Rectal medication (contains alcohol) switching to oral

Malea

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For a variety of reasons I‘ve been forced to take the rectal version of diazepam since February. It contains alcohol.

I‘m highly reactive to anything, however for a bit of time this worked much better than orally.

I now have to transfer from the rectal version with alcohol to the oral version. I started this a few months ago.

The first steps were horrific (much more than any usual withdrawal). I had no idea why.

I fastly learned (if understood correctly)that because it bypasses the first-pass effect of the liver, thatwith rectal there is actually more medication in the body than with oral. Which would mean even when i took the same dose orally, it wasn’t the same dose.
Is there any chance to find out how much this is?


The second part is the alcohol. Both diazepam and 2 other medications I am taking (eg Baclofen) are not supposed to be taken with alcohol at all. Because alcohol increases their effect. I‘m aware the low-doses of alcohol in rectal medications are not meant with this, but because of the extreme reactivity, i feel there have been intense lowering effects on my other medications like Baclofen. Again, is anyone aware how much this could be?

I can’t risk any further worsening, so I‘m desperately trying to find out how this all works and how much more oral i would need to get the same dose as rectal - both because of the alcohol and because of bypassing the first pass effect.

If anyone has any idea, please let me know 🙏

I may not be able to answer sufficiently because of current state.
 
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The first steps were horrific (much more than any usual withdrawal). I had no idea why.
If you're up to it, could you just very very briefly describe what the first steps in the transition were and how they affected you (ie, drowsy, nauseated, severe anxiety, trembling ...)

Dont worry about punctuation or complete sentences ...
 

Malea

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Thank you for your answer. My chaotic text probably didn’t make it clear, but I‘m specifically looking for advice/knowdledge on rectal vs. oral medication. I can’t seem to find anything about it in the www