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Non-fatal overdose following ingestion of encapsulated pure bromazolam powder: A case report

Year: 2025

Type: article

Abstract: Bromazolam is a potent designer benzodiazepine increasingly encountered in forensic and clinical toxicology. A case of non-fatal intoxication involving the ingestion of encapsulated pure bromazolam powder is reported, and, to our knowledge, it resulted in the highest documented bromazolam serum concentration to date. A healthy 20-year-old male was found unresponsive at home and admitted to intensive care. Toxicology confirmed bromazolam as the primary intoxicant, with an initial serum concentration exceeding 5800 ng/mL. The patient required prolonged intubation, and sedation persisted for over ten days despite supportive care and flumazenil administration. Five serum samples collected over 204 hours showed declining bromazolam concentrations consistent with first-order elimination kinetics and an estimated half-life of 31 hours. Analytical testing of seized powder at the scene confirmed pure bromazolam content, supporting the conclusion of high-dose exposure. Serum samples were diluted to fit within the method’s linear range, and dilution integrity testing demonstrated accurate bromazolam quantification at these levels. This case underscores the severe toxicological effects of ingesting pure bromazolam, the importance of timely toxicological confirmation in clinical decision-making, and the need for methods to quantify high-concentration samples.

Source: Forensic Science International Reports

DOI: 10.1016/j.fsir.2025.100432

Authors: Adam Bauer, Elva Eir Gretarsdottir, Valthor Asgrimsson, Sigurbergur Karason

Institutions: University of Iceland, National University Hospital of Iceland

Language: English

Topic: Forensic Toxicology and Drug Analysis

Subfield: Toxicology

Field: Pharmacology, Toxicology and Pharmaceutics

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,090