ethanol (Rx)

Brand and Other Names:alcohol (ethyl)
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Dosing & Uses

AdultPediatric

Dosage Forms & 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 = 1.5 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

Dosage Forms & 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: 0.2mL/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

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Interactions

Interaction Checker

and ethanol

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            Contraindicated (6)

            • acitretin

              acitretin, ethanol. Mechanism: altering metabolism. Contraindicated. Ethanol converts acitretin to etretinate, a teratogenic substance that can remain in the body for years. Women on acitretin should totally abstain from ethanol during and 2 months after stopping acitretin.

            • benznidazole

              benznidazole increases toxicity of ethanol by aldehyde dehydrogenase inhibition. Contraindicated. Abdominal cramps, nausea, vomiting, headaches, and/or flushing may occur if alcoholic beverages or products containing propylene glycol are consumed during or following therapy with nitroimidazole agents (structurally related to benznidazole). Do not consume alcohol or products containing propylene glycol during and for at least 3 days after benznidazole therapy.

            • calcium/magnesium/potassium/sodium oxybates

              ethanol, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.

            • flibanserin

              ethanol, flibanserin. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Coadministration of flibanserin within 2 hr of consuming alcohol is contraindicated. Increases the risk of severe hypotension and syncope.

            • levomilnacipran

              ethanol will increase the level or effect of levomilnacipran by enhancing GI absorption. Applies only to oral form of both agents. Contraindicated. Alcohol interacts with the extended-release properties of levomilnacipran capsules resulting in a pronounced accelerated drug release

            • sodium oxybate

              ethanol, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.

            Serious - Use Alternative (48)

            • acarbose

              ethanol, acarbose. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • amantadine

              ethanol will increase the level or effect of amantadine by Other (see comment). Avoid or Use Alternate Drug. Coadministration of amantadine with alcohol is not recommended, as it may increase the potential for CNS effects such as dizziness, confusion, lightheadedness, and orthostatic hypotension. Alcohol may result in dose-dumping if coadministered with extended-release amantadine.

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen, ethanol. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • chlorpropamide

              ethanol, chlorpropamide. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • clonidine

              clonidine, ethanol. Either increases toxicity of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration enhances CNS depressant effects.

            • diroximel fumarate

              ethanol decreases levels of diroximel fumarate by unspecified interaction mechanism. Avoid or Use Alternate Drug. Mean peak plasma MMF concentration for diroximel fumarate was decreased by 9% and 21%, when coadministered with 240 mL of 5% v/v and 40% v/v of ethanol, respectively.

            • disulfiram

              disulfiram will increase the level or effect of ethanol by affecting hepatic enzyme CYP2E1 metabolism. Avoid or Use Alternate Drug.

              disulfiram increases toxicity of ethanol by decreasing metabolism. Contraindicated. Enhanced CNS & cardiac toxicity.

            • fentanyl

              fentanyl, ethanol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fentanyl intranasal

              fentanyl intranasal, ethanol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fentanyl transdermal

              fentanyl transdermal, ethanol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fentanyl transmucosal

              fentanyl transmucosal, ethanol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • glimepiride

              ethanol, glimepiride. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • glipizide

              ethanol, glipizide. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • glyburide

              ethanol, glyburide. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • hydrocodone

              hydrocodone, ethanol. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • insulin aspart

              ethanol, insulin aspart. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin aspart protamine/insulin aspart

              ethanol, insulin aspart protamine/insulin aspart. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin degludec

              ethanol, insulin degludec. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin degludec/insulin aspart

              ethanol, insulin degludec/insulin aspart. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin detemir

              ethanol, insulin detemir. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin glargine

              ethanol, insulin glargine. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin glulisine

              ethanol, insulin glulisine. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin inhaled

              ethanol, insulin inhaled. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin isophane human/insulin regular human

              ethanol, insulin isophane human/insulin regular human. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin lispro

              ethanol, insulin lispro. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin lispro protamine/insulin lispro

              ethanol, insulin lispro protamine/insulin lispro. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin NPH

              ethanol, insulin NPH. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • insulin regular human

              ethanol, insulin regular human. Other (see comment). Avoid or Use Alternate Drug. Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

            • ketorolac

              ketorolac, ethanol. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: The risk of GI bleeding may be increased when combining alcohol with ketorolac. Monitor for increased GI bleeding if a patient regularly consumes alcohol and NSAIDs. Limit alcohol consumption during treatment with an NSAID.

