Medications Used for Medical Aid in Dying

Primary Drug Classes

Phenobarbital is an alternative barbiturate option, with dosing of 1-3 mg/kg IV or subcutaneous bolus, followed by infusion of 0.5 mg/kg/h, and usual maintenance of 50-100 mg/h, offering rapid onset and anticonvulsant properties 1, 2, 3
Midazolam is frequently used, particularly in combination protocols, with a starting dose of 0.5-1 mg/h continuous infusion, and usual effective dose of 1-20 mg/h, providing rapid onset and compatibility with opioids 1, 4, 5

Levomepromazine may be used as an adjunct, particularly when delirium is present, with a starting dose of 12.5-25 mg, up to 300 mg/day continuous infusion 1, 2, 3
Chlorpromazine may be used as an adjunct, with a dose of 12.5 mg IV/IM every 4-12 hours, or 25-100 mg rectally 1

Propofol offers rapid, titratable unconsciousness, with a loading dose of 20 mg, followed by infusion of 50-70 mg/h, and advantages of very short duration of action and rapid onset, making it easy to titrate 1, 2, 3