N PROTOCOL / REGIME / REGIMEN NOTES

[jgm63]

I have a concern/problem with the regimen. I am unsure of the period of time it needs to pass to take SN after taking the final meto dose. I read some say 30, 45 or one hour. I see most people leave 45 minutes according to Stans guide. The problem is that the H2 blocker I have is called FAMOTIDINE and the onset time of this is 1 hour. So I would like some advice regarding the regimen taking this into consideration. This is the draft I made on the regimen:

17:00 1 gr Paracetamol w a sip of water

17:15pm 3 X 10mg Metoclopramide (30mg in total) w a sip of water

17:30pm H2 blocker 40 mgs Famotidine 1 tab of 40 mgs w a sip of water.

18:20 pm Start preparing 3 SN drinks. Take first 23 gr SN DRINK in 50 ml water at 18:25- this means taking SN 1hour and 10 minutes after meto


So that would be 1 hour and 10 minutes after meto to take SN and aprox 50 minutes before SN for the antacid to work. Is it better to have less then 1h and 10 minutes between meto and SN? Like 30 or 45 minutes instead? That would mean I need to take the H2 blocker first and then Meto so it would be something like this:

17:00 1 gr Paracetamol w a sip of water

17:15pm H2 blocker 40 mgs Famotidine 1 tab of 40 mgs w a sip of water.

18:10 pm 3 X 10mg Metoclopramide (30mg in total) w a sip of water

18:40 pm Start preparing 3 SN drinks. Take first 23 gr SN DRINK in 50 ml water- that would mean taking SN 30 minutes after meto
OR
18:55 Start preparing 3 SN drinks. Take first 23 gr SN DRINK in 50 ml water- this means taking SN 45 minutes after meto.

Suggestions on how to do it? Info on what is the amount of time needed after METO for peak absorption?

This isn't the right thread for this question since the question is pretty SN specific (antacid / H2 blocker related).
I'm not an expert, and I'm not medically qualified, so my answer is just an "educated guess".
I would go with something like :
17:00 Pain killer
17:15 Antiemetic
17:30 Famotidine
18:20 SN drink

So, very close to your first suggestion.

 

[enjolras]

Just for the record, some years ago, I was able to exchange by email with Dr. Sobel of Exit A.D.M.D. (the 4th clinic in Switzerland that does not accept foreigners). Instead of Metoclopramide, they used to handle Domperidone sublingual, only 1 pill of 10mg. Also, it was common to mix the N preparation with some orange juice.

 

[jgm63]

----------------------------------------------------------------
48 hour vs stat antiemetic regime
----------------------------------------------------------------
(More concise version of earlier posting above)

EPS is disscussed below, but note that most people don't get EPS.
Some people may get some mild EPS. In very rare cases, EPS could be severe and interfere with / prevent an attempt.

The 48 hour regime may have lower EPS risk since you're not taking so much antiemetic at once.
However, some people find it too "drawn out", and prefer the stat dose. Some people suggest there's a lower vomiting risk with the 48 hour regime, but I haven't seen controlled data to support that.

It's considered a good idea to test taking the antiemetic, eg try 5mg of meto, then try 10mg a day or two later. Ideally, you would build up to testing the actual antiemetic regime you plan to use. You may choose to just do basic tests without testing the full regime.

If initial tests with 5 or 10 mg of meto cause mild EPS, then you might choose to go with the stat dose, so you don't have 48 hours of those symptoms. Taking diphenhydramine (50mg) after the stat dose may help. Another option is to use the 48 hour regime but take 15mg diphenhydramine with each antiemetic dose, to offset EPS. I can't say if this is a good idea since I'm not medically qualified. Testing the actual anti-emetic regime you plan to use is advisable.

If initial tests (5 or 10 mg) don't cause EPS, this suggests a 48 hour regimen is viable, assuming you favour the longer regimen, and the full test run might not be needed. You could still do the full test run, or a partial run, eg 24 hours. If initial tests don't cause EPS, but you're intending to use a stat regime, then a full test run is advisable to see if the stat dose causes EPS.

If you intend to use the stat regime, but did a test run and had significant EPS that wasn't satisfactorily mitigated by taking diphenhydramine, then you could switch to the 48 hour regimen, and re-test. If you started with the intention of using the 48 hour regime but when testing found it to be uncomfortable (eg minor EPS over an extended period), then you might switch to the stat regime combined with 50mg diphenhydramine, and test that.

