Ethanolamine Oleate

Pronunciation

(ETH a nol a meen OH lee ate)

U.S. Brand Names

Ethamolin®

Synonyms

Monoethanolamine

Generic Available

No

Use

Orphan drug: Sclerosing agent used for bleeding esophageal varices

Pregnancy Risk Factor

C

Contraindications

Hypersensitivity to agent or oleic acid

Warnings/Precautions

Fatal anaphylactic shock has been reported following administration; use with caution and decrease doses in patients with significant liver dysfunction (Child class C), with concomitant cardiorespiratory disease, or in the elderly or critically-ill

Adverse Reactions

1% to 10%:

Central nervous system: Pyrexia (1.8%)

Gastrointestinal: Esophageal ulcer (2%), esophageal stricture (1.3%)

Respiratory: Pleural effusion (2%), pneumonia (1.2%)

Miscellaneous: Retrosternal pain (1.6%)

<1%: Esophagitis, perforation, injection necrosis, acute renal failure, anaphylaxis

Overdosage/Toxicology

Anaphylaxis after administration of larger than normal volumes, severe intramural necrosis. Treatment is supportive with epinephrine, corticosteroids, fluids, and pressors.

Drug Interactions

No data reported

Mechanism of Action

Derived from oleic acid and similar in physical properties to sodium morrhuate; however, the exact mechanism of the hemostatic effect used in endoscopic injection sclerotherapy is not known. Intravenously injected ethanolamine oleate produces a sterile inflammatory response resulting in fibrosis and occlusion of the vein; a dose-related extravascular inflammatory reaction occurs when the drug diffuses through the venous wall. Autopsy results indicate that variceal obliteration occurs secondary to mural necrosis and fibrosis. Thrombosis appears to be a transient reaction.

Dosage

Adults: 1.5-5 mL per varix, up to 20 mL total or 0.4 mL/kg for a 50 kg patient; doses should be decreased in patients with severe hepatic dysfunction and should receive less than recommended maximum dose

Administration

Use care to use acceptable technique to avoid necrosis

Dental Health: Effects on Dental Treatment

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions

Dosage Forms

Injection, solution: 5% [50 mg/mL] (2 mL) [contains benzyl alcohol]