Ethanol
Ethyl alcohol
Also known as: Grain alcohol · Everclear · Vodka (used for compounding) · Medical alcohol · aethanolum · alcool · ethyl alcohol · EtOH
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Ethylene glycol poisoning | 5.5 mL/kg IV q4h for 5 treatments, then q6h for four additional treatments | IV | q4h then q6h | 9 treatments total | 🌎 NA |
| Ethylene glycol poisoning | 8.6 mL/kg slowly IV followed by a CRI of 1.43 mL/kg/hr | IV | CRI | at least 36 hours although 48 hours is probably better | 🌎 NA |
| Ethylene glycol toxicity | 5.5 ml of 20% ethanol solution/kg | IV | q4h for 5 treatments, then q6h for 4 additional treatments | 9 treatments total | 🌍 EU |
| Ethylene glycol toxicity (CRI method) | Loading dose of 1.3 ml/kg of 30% solution, then 0.42 mg/kg/h | IV | CRI | 48 hours | 🌍 EU |
| Ethylene glycol toxicity (mild cases) | As directed (equivalent to IV dosing) | PO | As directed | Until toxicity resolves | 🌍 EU |
- Ethylene glycol poisoning: As a 20% solution; dosed as a CRI over 1 hour
- Ethylene glycol poisoning: Make a 7% ethanol solution. If EG test was positive initially, check before stopping treatment; discontinue if it reverts to negative.
- Ethylene glycol toxicity: Adjust dose to maintain blood ethanol levels above 35 mg/dl.
- Ethylene glycol toxicity (CRI method): Constant rate infusion method.
- Ethylene glycol toxicity (mild cases): For clinically mild cases with minimal CNS signs; vodka is often used.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Ethylene glycol poisoning | 5 mL/kg IV q6h for 5 treatments, then q8h for four additional treatments | IV | q6h then q8h | 9 treatments total | 🌎 NA |
| Ethylene glycol poisoning | 8.6 mL/kg slowly IV followed by a CRI of 1.43 mL/kg/hr | IV | CRI | at least 36 hours although 48 hours is probably better | 🌎 NA |
| Ethylene glycol toxicity | 5 ml of 20% ethanol solution/kg | IV | q6h for 5 treatments, then q8h for 4 additional treatments | 9 treatments total | 🌍 EU |
- Ethylene glycol poisoning: As a 20% solution; dosed as a CRI over 1 hour
- Ethylene glycol poisoning: Make a 7% ethanol solution. If EG test was positive initially, check before stopping treatment; discontinue if it reverts to negative.
- Ethylene glycol toxicity: Fomepizole is generally preferred over ethanol in cats if available.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Ethanol (ethyl alcohol) is primarily used in veterinary medicine as an antidote for ethylene glycol (antifreeze) or methanol toxicity.
- Fomepizole (4-MP) is generally the modern treatment of choice for ethylene glycol poisoning, but ethanol remains a readily available and economical alternative if the patient presents within a few hours of ingestion.
- Alternative uses: Percutaneous injection of 95% ethanol has been used successfully to treat feline hyperthyroidism. Aerosolized ethanol has been used as a mucokinetic agent in horses.
Clinical Pearl: In emergency settings where pharmaceutical-grade ethanol is unavailable, commercial spirits (like vodka or grain alcohol/Everclear) are frequently compounded into IV fluids to create life-saving infusions.
Mechanism of action
Ethanol acts by competitively inhibiting the enzyme alcohol dehydrogenase.
- Ethylene glycol/Methanol + Alcohol dehydrogenase → Toxic metabolites (glycoaldehyde, glycolate, glyoxalate, and oxalic acid).
- By occupying the enzyme, ethanol prevents this conversion, allowing the parent toxin (ethylene glycol or methanol) to be excreted primarily unchanged in the urine.
- Note: For alcohol to be effective, it must be given very early after ingestion; it is seldom useful if started 8 hours after a significant ingestion.
Safety & warnings
Contraindications
- Concurrent use with fomepizole (usually contraindicated)
Adverse effects
- CNS depression
- Respiratory depression
- Diuresis
- Hypocalcemia
- Metabolic acidosis
- Pulmonary edema
- Injection site pain and infection
- Phlebitis
- Extravasation injury
- Bronchoconstriction and irritation (when aerosolized)
Precautions
Because ethylene glycol and methanol intoxications are life-threatening, there are no absolute contraindications to ethanol's use for these indications. Monitor fluid and electrolyte therapy requirements closely, as both the toxin and ethanol can cause diuresis. Watch for and avoid extravasation. Use during pregnancy only when necessary (FDA Category C). Ethanol may cause false positive reports on ethylene glycol screening tests.
Drug interactions
Alcohol may increase the severity of side effects seen with bromocriptine
Will inhibit absorption of orally administered ethanol; do not use if administering ethanol orally
Alcohol may cause additive CNS depression
Inhibits alcohol dehydrogenase; ethanol metabolism is reduced significantly and alcohol poisoning (CNS depression, coma, death) can occur. Use together is generally not recommended.
Alcohol may affect glucose metabolism and the actions of insulin or oral antidiabetic agents
A disulfiram reaction (increased acetaldehyde with tachycardia, vomiting, weakness) may occur
Increases risk of severe alcohol toxicity; concurrent use should be avoided.
Monitoring
- Alcohol blood levels (maintain at 100 to 130 mg/dL; safer to maintain >130 mg/dL than to fall below 100 mg/dL)
- Ethylene glycol or methanol levels
- Degree of CNS effect
- Fluid and electrolyte status
Pharmacokinetics
Absorption
Well absorbed orally, but administered intravenously for toxicity treatment.
Distribution
Rapidly distributes throughout the body and crosses the blood-brain barrier. Crosses the placenta and passes freely into milk.
Metabolism
Metabolized primarily in the liver by alcohol dehydrogenase.
Elimination
Excreted primarily via metabolism, with small amounts excreted unchanged in urine and breath.
Overdose
If clinical signs of overdosage occur (lateral nystagmus, respiratory depression, profound obtundation), either slow the infusion or discontinue temporarily. Alcohol blood levels may be used to monitor both efficacy and toxicity of alcohol.
Available products
Formulations
- Intravenous infusion (often compounded)
- Aerosol
- Percutaneous injection
Human-labeled
- 5% Alcohol and 5% Dextrose in Water in 1000 mL
- 10% Alcohol and 5% Dextrose in Water in 1000 mL
Regulatory status
POM (Prescription Only Medicine).
POM (Prescription Only Medicine).
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Alcohol should be protected from extreme heat or freezing. Do not use unless the solution is clear. Alcohol may precipitate many drugs; do not administer other medications in the alcohol infusion solution unless compatibility is documented.
Client information
- Intensive Care: Systemically administered alcohol is a life-saving antidote that must be given in a controlled clinical environment (ICU).
- Side Effects: Your pet will essentially be "intoxicated" during treatment. We will closely monitor their central nervous system, breathing, and fluid/electrolyte balance.
- Time-Sensitive: This treatment is most effective when started immediately after antifreeze or methanol ingestion.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.