            • lemborexant

              lemborexant, ethanol. Either increases effects of the other by sedation. Avoid or Use Alternate Drug. Advise patients not to consume alcohol in combination with lemborexant owing to additive effects.

            • metformin

              ethanol increases toxicity of metformin by Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn; alcohol may potentiate the risk of lactic acidosis.

            • methotrexate

              methotrexate, ethanol. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Ethanol (alcohol) may increase the risk for liver-related side effects of methotrexate. Patients should be advised to avoid intake of alcoholic beverages during methotrexate therapy. Patients who are noncompliant with alcohol restrictions (e.g., alcoholism) should not receive methotrexate.

            • methylphenidate

              ethanol increases levels of methylphenidate by enhancing GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Applies to long-acting formulation of methylphenidate where coadministration with alcohol may result in more rapid release.

            • metoclopramide intranasal

              ethanol, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

            • miglitol

              ethanol, miglitol. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • nateglinide

              ethanol, nateglinide. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • pioglitazone

              ethanol, pioglitazone. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • repaglinide

              ethanol, repaglinide. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • rosiglitazone

              ethanol, rosiglitazone. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • saxagliptin

              ethanol, saxagliptin. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • secnidazole

              ethanol increases toxicity of secnidazole by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid alcoholic beverages and preparations containing ethanol or propylene glycol during secnidazole therapy and for 2 days after treatment is stopped. Nausea, vomiting, diarrhea, abdominal pain, dizziness, and headache reported when coadministered. .

            • sitagliptin

              ethanol, sitagliptin. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • sufentanil SL

              sufentanil SL, ethanol. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • tinidazole

              tinidazole increases toxicity of ethanol by aldehyde dehydrogenase inhibition. Avoid or Use Alternate Drug. Alcoholic beverages and preparations containing ethanol or propylene glycol should be avoided during tinidazole therapy and for 3 days afterward because abdominal cramps, nausea, vomiting, headaches, and flushing may occur. Tinidazole should not be given to patients who have taken disulfiram within the last two weeks. .

            • tolazamide

              ethanol, tolazamide. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • tolbutamide

              ethanol, tolbutamide. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • valerian

              valerian and ethanol both increase sedation. Avoid or Use Alternate Drug.

            • vildagliptin

              ethanol, vildagliptin. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            Monitor Closely (214)

            • albuterol

              ethanol increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • alfentanil

              alfentanil and ethanol both increase sedation. Use Caution/Monitor.

            • alprazolam

              alprazolam and ethanol both increase sedation. Use Caution/Monitor.

            • amitriptyline

              amitriptyline and ethanol both increase sedation. Use Caution/Monitor.

            • amobarbital

              amobarbital and ethanol both increase sedation. Use Caution/Monitor.

            • amoxapine

              amoxapine and ethanol both increase sedation. Use Caution/Monitor.

            • antithrombin alfa

              ethanol increases effects of antithrombin alfa by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • antithrombin III

              ethanol increases effects of antithrombin III by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • apomorphine

              apomorphine and ethanol both increase sedation. Use Caution/Monitor.

            • arformoterol

              ethanol increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • argatroban

              ethanol increases effects of argatroban by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • aripiprazole

              aripiprazole and ethanol both increase sedation. Use Caution/Monitor.

            • armodafinil

              ethanol increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • avanafil

              ethanol, avanafil. additive vasodilation. Use Caution/Monitor. Combination may increase risk of orthostatic hypotension, tachycardia, dizziness and headache.

            • azelastine

              azelastine and ethanol both increase sedation. Use Caution/Monitor.

            • baclofen

              baclofen and ethanol both increase sedation. Use Caution/Monitor.

            • belladonna and opium

              belladonna and opium and ethanol both increase sedation. Use Caution/Monitor.

            • bemiparin

              ethanol increases effects of bemiparin by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • benperidol

              benperidol and ethanol both increase sedation. Use Caution/Monitor.

            • benzphetamine

              ethanol increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • beta carotene

              beta carotene, ethanol. Other (see comment). Use Caution/Monitor. Comment: Excessive alcohol ingestion decreases beta carotene levels in the body.

            • bivalirudin

              ethanol increases effects of bivalirudin by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • brexanolone

              brexanolone, ethanol. Either increases toxicity of the other by sedation. Use Caution/Monitor.

