol are not effective for pain caused by low blood pressure, including during sodium nitrite overdose. The discomfort in these cases comes from hypoxia, poor tissue perfusion, and ischemia – not from inflammation or fever, which is what these drugs target. While they might slightly dull general discomfort, they don't relieve the root cause like pressure in the head, cramps, or suffocating sensations from oxygen deprivation.

People often take paracetamol/ibuprofen for headaches, so they think, "maybe it helps here too."
But SN-related or low-BP headaches are from lack of oxygen or pressure→ different mechanism = no relief.

In fact, NSAIDs like ibuprofen can even be harmful in low-BP states by reducing kidney perfusion. So in SN overdose or hypotension, paracetamol and ibuprofen are basically useless for the actual pain.

Its just my research and opinion, if you think in your case they would be helpful (even acting like a placebo), go for them. They are not bad or harmful in SN protocol.

Thanks for your thoughts. Just to clarify, most of what you mentioned was already outlined in my earlier post in the thread, but I understand it's easy to miss replies in longer discussions.
Since then, the plan has been updated. I've potentially sourced meto, which is preferred over ondansetron per the pph . If meto doesn't arrive, the ondansetron protocol was spaced to maintain coverage given its ~4-hour half life, though I agree it's not ideal on its own. I have a pretty strong stomach but I'm not going to pretend I have any idea if that means anything against SN.

I am fasting. I kind of figured that was assumed but I guess I didn't clearly say it in my original post.

The oxycodone and zopiclone doses were intentionally conservative, but I appreciate the note. I've since adjusted to 20mg oxycodone and up to 15mg zopiclone as per my replies, depending on tolerance and how I feel on the day. The aim is to reduce anxiety and physical agitation without compromising awareness too early in the process as well as maintain my illness symptoms. I have a tolerance to zopi, just not the oxy. I only have a finite amount of the oxy as they're a controlled substance here and what I have is all I have and was discharged with, thus the amount I'm taking.

Totally agree on paracetamol and ibuprofen. I actually figured this out a bit after posting my original post, but it's more of a personal preference because of my current day to day medications and illnesses.

Thanks again!

 

[Romanticize]

Thanks for your thoughts. Just to clarify, most of what you mentioned was already outlined in my earlier post in the thread, but I understand it's easy to miss replies in longer discussions.
Since then, the plan has been updated. I've potentially sourced meto, which is preferred over ondansetron per the pph . If meto doesn't arrive, the ondansetron protocol was spaced to maintain coverage given its ~4-hour half life, though I agree it's not ideal on its own. I have a pretty strong stomach but I'm not going to pretend I have any idea if that means anything against SN.

I am fasting. I kind of figured that was assumed but I guess I didn't clearly say it in my original post.

The oxycodone and zopiclone doses were intentionally conservative, but I appreciate the note. I've since adjusted to 20mg oxycodone and up to 15mg zopiclone as per my replies, depending on tolerance and how I feel on the day. The aim is to reduce anxiety and physical agitation without compromising awareness too early in the process as well as maintain my illness symptoms. I have a tolerance to zopi, just not the oxy. I only have a finite amount of the oxy as they're a controlled substance here and what I have is all I have and was discharged with, thus the amount I'm taking.

Totally agree on paracetamol and ibuprofen. I actually figured this out a bit after posting my original post, but it's more of a personal preference because of my current day to day medications and illnesses.

Thanks again!

If you adjusted for meto, fasting and upped zopiclone dose, your plan is perfect now, risk of failing is minimal. I wish more people prepared and researched like you. Good luck!