Another option when experiencing EPS is to switch from metoclopramide to domperidone, which has a very low EPS risk. I can't state whether domperidone is as effective as metoclopramide (further research needed). Also see "Note on Domperidone for SN regimes" below.

Another variation is the 48 hour + stat "combined" regime, where the extra-high stat dose is taken at the last interval of the 48 hour regime. I'm not certain whether that approach offers any benefit. One possible view is that it negates the 48 hour regime lower EPS risk benefit, so it uses a more drawn-out regime, for no apparent benefit. Some may feel there is a benefit to having the antiemetic in the system for longer.

Some may consider the "full test run" over-the-top, or not want to take unnecessary additional meds.
Some may do little or no pre-testing, and simply go with the stat dose, taking the view that if they get EPS, it won't last long before the lethal item is taken. However, if the EPS were severe, it could interfere with or prevent an attempt (although this should be rare). Ultimately, you have to weigh the risks and decide. It is also possible to use the 48 hour regime without any pre-testing.
If you have a limited time window for your attempt, then you might want to pre-test as much as possible, to try to ensure everything will go smoothly during the planned window.

Having diphenhydramine on standby in case you get EPS is a good idea.

Note on Domperidone for SN regimes :
Domperidone is apparently not compatible with H2 blockers such as Tagamet / Zantac. The general opinion seems to be to stick with a basic antacid if using domperidone, eg Rennie, milk of magnesia, etc. Note that antacid is not considered to be essential, so it could be omitted. If using Domperidone you would want to leave a 30 minute gap before taking the antacid (that 30 min gap tends to be part of the SN protocol anyhow if following Stan's guide), since the domperidone leaflet states "Domperidone should be taken before meals and antacids".

 

[AcornUnderground]

I received 2 bottles of N that are sealed and look just like the bottles in the picture in this thread, however there are no ML measurements bumped out in the glass on the side. Any thoughts on this?

 

[enjolras]

Might be useful (over time and cycling of supplies) to those who actively seek anti-emetics



Looks like Meto can also be available as a suppository of 20mg (equaling 10mg oral)

 

[jgm63]

----------------------------------------------------------------
48 hour vs stat antiemetic regime notes
----------------------------------------------------------------
No claims are made regarding the validity of this information. The information should be viewed as suggestions you may wish to consider. No advice is given. Any use of this information is entirely at your own risk.

EPS is discussed below, but is rare. In very rare cases it could be severe and interfere with / prevent an attempt.
Diphenhydramine (50mg) can apparently be used to treat EPS.

Main advantage of 48 hour regime seems to be lower EPS risk, since not taking so much at once. Some may like the "structure" of it, but some may find it "drawn out". Other reported benefits lack data, so may be anecdotal.
Stat regime generally considered just as effective, and used by dignitas.

Testing with 5 or 10mg of meto is recommended, perhaps building up to testing the actual planned antiemetic regime. Maybe leave a day or two between each "build up".

If initial tests cause EPS, then a stat dose combined with diphenhydramine might be best. Another idea could be the 48 hour regime but taking 15mg diphenhydramine with each antiemetic dose (unproven, just an idea).

If initial tests don't cause EPS, then a 48 hour regimen is likely viable (if you favour it).
If initial tests don't cause EPS but you plan on stat regime, then full test advisable to see if stat dose causes EPS.

If plan on stat regime, but test gives EPS and not resolved by diphenhydramine, then maybe switch to 48 hour regime, and re-test.

If plan on 48 hour regime but tests give minor EPS, then maybe switch to stat regime combined with 50mg diphenhydramine, and re-test.

Alternative if get EPS is to switch to domperidone (low EPS risk), but see "Domperidone for SN regimes" below.

Another variant is 48 hour + stat "combined", where stat dose taken at last interval of 48 hour regime. However, this may negate the lower EPS risk benefit. Some may feel there's benefit to having antiemetic in the system for longer and opt for this variant, but this may be anecdotal.
Without controlled data, may just have to go with your gut feeling.

