Paraldehyde


Full Prescribing Info
Dosage/Direction for Use

Oral
Sedation
Adult: As 1 g/ml solution: 4-8 ml; dilute in milk or iced fruit juice.
Child: As 1 g/ml solution: 0.15-0.3 ml/kg; dilute in milk or iced fruit juice.

Intramuscular

Status epilepticus
Adult: 5-10 ml (10% solution in sodium chloride 0.9% solution or diluted with 1 or 2 parts of oil); max of 20 ml daily, ≤5 ml given at any one site.
Child: Single daily dose: up to 3 mth: 0.5 ml; 3-6 mth: 1 ml; 6-12 mth: 1.5 ml; 1-2 yr: 2 ml; 3-5 yr: 3-4 ml; 6-12 yr: 5-6 ml.

Intravenous

Status epilepticus
Adult: Not usually recommended; should be diluted (4-5% solution) in normal saline before use: 0.1-0.3 ml/kg.

Rectal

Status epilepticus
Adult: 10-20 ml (10% solution in sodium chloride 0.9% solution or diluted with 1 or 2 parts of oil). Mix paraldehyde 2:1 with cottonseed or olive oil.
Child: Single daily dose: up to 3 mth: 0.5 ml; 3-6 mth: 1 ml; 6-12 mth: 1.5 ml; 1-2 yr: 2 ml; 3-5 yr: 3-4 ml; 6-12 yr: 5-6 ml. Mix paraldehyde 2:1 with cottonseed or olive oil.
Contraindications
Gastric disorders, rectal admin in colitis.
Special Precautions
Bronchopulmonary disease, hepatic impairment, pregnancy and lactation. Must be well diluted before administration. IV administrations should be well diluted and given very slowly with extreme caution. IM admin should be careful not to cause nerve damage. Admin using plastic syringes should be avoided. Partly decomposed paraldehyde is dangerous if given, do not give if brownish in colour or has sharp penetrating odour of acetic acid. Do not abruptly discontinue in chronic use.
Adverse Reactions
Unpleasant taste, imparts smell to breath; skin rashes. Oral and rectal admin may cause gastric or rectal irritation; IM admin is associated with tissue necrosis, sterile abscesses, and nerve damage; IV admin may cause pulmonary oedema, haemorrhage, hypotension, cardiac dilatation, circulatory collapse and thrombophloebitis. Prolonged use may lead to dependence (especially in alcoholics).
Overdosage
Rapid laboured breathing (secondary to lung damage and to acidosis); nausea and vomiting; respiratory depression and coma; hepatic and renal damage.
Drug Interactions
Addtice sedative effects and/or respiratory depression with CNS depressants (e.g. barbiturates, ethanol, narcotic analgesics and other sedatives). Disulfiram may increase risk of toxicity of paraldehyde. Avoid alcohol.
Lab Interference
Ketonuria may be present.
Action
Paraldehyde is a hypnotic and sedative with antiepileptic effects. It is occasionally used to control status epilepticus resistant to conventional treatment.
Onset: Hypnosis: Oral: Within 10-15 min; IM: Within 2-3 min.
Duration: 6-8 hr
Absorption: Readily absorbed; slower after rectal than after oral or IM doses.
Distribution: Widely distributed; Half-life: 4-10 hr. Crosses the placenta, distributed into breast milk.
Metabolism: Hepatic (approx 70-80% of a dose), to acetaldehyde, which is oxidised by aldehyde dehydrogenase to acetic acid.
Excretion: Approx 30% as unchanged drug in expired air via the lungs; trace amounts via urine unchanged.
Storage
Intramuscular: Store in tightly closed containers; protect from light. Intravenous: Store in tightly closed containers; protect from light. Oral: Store in tightly closed containers; protect from light. Rectal: Store in tightly closed containers; protect from light.
ATC Classification
N05CC05 - paraldehyde ; Belongs to the class of aldehydes and derivatives. Used as hypnotics and sedatives.
Disclaimer: This information is independently developed by CIMS based on paraldehyde from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 CIMS. All rights reserved. Powered by CIMSAsia.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in