Ethanol

Ethanol is used in the management of toxicity due to ingestion of methanol, or ethylene glycol.

Ethanol is available under the following different brand and other names: alcohol (ethyl).

Adult and Pediatric Dosage Forms and Strengths

Injection solution (95%)

• 1 mL
• 5 mL

Dosage Considerations – Should be Given as Follows:
Methanol Toxicity, Ethylene Glycol Poisoning (Off-label)
 

Adult

Loading dose

• 600 mg/kg intravenous (IV) (i.e., 7.6 mL/kg of 10% EtOH solution)
• 600-700 mg/kg oral/nasogastric (NG) using a 95% solution diluted to 20% or less with water or juice

Maintenance dose

• 65-155 mg/kg/hour depending on alcohol consumption status (lower for nondrinker)
• Oral maintenance = 0.15 mL/kg/hour (IV = 1.4 mL/kg/hour) 10% ethanol
• Chronic alcoholics and hemodialysis patients need increased dose; increased maintenance by 50%; non-users may need less
• Maintain serum ethanol of 100-150 mg/dL [21.7-32.55 mmol/L]

Pediatric

Reduce ethanol loading dose if methanol or ethylene glycol ingested with alcohol

May need to increase ethanol maintenance dose in patients with chronic alcohol consumption

Loading dose (oral)

• 95% EtOH: 0.8-1 mL/kg
• 40% EtOH (80 proof undiluted liquor): 2 mL/kg
• 43% EtOH (86 proof undiluted liquor): 1.8 mL/kg

Maintenance dose (oral)

• 43% EtOH: 0.1 mL/kg/hour
• 95% EtOH: 0.1 mL/kg/hour

Intravenous (IV) dose (10% EtOH)

• 10% EtOH = 7.9 g/dL
• Loading: 8-10 mL/kg IV; not to exceed 200 mL
• Maintenance: 0.83 mL/kg/hour intravenous (IV)

10% EtOH = 7.9 g/dL

40% EtOH (80 proof undiluted liquor) = 31.6 g/dL

43% EtOH (86% proof undiluted liquor) = 34 g/dL

95% EtOH (absolute alcohol) = 75 g/dL

Continue maintenance dose until methanol or ethylene glycol levels are below 10 mg/dL

Common side effects of ethanol include:

• Intoxication
• Low blood pressure (hypotension) with flushing
• Agitation
• Low blood sugar (hypoglycemia)
• Nausea
• Vomiting
• Excessive urination

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication for diabetes, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Severe interactions of ethanol include:

• acitretin
• flibanserin
• levomilnacipran
• sodium oxybate

Ethanol has serious interactions with at least 39 different drugs.

Ethanol has moderate interactions with at least 219 different drugs.

Ethanol has mild interactions with at least 93 different drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

This medication contains ethanol. Do not take alcohol (ethyl) if you are allergic to ethanol or any ingredients contained in this drug.

Contraindications

Hypersensitivity

Seizure disorder

Diabetic coma

Subarachnoid injection of dehydrated alcohol in patients receiving anticoagulants

Effects of Drug Abuse

None.

Short-Term Effects

See "What Are Side Effects Associated with Using Ethanol?"

Long-Term Effects

See "What Are Side Effects Associated with Using Ethanol?"

Cautions

Caution in diabetes mellitus, gout patients, hepatic impairment, shock.

Following cranial surgery (caution).

Pregnancy and Lactation

Use ethanol (injection) with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available, or neither animal nor human studies were done.

Ethanol enters breast milk; use with caution if breastfeeding (American Academy of Pediatricians/AAP states "compatible with nursing").