Some may consider the "full test run" over-the-top.
Some may do little or no pre-testing, and go with the stat dose, so if they get EPS, it won't last long.
However, if EPS were severe, it could interfere with or prevent an attempt, though this should be rare.
You'll need to weigh risks and make your choice.
It's also possible to use the 48 hour regime without any pre-testing.

If you have a limited window for your attempt, maybe pre-test as much as possible, to ensure things go smoothly.

Domperidone for SN regimes :
Domperidone is apparently incompatible with H2 blockers, eg Tagamet / Zantac. Perhaps stick with basic antacid if using domperidone, eg Mylanta, milk of magnesia, Kremil-S, Maalox, Rennie, Tums. If using Domperidone, leave a 30 minute gap before taking antacid since the domperidone leaflet states "Domperidone should be taken before meals and antacids". Antacid is not essential, so could be omitted.

 

[Razor's Edge]

----------------------------------------------------------------
48 hour vs stat antiemetic regime notes
----------------------------------------------------------------
No claims are made regarding the validity of this information. The information should be viewed as suggestions you may wish to consider. No advice is given. Any use of this information is entirely at your own risk.

EPS is discussed below, but is rare. In very rare cases it could be severe and interfere with / prevent an attempt.
Diphenhydramine (50mg) can apparently be used to treat EPS.

Main advantage of 48 hour regime seems to be lower EPS risk, since not taking so much at once. Some may like the "structure" of it, but some may find it "drawn out". Other reported benefits lack data, so may be anecdotal.
Stat regime generally considered just as effective, and used by dignitas.

Testing with 5 or 10mg of meto is recommended, perhaps building up to testing the actual planned antiemetic regime. Maybe leave a day or two between each "build up".

If initial tests cause EPS, then a stat dose combined with diphenhydramine might be best. Another idea could be the 48 hour regime but taking 15mg diphenhydramine with each antiemetic dose (unproven, just an idea).

If initial tests don't cause EPS, then a 48 hour regimen is likely viable (if you favour it).
If initial tests don't cause EPS but you plan on stat regime, then full test advisable to see if stat dose causes EPS.

If plan on stat regime, but test gives EPS and not resolved by diphenhydramine, then maybe switch to 48 hour regime, and re-test.

If plan on 48 hour regime but tests give minor EPS, then maybe switch to stat regime combined with 50mg diphenhydramine, and re-test.

Alternative if get EPS is to switch to domperidone (low EPS risk), but see "Domperidone for SN regimes" below.

Another variant is 48 hour + stat "combined", where stat dose taken at last interval of 48 hour regime. However, this may negate the lower EPS risk benefit. Some may feel there's benefit to having antiemetic in the system for longer and opt for this variant, but this may be anecdotal.
Without controlled data, may just have to go with your gut feeling.

Some may consider the "full test run" over-the-top.
Some may do little or no pre-testing, and go with the stat dose, so if they get EPS, it won't last long.
However, if EPS were severe, it could interfere with or prevent an attempt, though this should be rare.
You'll need to weigh risks and make your choice.
It's also possible to use the 48 hour regime without any pre-testing.

If you have a limited window for your attempt, maybe pre-test as much as possible, to ensure things go smoothly.

Domperidone for SN regimes :
Domperidone is apparently incompatible with H2 blockers, eg Tagamet / Zantac. Perhaps stick with basic antacid if using domperidone, eg Mylanta, milk of magnesia, Kremil-S, Maalox, Rennie, Tums. If using Domperidone, leave a 30 minute gap before taking antacid since the domperidone leaflet states "Domperidone should be taken before meals and antacids". Antacid is not essential, so could be omitted.

Thank you so much for all of your information.
I believe it could be of real help to me and others.
Much appreciated!

 

[gnar201]

thanks for all the information! really appreciate it ❤

15:00 begin fast

what that part means?

 

[jgm63]

what that part means?

It means you stop eating, i.e. you begin the fast / you begin fasting.

If you want to reduce the number of hours you fast for, there are more fasting notes here :
https://sanctioned-suicide.net/threads/n-protocol-regime-regimen-notes.27092/post-509449

 

[Aap]

regarding EPS, I don't know if there has ever been a documented case of reglan induced EPS with a stat dose prior to ctb and certainly not one severe enough to prevent an attempt.

if anything, multiple testing doses should be avoided if one fears the VERY slight chance of this happening.