            • brivaracetam

              ethanol, brivaracetam. Other (see comment). Use Caution/Monitor. Comment: Coadministration with ethanol may enhance CNS depressant effects (eg, decreases in saccadic peak velocity, smooth pursuit, adaptive tracking performance, and Visual Analog Scale (VAS) alertness).

            • brompheniramine

              brompheniramine and ethanol both increase sedation. Use Caution/Monitor.

            • buprenorphine

              buprenorphine and ethanol both increase sedation. Use Caution/Monitor.

            • buprenorphine buccal

              buprenorphine buccal and ethanol both increase sedation. Use Caution/Monitor.

            • buprenorphine, long-acting injection

              ethanol increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

            • butabarbital

              butabarbital and ethanol both increase sedation. Use Caution/Monitor.

            • butalbital

              butalbital and ethanol both increase sedation. Use Caution/Monitor.

            • butorphanol

              butorphanol and ethanol both increase sedation. Use Caution/Monitor.

            • caffeine

              ethanol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • carbinoxamine

              carbinoxamine and ethanol both increase sedation. Use Caution/Monitor.

            • carisoprodol

              carisoprodol and ethanol both increase sedation. Use Caution/Monitor.

            • carvedilol

              ethanol increases levels of carvedilol by Other (see comment). Use Caution/Monitor. Comment: ETOH may affect the release rate of extended-release carvedilol (Coreg CR), resulting in higher peak plasma concentration. Separate by 2 hr. Immediate-release carvedilol (Coreg) not affected.

            • cefamandole

              cefamandole, ethanol. Mechanism: decreasing metabolism. Use Caution/Monitor. Risk of disulfiram like reaction; avoid EtOH during and for 2 days following Rx.

            • cefotetan

              cefotetan, ethanol. Mechanism: decreasing metabolism. Use Caution/Monitor. Risk of disulfiram like reaction; avoid EtOH during and for 2 days following Rx.

            • cenobamate

              cenobamate, ethanol. Either increases effects of the other by sedation. Use Caution/Monitor.

            • chloral hydrate

              chloral hydrate and ethanol both increase sedation. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide and ethanol both increase sedation. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine and ethanol both increase sedation. Use Caution/Monitor.

            • chlorpromazine

              chlorpromazine and ethanol both increase sedation. Use Caution/Monitor.

            • chlorzoxazone

              chlorzoxazone and ethanol both increase sedation. Use Caution/Monitor.

            • cinnarizine

              cinnarizine and ethanol both increase sedation. Use Caution/Monitor.

            • citalopram

              ethanol, citalopram. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive CNS depression.

            • clemastine

              clemastine and ethanol both increase sedation. Use Caution/Monitor.

            • clobazam

              ethanol, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

            • clomipramine

              clomipramine and ethanol both increase sedation. Use Caution/Monitor.

            • clonazepam

              clonazepam and ethanol both increase sedation. Use Caution/Monitor.

            • clorazepate

              clorazepate and ethanol both increase sedation. Use Caution/Monitor.

            • clozapine

              clozapine and ethanol both increase sedation. Use Caution/Monitor.

            • codeine

              codeine and ethanol both increase sedation. Use Caution/Monitor.

            • cyclizine

              cyclizine and ethanol both increase sedation. Use Caution/Monitor.

            • cyclobenzaprine

              cyclobenzaprine and ethanol both increase sedation. Use Caution/Monitor.

            • cyproheptadine

              cyproheptadine and ethanol both increase sedation. Use Caution/Monitor.

            • dabigatran

              ethanol increases effects of dabigatran by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • dalteparin

              ethanol increases effects of dalteparin by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • dantrolene

              dantrolene and ethanol both increase sedation. Use Caution/Monitor.

            • desipramine

              desipramine and ethanol both increase sedation. Use Caution/Monitor.

            • deutetrabenazine

              ethanol and deutetrabenazine both increase sedation. Use Caution/Monitor.

            • dexchlorpheniramine

              dexchlorpheniramine and ethanol both increase sedation. Use Caution/Monitor.

            • dexfenfluramine

              ethanol increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexmedetomidine

              dexmedetomidine and ethanol both increase sedation. Use Caution/Monitor.

            • dexmethylphenidate

              ethanol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextroamphetamine

              ethanol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextromoramide

              dextromoramide and ethanol both increase sedation. Use Caution/Monitor.

