Ethanolamine oleate is a medication used in sclerotherapy, a medical procedure used to treat varicose veins and esophageal varices. It is a sclerosing agent, meaning it is injected directly into the affected veins to cause them to shrink and eventually disappear. Ethanolamine oleate works by causing inflammation and scarring within the vein, which ultimately leads to its closure.

This medication is typically administered by a healthcare professional during a sclerotherapy session. It is important to follow the instructions of your healthcare provider carefully when undergoing sclerotherapy treatment with ethanolamine oleate.

Ethamolin (Ethanolamine oleate) is a sclerosant agent that is injected directly into the dilated tortuous veins (varix, varices) of the esophagus or stomach in patients with portal hypertension or liver fibrosis. It causes an inflammatory reaction in the walls of the varix resulting in fibrosis and occlusion of the vessels.

Ethamolin (Ethanolamine oleate) Uses:

• Esophageal varices:
  • It is indicated for the treatment of esophageal varices that has recently bled to prevent rebleeding episodes.

Ethamolin dose in Adults

Ethamolin dose in the treatment of Esophageal varices:

• Ethanolamine oleate is a medicine used to treat esophageal varices, which are swollen veins in the throat that can bleed.
• When given through a vein (IV), the typical dose is 1.5 to 5 mL for each swollen vein, with a maximum of 20 mL in one treatment.
• This treatment can be done when there's a sudden bleeding episode and then repeated after 1 week, 6 weeks, 3 months, and 6 months if needed.
• However, patients with heart or lung problems usually get a lower dose than the maximum to avoid complications.

Dose in children:

Not indicated.

Pregnancy Risk Factor: C

• Ethanolamine oleate is classified as a pregnancy risk factor C, which means that there haven't been studies done on how it affects pregnancy in animals.
• This rating indicates that it's uncertain whether it's safe to use during pregnancy, and the potential risks to the fetus are not fully known.

Use of ethanolamine oilate during breastfeeding

• It's unclear whether ethanolamine oleate passes into breast milk.
• Because of this uncertainty, the manufacturer advises caution when using ethanolamine oleate in nursing mothers.
• This means healthcare providers should carefully weigh the potential benefits and risks before deciding whether to administer it to breastfeeding women.

Dose in Kidney Disease:

• The manufacturer's instructions do not include specific dosage adjustments for people with kidney problems.
• This means that individuals with renal impairment may not need to alter the dose of ethanolamine oleate based solely on their kidney function.

Ethamolin Dose in Liver disease:

• The manufacturer's instructions do not offer specific dosage adjustments for patients with liver impairment.
• However, individuals with severe liver impairment, classified as Child-Pugh class C, typically should receive a lower dose than the recommended maximum.

Side Effects of Ethanolamine oleate (Ethamolin):

• Cardiovascular:
  • Substernal pain
• Gastrointestinal:
  • Esophageal ulcer
  • Esophageal stenosis
• Respiratory:
  • Pleural effusion
  • Pneumonia
• Miscellaneous:
  • Fever

Contraindications to Ethanolamine oleate (Ethamolin):

• People who have a hypersensitivity or allergy to ethanolamine, oleic acid, ethanolamine oleate, or any other ingredient in the formulation should not use ethanolamine oleate.
• Hypersensitivity reactions can range from mild to severe and may include symptoms such as rash, itching, swelling, or difficulty breathing.

Warnings and precautions

Anaphylaxis

• Anaphylaxis, which is a severe allergic reaction, including fatal anaphylactic shock, has been reported after injecting a larger-than-normal volume of ethanolamine oleate.
• This highlights the importance of administering the medication carefully and using the appropriate dosage to minimize the risk of such reactions.

Injection necrosis:

• Injection necrosis, which is severe tissue death at the injection site, can occur if sclerosing agents like ethanolamine oleate are injected directly and in excessive amounts.
• There have been reports of severe cases of injection necrosis, including a fatal instance of extensive esophageal necrosis resulting in death.
• This underscores the importance of careful administration of sclerosing agents, using appropriate volumes, and ensuring that healthcare providers are trained to minimize the risk of such complications.
• Any signs of tissue damage or adverse reactions should be promptly addressed to prevent serious consequences.

Effects on the renal system:

• There have been reports of acute renal failure occurring with the use of ethanolamine oleate.
• However, it's important to note that in some cases, patients have experienced spontaneous recovery from this condition.

Cardiorespiratory disease

• In individuals with pre-existing cardiorespiratory conditions, it's essential to use ethanolamine oleate with caution.
• Healthcare providers should minimize the total dose given during each treatment session and closely monitor patients for any adverse effects.
• This approach helps to mitigate the potential risks associated with the use of ethanolamine oleate in patients with underlying cardiorespiratory disease and ensures their safety during the treatment process.