 

[jgm63]

regarding EPS, I don't know if there has ever been a documented case of reglan induced EPS with a stat dose prior to ctb and certainly not one severe enough to prevent an attempt.

if anything, multiple testing doses should be avoided if one fears the VERY slight chance of this happening.

I would say that each person should decide for themselves.
If a person is worried about it, then doing some testing may put their mind at rest.....
Although it may be very rare, EPS can be severe.

Some people might still find moderate EPS to be disturbing, and may want to avoid anything interfering with the peacefulness.
So people may want to do pre-testing for peace of mind....

Some people worry more than others.
For those that tend to worry, pre-testing can be helpful to prevent worrying....

 

[Aap]

Fair enough I suppose, in the same sense that some avoid flying and chose driving after seeing a report of a plane crash on TV.

 

[lululoo]

Do you guys think a testing of the N is necessary (i.e. removing a small amount with a syringe and seeing if it puts you to sleep)?

 

[rhiino]

Why taking the Meto after eating the last light meal, won't that delay the uptake of the Meto? Why not Meto before last light meal?

 

[jgm63]

Why taking the Meto after eating the last light meal, won't that delay the uptake of the Meto? Why not Meto before last light meal?

Not too sure really, or whether it would really make that much difference....

 

[lululoo]

Is the N still considered to be "sealed" (and thus can last a long while longer) if you have removed the circular top of the plastic part and used a syringe to take a sample? Or does it need to be refrigerated and used quickly? The PPH does not explicitly explain this.
@calendulo @Idorus (you two seem to have good N knowledge so I thought I would tag you. sorry for the disturbance).

 

[TheNorthernSilence]

Is the N still considered to be "sealed" (and thus can last a long while longer) if you have removed the circular top of the plastic part and used a syringe to take a sample? Or does it need to be refrigerated and used quickly? The PPH does not explicitly explain this.
@calendulo @Idorus (you two seem to have good N knowledge so I thought I would tag you. sorry for the disturbance).

From what I've read: It's still considered as sealed if you remove the top plastic cap and then extract a sample with a syringe through the rubber. The rubber should reseal itself and refridgeration is not required after that, it's only if you remove the metal part.

However, I've kept my bottles in the fridge sealed/unopened for most of the time. I hope they're fine because there's moisture there and there's some mixed information about keeping them in the fridge unless they're opened. My bottles are like a month past the exp. date and I've read that keeping them in the fridge after that is good for their shelf life (2-3 years or so). But maybe someone with a better knowledge could still give their thougts: @enjolras @Mud.

 

[person123]

Should I take metoclopramide, or domperidon, before taking N?

 

[Living sucks]

@jgm63 do you mention anywhere that if one is taking an antipsychotic they should not take an AE? That's clear in the SN protocol and should be cautionary here also since many are viewing this lately

 

[Living sucks]

Would combining both regimens be good, or is it too much meto?

Combining how?

 

[Living sucks]

Doing the 48 hour regimen, and then taking the stat dose.

There's no purpose in that. One or the other

 

[Living sucks]

Are both regimes equally effective? I prefer the stat dose, because it takes less time and hassle.

It's personal preference.. The success is not dependent on either of these regimens. Nor is it determined to be less of more effective

 

[rikamonie]

stat:

start fast before sleep (10pm?)
11:40am - snack maybe
12pm - take x 3 meto
1pm - take N

is this ok? :')

i wanted to do 48 houe regimen but because of the time i need to take the N the 48 hour time schedule would have me up really early for 2 days to take meto so i cant really do that, can i take some meto before i go to sleep at like 1am? or will that not do anything because i wont be taking the N for so long?

is fasting through the night like that ok? i barely eat anything usually anyways so the day before i probably wont have had a meal just snacks

 

[rikamonie]

In the case of fasting to avoid throwing up and to hasten the absorption of the N, you should avoid all food for 8 hours, minimum 4. And only water and limit water intake and none 2 hours prior accept to ingest meds.

thats what i think too but info from PPH and other sources suggest that eating a light meal before taking N actually reduces likelihood of vomiting.. it makes no sense to me and im skeptical of eating anything at all

 

[peacefulhorizons]

From the PPH:
"Have something light to eat so your stomach is not empty is generally considered a good idea. The chance of reflex vomiting brought on by drinking the bitter Nembutal liquid is reduced if there is something in the stomach. This should not
be a significant meal that will slow the absorption of the drug. Something light is preferable, like tea and toast, an hour or so before taking the drug."

