-person-thumbnail.jpg?v=1758880627)
Etomidate is a sedative-hypnotic used medically to induce unconsciousness for medical anesthesia. Etomidate is also increasingly being used in e-cigarette or vaping devices, particularly in areas of Southeast Asia such as Singapore. This use of etomidate outside of medical indications is illegal and unregulated and can have severe or life-threatening consequences.
- Etomidate is a medication used as an anesthetic agent with fast and short-lived sedating effects.
- Etomidate is also being used illicitly in vaping products, which can cause severe adverse effects.
- Etomidate abuse can lead to dependence and addiction and may require professional treatment.
.jpg?v=1759836381)
What is etomidate?
Etomidate is an intravenous anesthetic. It is approved for use in clinical settings and is only administered intravenously. Etomidate is used for short medical procedures, such as reducing dislocated joints, curettage, and tracheal intubation, as the effects emerge very quickly and last a short time. [1]
After administration, effects begin to emerge within one minute, causing the individual to become unconscious in preparation for medical anesthesia. The effects of one dose last for around three to five minutes. Etomidate impacts GABA receptors, creating its sedating effects. [2]
Etomidate has similar or greater sedative effects than alternatives (such as propofol), and in some cases, it can be preferable, as it causes less impact on cardiac function. However, it can be dangerous when it is used continuously during longer periods of anesthesia and can cause impaired organ functioning. [3]
Etomidate dosage and administration
Etomidate is used as a sedative hypnotic agent, typically as a part of a sequence to induce anesthesia. Generally, it is administered at a dose of 0.3 mg per kg of body weight, although this can range from 0.2-0.6 mg/kg. It is injected into the vein over a period of 30 to 60 seconds, and it should only be administered by a professional with appropriate training in the administration of general anesthetics. [1][2]
Doses may need to be reduced for children or geriatric patients. Etomidate should not be given to people younger than 10 years old. [1]
Side effects & managing adverse events
Side effects of etomidate used within clinical settings can include: [1][2]
- Pain on injection
- Adrenocortical depression
- Post-operative nausea or vomiting
- Muscle spasms
- Involuntary movements
In some cases, side effects can occur that affect breathing or heart function. However, because etomidate is administered only in a surgical setting, these side effects can be effectively managed by professionals. [2]
Drug interactions
Etomidate is a sedative, causing central nervous system (CNS) depression. Because of this, using etomidate with other CNS depressant substances, whether in a clinical setting or as a recreational drug, can increase the risk of severe sedation, respiratory depression, and even death. This can include substances such as alcohol, benzodiazepines, and opioids.
Emerging patterns of misuse in vapes
Reports of etomidate misuse are increasing in several countries worldwide, but particularly in East and Southeast Asia, where it is being sold in cartridges to be used in e-vaporizers. In Singapore, for example, etomidate-laced cartridges are sold online and referred to as Kpods. [4]
This use of etomidate has been reported to lead to severe adverse effects, including neuropsychiatric and physiological effects: [5][6][7]
- Agitation
- Mood swings
- Aggression
- Suicidal behavior
- Psychosis
- Drowsiness
- Confusion
- Weakness
- Shaking
- Involuntary movements
- Adrenal dysfunction
- Changes in blood pressure
- Cardiac arrhythmias
It has also been found to lead to cases of addiction, dependence, withdrawal, toxicity, and overdose. [7]
Risks of unregulated etomidate vapes
Using etomidate vapes is particularly dangerous because these products are unregulated. As such, their content and potency can vary significantly between products, and people may be unaware of the dosage being used or if the product is safe to use. [6]
Furthermore, vaping poses particular risks, as users may easily lose track of how much they have smoked or might use the product consistently over several hours or days, potentially leading to toxicity and unpredictable effects. [7]
Etomidate dependence and withdrawal
Currently, research into the effects of etomidate as a recreational drug related to the development of dependence and addiction is limited. However, there are some reports about individual use of etomidate e-cigarettes that detail steadily increasing use and withdrawal symptoms upon cessation, suggesting it carries a risk of tolerance, dependence, and addiction development. [6][7]
One report includes a female patient who abruptly stopped excessive etomidate vaping, which led to severe mood swings, suicidal ideation, hallucinations, and anxiety. She was admitted to the hospital, where she received detoxification treatment and symptom management. [7]
Etomidate toxicity and overdose
Etomidate use in vapes has been found to be associated with several cases of severe toxicity and overdose, resulting in: [5][6][7]
- Dangerously low blood potassium levels (hypokalemia)
- Adrenal insufficiency and dysfunction
- Extreme weakness in muscles and limbs
- Loss of consciousness and coma
- Seizures
- Severe agitation and aggression
- Psychotic symptoms
- Cardiac arrhythmias
- Death
Legal status and regulatory developments
Etomidate abuse with vapes is mostly affecting East and Southeast Asian countries, including Hong Kong and Singapore. In Singapore, the Health Minister Ong Ye Kung announced in July 2025 that etomidate will be reclassified under the Misuse of Drugs Act (MDA). Previously, etomidate was included in the Poisons Act, which states that it can only be used by licensed professionals, and the possession, use, or sale of etomidate is illegal with significant fines and prison time. [4][8]
In Hong Kong, etomidate was regulated under the Pharmacy and Poisons Regulations, which means possession of etomidate can be punished with fines and prison sentences. It was reclassified in February 2025 as a controlled drug under the Dangerous Drugs Ordinance. [9]
These new classifications mean that offences involving etomidate, including possession, use, or trafficking of etomidate, can incur much heavier fines and sentences. Illicit etomidate use is also reportedly increasing in other countries, including the US and UK, where it is being found in the drug supply, often mixed with fentanyl or other substances. [4]
Seeking help: Harm reduction & treatment
Using etomidate as a recreational drug, such as smoking in vapes, can lead to severe risks and harm. Trying to stop etomidate use can be difficult without professional support, as this can cause dangerous withdrawal symptoms. People who wish to manage etomidate use without professional support may benefit from gradually reducing their use, rather than abruptly stopping.
People can consult with their primary care physician for advice about available treatment options and specialist services. Substance use disorder treatments can help with supportive care of withdrawal, via inpatient or outpatient services, and medicinal and therapeutic interventions to support recovery.
_-Effects,-Use,-and-Addiction-guide-detail.jpg?v=1747911918)
-guide-detail.jpg?v=1722502466)