Alcohol

Aka: Alcohol, Ethyl Alcohol, Ethanol, Alcohol-Related Drug Interactions, Toxic Effect of Alcohol, Alcohol Toxicity, Alcohol Related Cardiac Effects, Toxic Alcohol

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II. Physiology

  1. Central Nervous System Depressant and Sedative via GABA-mediated activation
  2. Metabolism
    1. Alcohol undergoes hepatic metabolism in the liver by Alcohol dehydrogenase
    2. Alcohol elimination follows a dose dependent rate

III. Adverse Effects

  1. Ethanol in Children (Acute Poisoning)
    1. See Alcohol Poisoning
    2. Hypoglycemia
  2. Ethanol in Adults
    1. Alcohol Abuse
    2. Alcoholic Hepatitis and Cirrhosis
    3. Korsakoff's Disease
    4. Fetal Alcohol Syndrome
  3. Toxic Alcohols
    1. Methanol Poisoning
      1. Acute Vision Loss
      2. Parkinsonism
      3. Hemorrhagic Pancreatitis
      4. Death
    2. Ethylene Glycol Poisoning
      1. Renal Failure
    3. Isopropyl Alcohol Poisoning
      1. Rhabdomyolysis
      2. Shock

IV. Drug Interactions: Disulfiram Reaction Risk (Antabuse Reaction Risk)

  1. Chlorpropamide
  2. Antibiotics
    1. Metronidazole
    2. Tinidazole
    3. Cefoperazone
    4. Cefotetan

V. Drug Interactions: Drug effect potentiated by Alcohol

  1. Warfarin
    1. Increased INR with acute Alcohol use, decreased INR with chronic Alcohol use
  2. Sulfonylureas (Hypoglycemia)
  3. Avinza (Morphine Overdose due to rapid release)
  4. Extended-release agents (never use with Alcohol)
    1. Nucynta ER
    2. Zohydro ER
    3. Opana ER
    4. Embeda
  5. CNS Depressants
    1. Benzodiazepines
    2. Opioids
    3. Benzodiazepine Receptor Agonist (e.g. Zolpidem or Ambien)

VI. Drug Interactions: Toxicity potentiated by Alcohol

  1. Hepatotoxicity risk
    1. Heavy Alcohol use potentiates hepatotoxicity (esp. >2 drinks per day)
    2. Isoniazid
    3. Acetaminophen
      1. Potentiated hepatotoxicity when Overdosed >4 grams/day
  2. Other effects
    1. NSAIDs or Aspirin (higher risk of Gastrointestinal Bleeding)
    2. Acitretin (converts to Teratogenic metabolites that take years to fully excrete)
    3. Chantix (increased aggressive behavior, Amnesia, Intoxication)
    4. Addyi or Flibanserin (severe Hypotension risk; no Alcohol within 2 days of Addyi use)

VII. Precautions

  1. Powdered Alcohol (Palcohol)
    1. Approved by TTB in U.S., 2015 (but individual states may ban)
    2. Freeze-dried Alcohol in single serving sizes (one shot of liquor)
    3. Reconstituted with 6 ounces water
    4. Increased risk of abuse by teens
    5. (2015) Presc Lett 22(6): 34

VIII. Indications: Ethyl Alcohol Medical Uses

  1. Ethylene Glycol Poisoning
  2. Cardiovascular Prevention
    1. Excessive use has significant adverse effects
    2. Those who do not drink, should not start
    3. Alcohol's benefit is limited to low to moderate use
      1. Increases Cardioprotective Apolipoprotein A-1
      2. Decreases Atherogenic Apolipoprotein B
      3. Inhibits Platelet aggregation
      4. May result in Coronary Artery vasodilation

IX. References

  1. (2015) Presc Lett 22(12): 70
  2. (2008) Presc Lett 15(1):3

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Related Studies

Cost: Medications

alcohol (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
ALCOHOL 70% PREP PADS Generic OTC $0.01 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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