ethanol: clinical use

Prescribing considerations

• The selected eMC product is marked discontinued; confirm local specialist availability and governance.
• Neurolytic injection can cause prolonged or permanent nerve damage and requires informed consent, precise placement and appropriate imaging.
• Intravenous use for methanol poisoning requires specialist toxicology input and critical-care-level observation.
• Consider increased susceptibility in older people and cautions including hepatic impairment and peptic ulcer disease.
• For invasive nerve procedures, assess infection, anticoagulant or antiplatelet therapy and procedure-specific bleeding risk.

Contraindications and cautions

• Known hypersensitivity to ethanol

Monitoring

• For methanol poisoning, monitor blood ethanol and methanol-related biochemical markers according to specialist toxicology guidance.
• Monitor consciousness, respiration, glucose, temperature and cardiovascular status during systemic treatment.
• After neurolytic injection, monitor blood pressure, pulse, neurological status and procedure-related complications.

Clinical pharmacology

Ethanol is a central nervous system and vasomotor depressant. Local exposure near peripheral nerves causes neuritis and degeneration and reduces sodium and potassium conductance. It distributes rapidly, crosses the placenta and is mainly oxidised in the liver to acetaldehyde and then acetate.

Formulation and product differences

• The selected product is a sterile, clear, colourless dehydrated ethanol solution for injection with no listed excipients.
• It may require preparation or dilution appropriate to the intended specialist route; it is not interchangeable with drinking alcohol or topical alcohol.
• The selected eMC listing is discontinued.