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ethanol

V03AB16

Forms & Strengths

Intravenous infusion: 5% in water, 10% in water
Oral solution: various concentrations (e.g., 95% USP)
Topical solution: 70%, 95%

Adult Dosing

Ethylene glycol or methanol poisoning: Loading dose 0.6 g/kg IV or orally, followed by maintenance infusion of 66-154 mg/kg/hour to maintain blood ethanol concentration of 100-150 mg/dL

Pediatric Dosing

Ethylene glycol or methanol poisoning: Same loading and maintenance principles as adults, adjusted for total body water and clearance rates, targeting blood ethanol 100-150 mg/dL

Indications

Antidote for methanol poisoning
Antidote for ethylene glycol poisoning
Antiseptic (topical)

Mechanism of Action

Competitive substrate for alcohol dehydrogenase, having a much higher affinity for the enzyme than methanol or ethylene glycol, thereby preventing the formation of toxic metabolites (formaldehyde, formic acid, glyoxylic acid, oxalic acid)

Contraindications

Hypersensitivity to ethanol
Severe hepatic impairment
Epilepsy or history of seizures
Concurrent use with central nervous system depressants

Adverse Reactions

Central nervous system depression
Hypoglycemia
Nausea and vomiting
Incoordination and ataxia
Respiratory depression
Local irritation (topical)

Drug Interactions

CNS depressants (e.g., opioids, benzodiazepines): Enhanced sedative and respiratory depressant effects
Disulfiram: Causes severe disulfiram-ethanol reaction (flushing, nausea, tachycardia, hypotension)
Acetaminophen: Increased risk of hepatotoxicity due to CYP2E1 induction
Metronidazole: Disulfiram-like reaction

Curated Content: Needs Vetting Before Put to Clinical Use