            • diamorphine

              diamorphine and ethanol both increase sedation. Use Caution/Monitor.

            • diazepam

              diazepam and ethanol both increase sedation. Use Caution/Monitor.

            • diazepam intranasal

              diazepam intranasal, ethanol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

            • diethylpropion

              ethanol increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • difenoxin hcl

              difenoxin hcl and ethanol both increase sedation. Use Caution/Monitor.

            • dimenhydrinate

              dimenhydrinate and ethanol both increase sedation. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine and ethanol both increase sedation. Use Caution/Monitor.

            • diphenoxylate hcl

              diphenoxylate hcl and ethanol both increase sedation. Use Caution/Monitor.

            • dipipanone

              dipipanone and ethanol both increase sedation. Use Caution/Monitor.

            • dobutamine

              ethanol increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopamine

              ethanol increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopexamine

              ethanol increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • doxepin

              doxepin and ethanol both increase sedation. Use Caution/Monitor.

            • doxylamine

              doxylamine and ethanol both increase sedation. Use Caution/Monitor.

            • droperidol

              droperidol and ethanol both increase sedation. Use Caution/Monitor.

            • duloxetine

              ethanol, duloxetine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive hepatotoxicity.

            • enoxaparin

              ethanol increases effects of enoxaparin by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • ephedrine

              ethanol increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • epinephrine

              ethanol increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • epinephrine racemic

              ethanol increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • esketamine intranasal

              esketamine intranasal, ethanol. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

            • estazolam

              estazolam and ethanol both increase sedation. Use Caution/Monitor.

            • etomidate

              etomidate and ethanol both increase sedation. Use Caution/Monitor.

            • fenfluramine

              ethanol increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fluphenazine

              fluphenazine and ethanol both increase sedation. Use Caution/Monitor.

            • flurazepam

              flurazepam and ethanol both increase sedation. Use Caution/Monitor.

            • fondaparinux

              ethanol increases effects of fondaparinux by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • formoterol

              ethanol increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fosphenytoin

              ethanol decreases levels of fosphenytoin by increasing metabolism. Use Caution/Monitor. Decreased phenytoin levels may be seen with chronic alcohol ingestion.

              ethanol will increase the level or effect of fosphenytoin by decreasing metabolism. Use Caution/Monitor. Increased phenytoin levels may be seen with acute alcohol ingestion

            • gabapentin

              gabapentin, ethanol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • gabapentin enacarbil

              gabapentin enacarbil, ethanol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • haloperidol

              haloperidol and ethanol both increase sedation. Use Caution/Monitor.

            • heparin

              ethanol increases effects of heparin by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • hydromorphone

              hydromorphone and ethanol both increase sedation. Use Caution/Monitor.

            • hydroxyzine

              hydroxyzine and ethanol both increase sedation. Use Caution/Monitor.

            • iloperidone

              iloperidone and ethanol both increase sedation. Use Caution/Monitor.

            • imipramine

              imipramine and ethanol both increase sedation. Use Caution/Monitor.

            • isoniazid

              isoniazid will increase the level or effect of ethanol by affecting hepatic enzyme CYP2E1 metabolism. Use Caution/Monitor. Generally avoid; increased risk of hepatotoxicity

            • isoproterenol

              ethanol increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ketamine

              ketamine and ethanol both increase sedation. Use Caution/Monitor.

            • ketotifen, ophthalmic

              ethanol and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

            • lasmiditan

              lasmiditan, ethanol. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

            • levalbuterol

              ethanol increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • levorphanol

              levorphanol and ethanol both increase sedation. Use Caution/Monitor.

            • lisdexamfetamine

              ethanol increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lofepramine

              lofepramine and ethanol both increase sedation. Use Caution/Monitor.

            • lofexidine

              ethanol and lofexidine both increase sedation. Use Caution/Monitor.

            • loprazolam

              loprazolam and ethanol both increase sedation. Use Caution/Monitor.

            • lorazepam

              lorazepam and ethanol both increase sedation. Use Caution/Monitor.

            • lormetazepam

              lormetazepam and ethanol both increase sedation. Use Caution/Monitor.

            • loxapine

              loxapine and ethanol both increase sedation. Use Caution/Monitor.

            • loxapine inhaled

              loxapine inhaled and ethanol both increase sedation. Use Caution/Monitor.