 

[Living sucks]

The guide says, to eat a snack, after fasting.

I will be deleting my post. I missed that completely thx

 

[Aloha]

----------------------------------------------------------------
48 hour vs stat antiemetic regime notes
----------------------------------------------------------------
No claims are made regarding the validity of this information. The information should be viewed as suggestions you may wish to consider. No advice is given. Any use of this information is entirely at your own risk.

EPS is discussed below, but is rare. In very rare cases it could be severe and interfere with / prevent an attempt.
Diphenhydramine (50mg) can apparently be used to treat EPS.

Main advantage of 48 hour regime seems to be lower EPS risk, since not taking so much at once. Some may like the "structure" of it, but some may find it "drawn out". Other reported benefits lack data, so may be anecdotal.
Stat regime generally considered just as effective, and used by dignitas.

Testing with 5 or 10mg of meto is recommended, perhaps building up to testing the actual planned antiemetic regime. Maybe leave a day or two between each "build up".

If initial tests cause EPS, then a stat dose combined with diphenhydramine might be best. Another idea could be the 48 hour regime but taking 15mg diphenhydramine with each antiemetic dose (unproven, just an idea).

If initial tests don't cause EPS, then a 48 hour regimen is likely viable (if you favour it).
If initial tests don't cause EPS but you plan on stat regime, then full test advisable to see if stat dose causes EPS.

If plan on stat regime, but test gives EPS and not resolved by diphenhydramine, then maybe switch to 48 hour regime, and re-test.

If plan on 48 hour regime but tests give minor EPS, then maybe switch to stat regime combined with 50mg diphenhydramine, and re-test.

Alternative if get EPS is to switch to domperidone (low EPS risk), but see "Domperidone for SN regimes" below.

Another variant is 48 hour + stat "combined", where stat dose taken at last interval of 48 hour regime. However, this may negate the lower EPS risk benefit. Some may feel there's benefit to having antiemetic in the system for longer and opt for this variant, but this may be anecdotal.
Without controlled data, may just have to go with your gut feeling.

Some may consider the "full test run" over-the-top.
Some may do little or no pre-testing, and go with the stat dose, so if they get EPS, it won't last long.
However, if EPS were severe, it could interfere with or prevent an attempt, though this should be rare.
You'll need to weigh risks and make your choice.
It's also possible to use the 48 hour regime without any pre-testing.

If you have a limited window for your attempt, maybe pre-test as much as possible, to ensure things go smoothly.

Domperidone for SN regimes :
Domperidone is apparently incompatible with H2 blockers, eg Tagamet / Zantac. Perhaps stick with basic antacid if using domperidone, eg Mylanta, milk of magnesia, Kremil-S, Maalox, Rennie, Tums. If using Domperidone, leave a 30 minute gap before taking antacid since the domperidone leaflet states "Domperidone should be taken before meals and antacids". Antacid is not essential, so could be omitted.

Would one 10mg single stat dose of Meto about 45-60 minutes before be sufficient? I just tried 5mg today with no EPS but an upset stomach for a few hours. I don't think my system would handle more than 10mg.

 

[rhiino]

@Aloha
I would not risk to only take 10 mg and then vomit the N. Having side effects one time does not mean you have them the next time, plus an increased dose does not necessarily mean an increased risk or increased severity of side effects.

 

[Aloha]

@Aloha
I would not risk to only take 10 mg and then vomit the N. Having side effects one time does not mean you have them the next time, plus an increased dose does not necessarily mean an increased risk or increased severity of side effects.

So does it have to be 30mg or is 20mg sufficient? The PPH says 20 to 30mg, so it's not concise. Also, can you have say almond butter as a light snack instead of toast?
PS- It's an immune issue for me , so I'll get the stomach upset, but taking 1 HCL and ginger tea will lessen it.
PSS- Would taking 10 mg 2 hours before N still be too risky of vomiting?

 

[rhiino]

@Aloha
I don't know the answer to your questions. When PPH says 20 is okay it probably is. It was 60 mg once