Dosing and uses of Alcohol, ethyl (ethanol)
Adult dosage forms and strengths
Injection solution (95%)
- 1 mL
- 5 mL
Methanol Toxicity, Ethylene Glycol Poisoning (Off-label)
Loading dose
- 600 mg/kg IV (ie, 7.6 mL/kg of 10% EtOH solution)
- 600-700 mg/kg PO/NG using a 95% solution diluted to ≤ 20% with water or juice
Maintenance dose
- 65-155 mg/kg/hr depending on alcohol consumption status (lower for nondrinker)
- Oral maintenance = 0.15 mL/kg/hr (IV = 1.4 mL/kg/hr) 10% ethanol
- Chronic alcoholics and hemodialysis patients need increased dose; increased maintainence by 50%; non-users may need less
- Maintain serum ethanol of 100-150 mg/dL [21.7-32.55 mmol/L]
Venous & Lymphatic Malformations (Orphan)
Treatment of congenital venous and lymphatic malformations
Orphan indication sponsor
- Orfagen; Parc Technologique du Canal, 31521 Ramonville Saint Agne Cedex; France
Pediatric dosage forms and strengths
Injection solution (95%)
- 1 mL
- 5 mL
Methanol & Ethylene Glycol Poisoning (Off-label)
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 (PO)
- 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 (PO)
- 43% EtOH: 0.1 mL/kg/hr
- 95% EtOH: 0.1 mL/kg/hr
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/hr 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
Alcohol, ethyl (ethanol) adverse (side) effects
Frequency not defined
Intoxication
Flushing hypotension
Agitation
Hypoglycemia
N/V
Polyuria
Intoxication
Warnings
Contraindications
hypersensitivity
Seizure disorder
Diabetic coma
Subarachnoid injection of dehydrated alcohol in patients receiving anticoagulants
Precautions
Caution in diabetes mellitus, gout patients, hepatic impairment, shock
Following cranial surgery (caution)
Pregnancy and lactation
Pregnancy category: C (injection)
Lactation: enters breast milk; use with caution (AAP states "compatible with nursing")
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Alcohol, ethyl (ethanol)
Mechanism of action
Competes with methanol & ethylene glycol for alcohol dehydrogenase to inhibit production of toxic metabolites
Pharmacokinetics
Metabolism: Liver
Half-life elimination: 15-20 mg/dL/hr
Excretion: Urine; lungs
Vd: 0.6-0.7 L/kg