            • lurasidone

              ethanol and lurasidone both increase sedation. Modify Therapy/Monitor Closely.

            • maprotiline

              maprotiline and ethanol both increase sedation. Use Caution/Monitor.

            • marijuana

              ethanol and marijuana both increase sedation. Use Caution/Monitor.

            • melatonin

              ethanol and melatonin both increase sedation. Use Caution/Monitor.

            • meperidine

              meperidine and ethanol both increase sedation. Use Caution/Monitor.

            • meprobamate

              ethanol and meprobamate both increase sedation. Use Caution/Monitor.

              meprobamate, ethanol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive CNS depression.

            • metaproterenol

              ethanol increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaxalone

              metaxalone and ethanol both increase sedation. Use Caution/Monitor.

            • methadone

              methadone and ethanol both increase sedation. Use Caution/Monitor.

            • methamphetamine

              ethanol increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methocarbamol

              methocarbamol and ethanol both increase sedation. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              ethanol increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metronidazole

              metronidazole, ethanol. Mechanism: decreasing metabolism. Use Caution/Monitor. Disulfiram like reaction.

            • midazolam

              midazolam and ethanol both increase sedation. Use Caution/Monitor.

            • midazolam intranasal

              midazolam intranasal, ethanol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

            • midodrine

              ethanol increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • mirtazapine

              ethanol and mirtazapine both increase sedation. Use Caution/Monitor.

            • modafinil

              ethanol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • morphine

              morphine and ethanol both increase sedation. Use Caution/Monitor.

            • motherwort

              ethanol and motherwort both increase sedation. Use Caution/Monitor.

            • moxonidine

              ethanol and moxonidine both increase sedation. Use Caution/Monitor.

            • nabilone

              ethanol and nabilone both increase sedation. Use Caution/Monitor.

            • nalbuphine

              nalbuphine and ethanol both increase sedation. Use Caution/Monitor.

            • nitroglycerin rectal

              ethanol increases effects of nitroglycerin rectal by Other (see comment). Use Caution/Monitor. Comment: Vasodilating effects of nitroglycerin have been shown to be additive to the effects observed with alcohol. Avoid alcohol assumption.

            • norepinephrine

              ethanol increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nortriptyline

              nortriptyline and ethanol both increase sedation. Use Caution/Monitor.

            • olanzapine

              olanzapine and ethanol both increase sedation. Use Caution/Monitor.

            • oliceridine

              ethanol, oliceridine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • opium tincture

              opium tincture and ethanol both increase sedation. Use Caution/Monitor.

            • orphenadrine

              orphenadrine and ethanol both increase sedation. Use Caution/Monitor.

            • oxazepam

              oxazepam and ethanol both increase sedation. Use Caution/Monitor.

            • oxycodone

              oxycodone and ethanol both increase sedation. Use Caution/Monitor.

            • oxymorphone

              oxymorphone and ethanol both increase sedation. Use Caution/Monitor.

            • paliperidone

              paliperidone and ethanol both increase sedation. Use Caution/Monitor.

            • papaveretum

              papaveretum and ethanol both increase sedation. Use Caution/Monitor.

            • papaverine

              ethanol and papaverine both increase sedation. Use Caution/Monitor.

            • pentazocine

              pentazocine and ethanol both increase sedation. Use Caution/Monitor.

            • pentobarbital

              pentobarbital and ethanol both increase sedation. Use Caution/Monitor.

            • perampanel

              perampanel and ethanol both increase sedation. Use Caution/Monitor.

            • perphenazine

              perphenazine and ethanol both increase sedation. Use Caution/Monitor.

            • phendimetrazine

              ethanol increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenindione

              ethanol increases effects of phenindione by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • phenobarbital

              phenobarbital and ethanol both increase sedation. Use Caution/Monitor.

            • phentermine

              ethanol increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine

              ethanol increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine PO

              ethanol increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • phenytoin

              ethanol decreases levels of phenytoin by increasing metabolism. Use Caution/Monitor. Decreased phenytoin levels may be seen with chronic alcohol ingestion.

              ethanol increases levels of phenytoin by decreasing metabolism. Use Caution/Monitor. Increased phenytoin levels may be seen with acute alcohol ingestion.

            • pholcodine

              ethanol and pholcodine both increase sedation. Use Caution/Monitor.

            • pimozide

              pimozide and ethanol both increase sedation. Use Caution/Monitor.

