This information explains what you and your caregiver should know after you get your Medical Aid in Dying (MAiD) medicine.
Your MAiD care team and pharmacy will give you separate instructions about your medicine. Follow their instructions carefully.
Getting your MAiD medicine
Your MAiD medicine will come from a compounding pharmacy. A compounding pharmacy is a type of pharmacy that custom-mixes medicines that are not available at other, traditional pharmacies.
You can pick up your medicine from the compounding pharmacy or have it delivered. There may be a fee for delivery.
The compounding pharmacy will give you written instructions with your MAiD medicine. Keep these instructions with your medicine.
Your MAiD medicine will have a use-by date on the bottle. Do not use the medicine after this date.
Keep the medicine in its original container (the container it came in).
Storing your MAiD medicine
MAiD medicine is very dangerous if another person takes it. It’s important to follow these instructions to store it safely.
Store your MAiD medicine:
- In its original container.
- Away from children and pets.
- Away from anyone it was not prescribed for.
- Following the instructions from the compounding pharmacy.
Do not share your MAiD medicine with anyone.
Your caregiver or support person can help you get ready
You do not have to get everything ready by yourself. A caregiver or support person can help you. This includes helping mix the medicine.
You must self-administer the MAiD medicine. That means you must be able to give yourself the medicine on your own. No one else can administer it for you.
Choosing when and where to take the MAiD medicine
Getting the MAiD medicine does not mean you must take it. You decide if and when to take the medicine. You can change your mind at any time.
You must take the medicine in the state where you were approved for MAiD. Plan to take the medicine at your home or at a caregiver’s home. Do not take this medicine in a public place.
If you decide not to take the MAiD medicine on the day you planned, keep it stored as directed.
When you are ready to take the MAiD medicine
When you are ready to take the MAiD medicine, you should have a plan. Review the other education resources your care team gave you. (Insert link to the other MAiD resource)
Do not get the MAiD medicine ready ahead of time. Only get it ready when you have decided you are ready to take it.
Follow the written instructions from your pharmacy and MAiD care team. If someone is helping you prepare, make sure they also read the pharmacy instructions.
The day before taking MAiD medicine
- Keep taking all your usual medicines unless your care team gives you different instructions.
- It’s OK to eat dinner like usual the day before you’re planning to take the MAiD medicine. Starting after dinner, do not eat any solid foods.
- After dinner, you can drink water and other clear, non-fatty liquids. Avoid drinking so much that you feel full. This will make it easier to take the MAiD medicine.
- Do not eat any solid foods on the day you plan to take the MAiD medicine. It’s OK to keep drinking clear, non-fatty liquids.
30 minutes before taking MAiD medicine
Before you take the MAiD medicine, take the anti-nausea medicines you have been prescribed. This usually will be:
- 8 milligrams (mg) of ondansetron (Zofran®)
- 20 mg of metoclopramide (Reglan®)
Just before taking MAiD medicine
- Carefully pour 2 ounces of liquid into the bottle with the medicine. You can use 2 ounces of warm (not hot) water or 2 ounces of another clear liquid, such as apple juice or Gatorade®.
- Shake the contents of the bottle to mix.
- Suck on an ice pop or a spoonful or two of sorbet until your mouth feels as frozen as you can tolerate.
- Swallow the dissolved medicine.
- It is important that all the liquid of the MAiD medicine be swallowed within 2 to 3 minutes. It will taste bitter. Sometimes sips of water, juice or sorbet between swallows of meds can be helpful so long as it is done quickly.
After taking the medicine
Keep the dying person in a sitting position for at least 20 minutes. This lowers the risk of choking or regurgitation (after the person loses consciousness).
After 20 min they can be lowered to a semi upright position (with the back at 30-45 degrees relative to horizontal) and turned to the right side. Positioning is not required but may help absorption of the life-ending medicine in the small intestine. If you are unable to reposition the person, leave them in a seated position.
What to expect after you take the MAiD medicine
Loss of consciousness occurs within 3 to 5 minutes in most cases.
The time to death after taking the medicine varies depending on the person’s condition and ability to absorb the medicine.
The dying person stays unconscious until a peaceful death occurs.
Once the patient is unconscious and unarousable, supplemental oxygen may be turned off.
If another method is planned
Some people may not be able to take MAiD medicine by mouth. Your MAiD care team will talk with you about other options if needed.
If rectal administration is planned, an outside clinician will help with the preparation. Your care team and MAiD social worker will help coordinate this care.
You will still need to self-administer the medicine.
If something unexpected happens
Contact your MAiD social worker if you or your caregiver have questions or concerns.
Your social worker can connect you with your MAiD attending physician or the right member of your care team.
What to do if you change your mind
You can change your mind at any time. If you have not prepared the medicine, keep it stored as directed until you decide what to do. If the medicine has already been prepared, do not save it to use another day. Your care team will tell you how to safely dispose of it.
If you later decide to continue the MAiD process, contact your MAiD social worker.
Choose someone to dispose of unused medicine
Choose a person in advance who will be responsible for disposing of unused MAiD medicine.
Unused medicine may need to be disposed of if:
- You decide not to take it.
- You prepare it but change your mind.
- You die before taking it.
- The medicine reaches its use-by date.
Unused medicine should be taken to an approved prescription medicine drop-off location.
Your care team will give your designated person instructions for safe disposal.
Planning with hospice
If you’re getting hospice care, talk with your MAiD social worker about your plans. Hospice organizations may have their own policies about MAiD.
What to do if you have questions
If you have questions after receiving your MAiD medicine, contact your MAiD social worker.
You can:
- Call Social Work Services at 212-639-7020.
- Send a message through MSK MyChart.
Your social worker can connect you with your MAiD attending physician or other members of your care team.
For questions about your prescription, storage, or pharmacy instructions, contact your dispensing pharmacy.
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