Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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 (49)
- 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.
- olopatadine intranasal
ethanol and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- 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 (228)
- acrivastine
acrivastine and ethanol both increase sedation. Use Caution/Monitor.
- 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.
- asenapine
asenapine and ethanol both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and ethanol both increase sedation. Use Caution/Monitor.
- avanafil
ethanol, avanafil. additive vasodilation. Use Caution/Monitor. Combination may increase risk of orthostatic hypotension, tachycardia, dizziness and headache.
- avapritinib
avapritinib and ethanol both increase sedation. Use Caution/Monitor.
- 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.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen 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.
- brexpiprazole
brexpiprazole and ethanol both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and ethanol both increase 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).
brivaracetam and ethanol both increase sedation. Use Caution/Monitor. - 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 subdermal implant
buprenorphine subdermal implant and ethanol both increase sedation. Use Caution/Monitor.
- buprenorphine transdermal
buprenorphine transdermal 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.
buprenorphine, long-acting injection and ethanol both increase sedation. Use Caution/Monitor. - 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.
- daridorexant
ethanol and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- 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.
- fentanyl
fentanyl and ethanol both increase sedation. Use Caution/Monitor.
- fentanyl intranasal
fentanyl intranasal and ethanol both increase sedation. Use Caution/Monitor.
- fentanyl iontophoretic transdermal system
fentanyl iontophoretic transdermal system and ethanol both increase sedation. Use Caution/Monitor.
- fentanyl transdermal
fentanyl transdermal and ethanol both increase sedation. 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.
- ganaxolone
ethanol and ganaxolone both increase sedation. Use Caution/Monitor.
- 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.
- 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.
Adverse Effects
Frequency Not Defined
Intoxication
Flushing hypotension
Agitation
Hypoglycemia
N/V
Polyuria
Intoxication
Warnings
Contraindications
Hypersensitivity to ethyl alcohol or any component of the formulation; seizure disorder and diabetic coma; subarachnoid injection of dehydrated alcohol in patients receiving anticoagulants
Precautions
Heart block (septal ablation)
- Transient heart block is common at time alcohol is injected into septal artery; ~10% of complete heart block events become permanent and require a permanent pacemaker following percutaneous transluminal septal myocardial ablation
- Risk factors for permanent pacemaker dependency include a baseline PQ interval >160 msec, baseline minimum heart rate <50 bpm, baseline left ventricular outflow gradient >70 mmHg, maximum QRS during the first 48 hours >155 msec, third-degree atrioventricular block occurring during the procedure, and no clinical recovery between 12 to 48 hours after the procedure
Myocardial infarction
- Use is intended to create a controlled MI for therapeutic purposes; however, excessive myocardial necrosis and subsequent heart failure reported; factors increasing risk of excessive tissue necrosis include higher volume of alcohol used and a higher number of septal branches injected to reduce left ventricular outflow tract gradient
Ventricular arrhythmia (septal ablation)
- Ventricular tachycardia and ventricular fibrillation requiring electrocardioversion occurred at a frequency of approximately 1%; perform continuous electrocardiographic monitoring for 48 hours after the procedure
Disease-related concerns:
- Diabetes: Use with caution in patients with diabetes mellitus; ethyl alcohol may decrease blood sugar
- Gout: Use with caution in patients with gout
- Hepatic impairment: Use with caution in patients with hepatic impairment
- Shock: Use with caution in patients with shock
Special populations:
- Cranial surgery: Use with caution in patients following cranial surgery.
- Older adult: Use with caution in the elderly; the rate of heart blocks, pacemaker dependency, and dysrhythmia following injection into a septal artery increased with age.
- Infants: Minimize dermal exposure of ethyl alcohol in infants as significant systemic absorption and toxicity can occur.
Administration:
- Parenteral: Proper positioning of patient for neurolytic administration is essential to control localization of the injection of dehydrated alcohol (which is hypobaric) into the subarachnoid space; avoid extravasation
- Not for SC administration; not for administration simultaneously with blood due to possibility of pseudoagglutination or hemolysis; may potentiate severe hypoprothrombic bleeding; avoid extravasation during IV administration
- Antiseptic: Appropriate use: Improper use may lead to product contamination; although infrequent, product contamination has been associated with reports of localized and systemic infections; to reduce risk of infection, ensure antiseptic products are used according to labeled instructions; avoid diluting products after opening; and apply single-use containers only one time to one patient and discard any unused solution
- Monitoring: Clinical evaluation and periodic lab determinations, including serum ethanol levels, are necessary to monitor effectiveness, changes in electrolyte concentrations, and acid-base balance (when used as an antidote); monitor blood glucose closely, particularly in children as treatment of ingestions is associated with hypoglycemia
Pregnancy & Lactation
Pregnancy
Ethanol crosses the placenta, enters the fetal circulation, and has teratogenic effects in humans
The following withdrawal symptoms have been noted in the neonate following maternal ethanol consumption during pregnancy; crying, hyperactivity, irritability, poor suck, tremors, seizures, poor sleeping pattern, hyperphagia, and diaphoresis
Fetal alcohol syndrome (FAS) is a term referring to combination of physical, behavioral, and cognitive abnormalities resulting from ethanol exposure during fetal development; since a "safe" amount of ethanol consumption during pregnancy has not been determined, the AAP recommends those women who are pregnant refrain from all ethanol intake
When used as an antidote during second or third trimester, FAS is not likely to occur due to short treatment period; use during first trimester is controversial; following administration into septal artery during percutaneous transluminal septal myocardial ablation, systemic concentrations are not expected to result in significant exposure of ethanol to fetus, however procedure should be postponed until after delivery when possible
Lactation
Ethanol is present in breast milk in concentrations similar to maternal blood concentrations
Milk production may be decreased and adverse events to breastfeeding infant may occur (eg, sleep disturbances, impaired motor development or postnatal growth); the actual clearance of ethanol from breast milk is dependent upon the mother's weight and amount of ethanol consumed
Guidelines recommend to avoid drinking completely, or limit intake to equivalent of ethanol 0.5 g/kg/day and waiting 90 to 120 minutes after alcohol ingestion before breastfeeding; however, following administration into a septal artery during percutaneous transluminal septal myocardial ablation, systemic concentrations of endogenous alcohol are not expected to result in significant exposure of ethanol to the infant
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
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
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Dehydrated Alcohol injection - | 98 % vial |  |
Copyright © 2010 First DataBank, Inc.
Formulary
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