            • pirbuterol

              ethanol increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pregabalin

              pregabalin, ethanol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • primidone

              primidone and ethanol both increase sedation. Use Caution/Monitor.

            • prochlorperazine

              prochlorperazine and ethanol both increase sedation. Use Caution/Monitor.

            • promethazine

              promethazine and ethanol both increase sedation. Use Caution/Monitor.

            • propofol

              propofol and ethanol both increase sedation. Use Caution/Monitor.

            • propranolol

              ethanol, propranolol. Other (see comment). Use Caution/Monitor. Comment: Propranolol plasma levels may increase with acute alcohol consumption, but decrease with chronic alcohol consumption.

            • propylhexedrine

              ethanol increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • protamine

              ethanol increases effects of protamine by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.

            • protriptyline

              protriptyline and ethanol both increase sedation. Use Caution/Monitor.

            • quazepam

              quazepam and ethanol both increase sedation. Use Caution/Monitor.

            • quetiapine

              quetiapine and ethanol both increase sedation. Use Caution/Monitor.

            • ramelteon

              ethanol and ramelteon both increase sedation. Use Caution/Monitor.

            • risperidone

              risperidone and ethanol both increase sedation. Use Caution/Monitor.

            • salmeterol

              ethanol increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • scullcap

              ethanol and scullcap both increase sedation. Use Caution/Monitor.

            • secobarbital

              secobarbital and ethanol both increase sedation. Use Caution/Monitor.

            • shepherd's purse

              ethanol and shepherd's purse both increase sedation. Use Caution/Monitor.

            • sodium sulfate/?magnesium sulfate/potassium chloride

              sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ethanol by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

            • sodium sulfate/potassium sulfate/magnesium sulfate

              sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ethanol by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

            • stiripentol

              stiripentol, ethanol. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

            • sufentanil

              sufentanil and ethanol both increase sedation. Use Caution/Monitor.

            • suvorexant

              suvorexant and ethanol both increase sedation. Modify Therapy/Monitor Closely. Advise patient not to consume alcohol because of additive CNS depressant effects

            • tadalafil

              ethanol, tadalafil. Either increases effects of the other by additive vasodilation. Use Caution/Monitor. Combination may increase risk of orthostatic hypotension, tachycardia, dizziness and headache.

            • tapentadol

              tapentadol and ethanol both increase sedation. Use Caution/Monitor.

              ethanol, tapentadol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Monitor for additive respiratory and CNS depressant effects (hypoventilation, hypotension, sedation) during concomitant use; reduce dose of each agent.

            • tasimelteon

              ethanol and tasimelteon both increase sedation. Use Caution/Monitor.

            • temazepam

              temazepam and ethanol both increase sedation. Use Caution/Monitor.

            • terbutaline

              ethanol increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • thalidomide

              thalidomide increases effects of ethanol by unspecified interaction mechanism. Use Caution/Monitor. Increased sedative effects.

            • thioridazine

              thioridazine and ethanol both increase sedation. Use Caution/Monitor.

            • thiothixene

              thiothixene and ethanol both increase sedation. Use Caution/Monitor.

            • tiopronin

              ethanol increases levels of tiopronin by Other (see comment). Modify Therapy/Monitor Closely. Comment: Tiopronin is released faster from the delayed-release product (Thiola EC) in the presence of alcohol and the risk for adverse events when taken with alcohol is unknown. Avoid alcohol consumption 2 hr before and 3 hr after taking delayed-release tiopronin.

            • topiramate

              ethanol and topiramate both increase sedation. Modify Therapy/Monitor Closely.

            • tramadol

              tramadol and ethanol both increase sedation. Use Caution/Monitor.

            • trazodone

              trazodone and ethanol both increase sedation. Use Caution/Monitor.

            • triazolam

              triazolam and ethanol both increase sedation. Use Caution/Monitor.

            • triclofos

              triclofos and ethanol both increase sedation. Use Caution/Monitor.

            • trifluoperazine

              trifluoperazine and ethanol both increase sedation. Use Caution/Monitor.

            • trimipramine

              trimipramine and ethanol both increase sedation. Use Caution/Monitor.

            • triprolidine

              triprolidine and ethanol both increase sedation. Use Caution/Monitor.

