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pentobarbital sodium (Pentobarbital Sodium Injection)

What is Nembutal Liquid (Pentobarbital Sodium Injection) ?

Nembutal Liquid is a proven, reliable drug that brings about a peaceful death. Almost no failures are known, despite large statistics (for example, the Swiss euthanasia organisation Dignitas reported 840 exits with no single failure). There are however reports on seemingly slow or painful deaths with Nembutal in capital punishment, although this may be due to poor quality of the drug from compounding pharmacies given intravenously rather than orally.

Nembutal Liquid is a barbiturate that has been used in anesthesia and as a sleeping pill (for its hypnotic properties). It is known to cause some dependency.

Nembutal Liquid is used in high doses to practice euthanasia, mainly veterinary, but also in helping suicide in countries where this practice is legal and causes a painless death.

Nembutal Liquid is supposedly very difficult to obtain, as its sole remaining human use in most of the world is in liquid form for use as a sedative and anesthetic in hospitals. In Europe it is even more scarce than in the US. Because of this, no brick-and-mortar or mail-order pharmacy sells Nembutal; any such site that claims to do so is likely fake. Also, veterinary Nembutal is a liquid and not in pill-form, which means that it has a shorter shelf life. On the other hand, Seconal (secobarbital), a short acting barbiturate that is as powerful as Nembutal if not more powerful, is still available in capsule form in the USA and probably the UK. However, it is very rarely, if ever, prescribed. Nembutal has a bitter taste that require the use of anti-emetics to prevent vomiting when given orally at high dosages.

Side effects

A pentobarbital sodium overdose is an amount taken in excess of that which is medically recommended. Two to ten grams can cause death. CNS and respiratory depression which may progress to Cheyne-Stokes respiration, areflexia, constriction of the pupils to a slight degree (though in severe poisoning they may show paralytic dilation), oliguria, tachycardia, hypotension, lowered body temperature, and coma. Typical shock syndrome (apnea, circulatory collapse, respiratory arrest, and death) may occur.

In extreme overdose, all electrical activity in the brain may cease, in which case a “flat” EEG normally equated with clinical death cannot be accepted. This effect is fully reversible unless hypoxic damage occurs. Consideration should be given to the possibility of barbiturate intoxication even in situations that appear to involve trauma.

Complications such as pneumonia, pulmonary edema, cardiac arrhythmias, congestive heart failure, and renal failure may occur. Uremia may increase CNS sensitivity to barbiturates. Differential diagnosis should include hypoglycemia, head trauma, cerebrovascular accidents, convulsive states, and diabetic coma.

What drugs interact with Nembutal?

Barbiturates should be used with caution with some medications because they accelerate the breakdown of these medications leading to decreased effectiveness. Examples of these medications that interact with barbiturates include:

atazanavir (Reyataz),
boceprevir (Victrelis),
lurasidone (Latuda),
ranolazine (Ranexa),
telaprevir (Incivek),
voriconazole, (Vfend), and
ritonavir (Norvir).
Concomitant use of barbiturates and other central nervous system depressant medications should be used with caution because concomitant use can lead to excessive sedation, lethargy, and in severe cases coma and death. Examples of these medications that should be used with caution with other central nervous system depressant medications such as:

alprazolam (Xanax),
clonazepam (Klonopin),
diazepam (Valium),
zolpidem (Ambien), and
zaleplon (Sonata).

What formulations of are available barbiturates?

Amobarbital and pentobarbital are available as injections.
Butabarbital, phenobarbital, belladonna and phenobarbital, butalbital/aspirin/caffeine, and butalbital/acetaminophen/caffeine are available as tablets.
Butalbital/acetaminophen/caffeine, butalbital/aspirin/caffeine, and secobarbital are available as capsules.
Butabarbital, phenobarbital, belladonna and phenobarbital, and butalbital/acetaminophen/caffeine are available as oral liquids.

Time To Death

Experience in The Netherlands has learned that after ingesting 9 grams of either pentobarbital or secobarbital, death generally occurs within two hours (see the tables below).

  • Time to death after oral ingestion of 9 grams pentobarbital (102 cases) or secobarbital (21 cases)

Time to death data in the Dutch euthanasia group: 123 cases from A. Horikx, staff member of the Royal Dutch Pharmaceutical Society.

Time To Death Number ofpeople/percentages
0–15 minutes 39 people (32%)
16–30 minutes 40 (33%)
30–60 minutes 21 (17%)
1–2 hours 9 (7%)
Euthanasia by doctor after > 2 hours waiting 9 (7%)
Unknown time 5 (4%)
Total 123 (100%)
  • Time to death after oral ingestion of 10-12 grams pentobarbital (261 cases)

Similarly to the table displayed above, the following table provides the time to death as reported by the right-to-die organization “Exit deutsche Schweiz” (which literally translates as Exit German Switzerland).

Time To Death Number ofpeople/percentages
0–15 minutes 70 people (27%)
16–30 minutes 115 (44%)
30–60 minutes 44 (17%)
1–2 hours 11 (4%)
2–12 hours 20 (8%)
> 12 hours 1 (0.4%)
Total 261 (100%)


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