Etomidate: A Comprehensive Guide

Etomidate is a fast-acting sedative-hypnotic agent primarily used in medical settings to induce anesthesia. Recently, it has gained attention due to its presence in illicit vape products known as “Space Oil” or “Space Vapes.” This guide covers etomidate’s chemistry, pharmacology, effects, medicinal and recreational uses, legal status, and safety concerns.

What Is Etomidate?

Etomidate is a short-acting intravenous anesthetic commonly used in emergency medicine for rapid sequence intubation (RSI) and procedural sedation. It works by depressing the central nervous system, leading to sedation and unconsciousness without significantly affecting cardiovascular stability—a key reason for its use in critical care.

• IUPAC Name: (R)-1-(1-ethylphenyl)-1H-imidazole-5-carboxylate
• Molecular Formula: C₁₄H₁₆N₂O₂
• Molecular Weight: 244.29 g/mol

History of Etomidate

Etomidate was first synthesized in the 1960s by chemists at Janssen Pharmaceutica. It was approved for medical use in the 1970s, primarily for its rapid onset and short duration of action, making it ideal for procedures requiring quick sedation. Over time, its use became widespread in emergency and surgical settings due to its minimal cardiovascular side effects compared to other anesthetics.

Chemistry of Etomidate

Etomidate is an imidazole derivative with a unique structure that allows it to interact with the central nervous system effectively. It is typically administered as a clear, sterile injectable solution but has recently appeared in liquid forms for vaping, often mixed with unknown substances.

• Solubility: Slightly soluble in water, highly soluble in lipids
• Appearance: Colorless liquid (when used in medical settings)

Pharmacology of Etomidate

Etomidate exerts its effects by enhancing the activity of gamma-aminobutyric acid (GABA), the brain’s primary inhibitory neurotransmitter. It binds to the GABA-A receptor complex, increasing chloride ion flow into neurons, leading to sedation and hypnosis.

• Onset of Action: Within 30–60 seconds (when injected)
• Duration of Action: 3–5 minutes
• Half-Life: 75 minutes (can vary based on dose and route)

Effects of Etomidate

Medicinal Effects:

• Rapid induction of anesthesia
• Short-term sedation for medical procedures
• Minimal impact on heart rate and blood pressure

Side Effects (Medical Use):

• Nausea and vomiting
• Muscle twitching or involuntary movements
• Adrenal suppression with prolonged use

Recreational Effects (Reported):

• Dissociation or a sense of detachment
• Sedation and relaxation
• Impaired motor control (ataxia)
• Short-term memory loss

Note: Etomidate is not intended for recreational use, and its effects can be unpredictable outside medical supervision.

Recreational Use of ‘Space Oil’ Vapes

Etomidate has recently surfaced in illicit products like “Space Oil” or “Space Vapes” in New Zealand and internationally. These vapes are often advertised to contain etomidate but may also include substances like ketamine, cannabis extracts, or other unknown chemicals.

Risks of Etomidate in Vapes:

• Unpredictable dosing: Vaping can lead to rapid absorption, increasing overdose risks.
• Breathing difficulties (hypoventilation): Especially dangerous when combined with depressants like alcohol, opioids, or benzodiazepines.
• Loss of coordination (ataxia): Leading to falls or accidents.
• Potential for unconsciousness: Without warning signs.

Mixing with other depressants can be fatal. Users have reported severe sedation, breathing issues, and loss of consciousness.

Legality of Etomidate

• New Zealand: Etomidate is a prescription-only medicine under the Medicines Act. Its sale, possession, or use without a prescription is illegal.
• International: Regulated in most countries for medical use only. Non-medical possession can result in criminal charges.

Etomidate is not approved for recreational use anywhere.

Warnings and Safety Information

• DO NOT use etomidate outside of a medical setting.
• Vaping unknown substances labeled as “Space Oil” carries serious health risks.
• Never mix with alcohol, opioids, benzodiazepines, or other depressants.
• If you or someone else experiences severe drowsiness, breathing problems, or loss of consciousness, call emergency services immediately.
• Report unexpected drug effects to Report Unusual Effects in New Zealand.
• Contact the National Poisons Centre (0800 764 766) for urgent advice.

References

1. Drug Information and Alerts Aotearoa New Zealand (DIANZ).
2. Clinical Pharmacology of Etomidate - National Library of medicine.
3. New Zealand Drug Foundation.
4. MindFuel Blog -
   Stay Informed: What You Need to Know About ‘Space Oil’ Vapes.
5. Janssen Pharmaceutica.
6. New Zealand National Poisons Centre.
7. Wellington ICU drug Database - Etomidate

This article is for informational purposes only and does not promote the use of any controlled substances. Always prioritize your safety and seek professional medical advice if needed.