            • varenicline

              varenicline increases effects of ethanol by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration have resulted in some patients experiencing increased intoxicating effects of alcohol, sometimes associated with aggressive behavior and/or amnesia. Advise patients to reduce the amount of alcohol they consume while taking varenicline until they know whether it affects their tolerance for alcohol.

            • verapamil

              verapamil increases levels of ethanol by decreasing metabolism. Use Caution/Monitor.

            • warfarin

              ethanol, warfarin. Mechanism: altering metabolism. Use Caution/Monitor. Avoid alcohol ingestion; acute, excessive EtOH ingestion (binge drinking) decreases .

            • xylometazoline

              ethanol increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • yohimbine

              ethanol increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ziconotide

              ethanol and ziconotide both increase sedation. Use Caution/Monitor.

            • ziprasidone

              ziprasidone and ethanol both increase sedation. Use Caution/Monitor.

            Minor (88)

            • abacavir

              ethanol increases levels of abacavir by decreasing metabolism. Minor/Significance Unknown. Interaction usually not clinically significant.

            • acetaminophen

              ethanol will decrease the level or effect of acetaminophen by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

              ethanol increases toxicity of acetaminophen by decreasing metabolism. Minor/Significance Unknown.

            • acetaminophen IV

              ethanol will decrease the level or effect of acetaminophen IV by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

              ethanol increases toxicity of acetaminophen IV by decreasing metabolism. Minor/Significance Unknown.

            • acetaminophen rectal

              ethanol will decrease the level or effect of acetaminophen rectal by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

              ethanol increases toxicity of acetaminophen rectal by decreasing metabolism. Minor/Significance Unknown.

            • acetohydroxamic acid

              acetohydroxamic acid, ethanol. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Temporary rash, flushing.

            • alfuzosin

              alfuzosin, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

            • amitriptyline

              ethanol, amitriptyline. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive impairment of motor skills.

            • aripiprazole

              ethanol, aripiprazole. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • asenapine

              asenapine, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

            • aspirin

              ethanol increases toxicity of aspirin by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • aspirin rectal

              ethanol increases toxicity of aspirin rectal by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • aspirin/citric acid/sodium bicarbonate

              ethanol increases toxicity of aspirin/citric acid/sodium bicarbonate by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • balsalazide

              ethanol increases toxicity of balsalazide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • benperidol

              ethanol, benperidol. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • brimonidine

              brimonidine increases effects of ethanol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

            • bupropion

              ethanol, bupropion. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • chlorpromazine

              ethanol, chlorpromazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • choline magnesium trisalicylate

              ethanol increases toxicity of choline magnesium trisalicylate by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • clozapine

              ethanol, clozapine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • cyanocobalamin

              ethanol decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

            • dapsone

              ethanol will decrease the level or effect of dapsone by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

            • desipramine

              ethanol decreases levels of desipramine by increasing metabolism. Minor/Significance Unknown. Interaction esp. seen in detoxified alcoholics.

            • didanosine

              didanosine, ethanol. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Enhanced risk of pancreatitis.

            • diflunisal

              ethanol increases toxicity of diflunisal by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • doxazosin

              doxazosin, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

            • doxepin

              ethanol, doxepin. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive impairment of motor skills.

            • doxepin cream

              ethanol increases effects of doxepin cream by pharmacodynamic synergism. Minor/Significance Unknown.

            • doxycycline

              ethanol decreases levels of doxycycline by increasing elimination. Minor/Significance Unknown.

            • droperidol

              ethanol, droperidol. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • erythromycin base

              ethanol decreases levels of erythromycin base by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

            • erythromycin ethylsuccinate

              ethanol decreases levels of erythromycin ethylsuccinate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

            • erythromycin lactobionate

              ethanol decreases levels of erythromycin lactobionate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

            • erythromycin stearate

              ethanol decreases levels of erythromycin stearate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

            • ethotoin

              ethanol decreases levels of ethotoin by increasing metabolism. Minor/Significance Unknown.

            • eucalyptus

              ethanol and eucalyptus both increase sedation. Minor/Significance Unknown.

            • felodipine

              ethanol increases levels of felodipine by decreasing metabolism. Minor/Significance Unknown.

            • fluphenazine

              ethanol, fluphenazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • glyceryl trinitrate pr

              glyceryl trinitrate pr, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible hypotension.

            • haloperidol

              ethanol, haloperidol. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • iloperidone

              ethanol, iloperidone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • imipramine

              ethanol decreases levels of imipramine by increasing metabolism. Minor/Significance Unknown. Interaction esp. seen in detoxified alcoholics.

            • isoniazid

              isoniazid increases toxicity of ethanol by decreasing metabolism. Minor/Significance Unknown. Enhanced hepatotoxicity.

            • loxapine

              ethanol, loxapine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • loxapine inhaled

              ethanol, loxapine inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • mesalamine

              ethanol increases toxicity of mesalamine by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • metoclopramide

              metoclopramide increases effects of ethanol by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Increased CNS depression.

              metoclopramide increases effects of ethanol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

            • metronidazole

              metronidazole will increase the level or effect of ethanol by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

            • metronidazole topical

              metronidazole topical will increase the level or effect of ethanol by decreasing metabolism. Minor/Significance Unknown. Disulfiram-like reaction with oral metronidazole and alcohol; less likely to occur with vaginal administration because of low absorption

            • metronidazole vaginal

              metronidazole vaginal will increase the level or effect of ethanol by decreasing metabolism. Minor/Significance Unknown. Disulfiram-like reaction with oral metronidazole and alcohol; less likely to occur with vaginal administration because of low absorption

            • mirtazapine

              ethanol, mirtazapine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • moxisylyte

              moxisylyte, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

            • nifedipine

              ethanol increases levels of nifedipine by decreasing metabolism. Minor/Significance Unknown.

            • nitroglycerin IV

              nitroglycerin IV, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible hypotension.

            • nitroglycerin sublingual

              nitroglycerin sublingual, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible hypotension.

            • nitroglycerin topical

              nitroglycerin topical, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible hypotension.

            • nitroglycerin transdermal

              nitroglycerin transdermal, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible hypotension.

            • nitroglycerin translingual

              nitroglycerin translingual, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible hypotension.

            • olanzapine

              ethanol, olanzapine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • paliperidone

              ethanol, paliperidone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • perphenazine

              ethanol, perphenazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • phenoxybenzamine

              phenoxybenzamine, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

            • phentolamine

              phentolamine, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

            • pimozide

              ethanol, pimozide. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • porfimer

              ethanol decreases levels of porfimer by increasing metabolism. Minor/Significance Unknown.

            • prazosin

              prazosin, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

            • prochlorperazine

              ethanol, prochlorperazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • promethazine

              ethanol, promethazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • quetiapine

              ethanol, quetiapine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • rifampin

              ethanol decreases levels of rifampin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Interaction more likely with chronic EtOH use.

            • risperidone

              ethanol, risperidone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • sage

              ethanol and sage both increase sedation. Minor/Significance Unknown.

            • salicylates (non-asa)

              ethanol increases toxicity of salicylates (non-asa) by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • salsalate

              ethanol increases toxicity of salsalate by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • silodosin

              silodosin, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

            • sulfasalazine

              ethanol increases toxicity of sulfasalazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • terazosin

              terazosin, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

            • thiamine

              ethanol decreases levels of thiamine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Thiamine supplementation recommended in alcoholism.

            • thioridazine

              ethanol, thioridazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • thiothixene

              ethanol, thiothixene. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • trazodone

              ethanol, trazodone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive impairment of motor skills.

            • trifluoperazine

              ethanol, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • vasopressin

              ethanol decreases effects of vasopressin by pharmacodynamic antagonism. Minor/Significance Unknown.

            • verteporfin

              ethanol decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.

            • vitamin E

              ethanol decreases levels of vitamin E by unspecified interaction mechanism. Minor/Significance Unknown.

            • willow bark

              ethanol increases toxicity of willow bark by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

            • ziprasidone

              ethanol, ziprasidone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • zolpidem

              zolpidem, ethanol. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • zotepine

              ethanol, zotepine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

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            Adverse Effects

            Frequency Not Defined

            Intoxication

            Flushing hypotension

            Agitation

            Hypoglycemia

            N/V

            Polyuria

            Intoxication

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            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

            Use caution following cranial surgery

            Significant systemic absorption and toxicity may occur in infants following dermal exposure; use caution

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            Pregnancy & Lactation

            Pregnancy Category: C (injection)

            Lactation: Enters breast milk at levels approximately equivalent to maternal serum level; 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.

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            Pharmacology

            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

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Dehydrated Alcohol injection
            -
            98 % vial

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            A Patient Handout is not currently available for this monograph.
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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.