Hepatic impairment

• In patients with severe hepatic impairment, specifically those classified as Child-Pugh class C, the use of ethanolamine oleate should be approached with caution.
• These patients are at a higher risk of developing esophageal ulceration.
• Therefore, it is recommended to administer a dose lower than the maximum to minimize the potential for adverse effects.

Monitoring Parameters:

Observe the patient for retrosternal chest pain and signs of upper GI bleed (melena, hypotension, and tachycardia).

How to administer Ethanolamine oleate (Ethamolin)?

• To prevent injection necrosis, which can occur with the direct injection of sclerosing agents like ethanolamine oleate, it's crucial to use an acceptable injection technique.
• This means being careful not to use excessive volumes of the medication.
• Additionally, it's important to avoid injecting the medication into the submucosal layer, as this can increase the risk of ulceration and necrosis.

Mechanism of action of Ethanolamine oleate (Ethamolin):

• Ethanolamine oleate triggers a sterile inflammatory response that is related to the dosage administered.
• This response leads to the development of fibrosis, which can eventually block the vein.
• Additionally, there's a dose-dependent inflammatory reaction that occurs outside the vein when the medication diffuses through the venous wall.
• These effects contribute to the therapeutic action of ethanolamine oleate in sclerotherapy, where the goal is to close off abnormal veins by inducing controlled inflammation and scarring.

International Brand Names of Ethanolamine oleate:

• Ethamolin

Ethanolamine oleate Brand Names in Pakistan:

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Ethanolamine oleate is a medication used in sclerotherapy, a medical procedure used to treat varicose veins and esophageal varices. It is a sclerosing agent, meaning it is injected directly into the affected veins to cause them to shrink and eventually disappear. Ethanolamine oleate works by causing inflammation and scarring within the vein, which ultimately leads to its closure.

This medication is typically administered by a healthcare professional during a sclerotherapy session. It is important to follow the instructions of your healthcare provider carefully when undergoing sclerotherapy treatment with ethanolamine oleate.

Ethamolin (Ethanolamine oleate) is a sclerosant agent that is injected directly into the dilated tortuous veins (varix, varices) of the esophagus or stomach in patients with portal hypertension or liver fibrosis. It causes an inflammatory reaction in the walls of the varix resulting in fibrosis and occlusion of the vessels.

Ethamolin (Ethanolamine oleate) Uses:

• Esophageal varices:
  • It is indicated for the treatment of esophageal varices that has recently bled to prevent rebleeding episodes.

Ethamolin dose in Adults

Ethamolin dose in the treatment of Esophageal varices:

• Ethanolamine oleate is a medicine used to treat esophageal varices, which are swollen veins in the throat that can bleed.
• When given through a vein (IV), the typical dose is 1.5 to 5 mL for each swollen vein, with a maximum of 20 mL in one treatment.
• This treatment can be done when there's a sudden bleeding episode and then repeated after 1 week, 6 weeks, 3 months, and 6 months if needed.
• However, patients with heart or lung problems usually get a lower dose than the maximum to avoid complications.

Dose in children:

Not indicated.

Pregnancy Risk Factor: C

• Ethanolamine oleate is classified as a pregnancy risk factor C, which means that there haven't been studies done on how it affects pregnancy in animals.
• This rating indicates that it's uncertain whether it's safe to use during pregnancy, and the potential risks to the fetus are not fully known.

Use of ethanolamine oilate during breastfeeding

• It's unclear whether ethanolamine oleate passes into breast milk.
• Because of this uncertainty, the manufacturer advises caution when using ethanolamine oleate in nursing mothers.
• This means healthcare providers should carefully weigh the potential benefits and risks before deciding whether to administer it to breastfeeding women.

Dose in Kidney Disease:

• The manufacturer's instructions do not include specific dosage adjustments for people with kidney problems.
• This means that individuals with renal impairment may not need to alter the dose of ethanolamine oleate based solely on their kidney function.

Ethamolin Dose in Liver disease:

• The manufacturer's instructions do not offer specific dosage adjustments for patients with liver impairment.
• However, individuals with severe liver impairment, classified as Child-Pugh class C, typically should receive a lower dose than the recommended maximum.

Side Effects of Ethanolamine oleate (Ethamolin):

• Cardiovascular:
  • Substernal pain
• Gastrointestinal:
  • Esophageal ulcer
  • Esophageal stenosis
• Respiratory:
  • Pleural effusion
  • Pneumonia
• Miscellaneous:
  • Fever

Contraindications to Ethanolamine oleate (Ethamolin):

• People who have a hypersensitivity or allergy to ethanolamine, oleic acid, ethanolamine oleate, or any other ingredient in the formulation should not use ethanolamine oleate.
• Hypersensitivity reactions can range from mild to severe and may include symptoms such as rash, itching, swelling, or difficulty breathing.

Warnings and precautions

Anaphylaxis

• Anaphylaxis, which is a severe allergic reaction, including fatal anaphylactic shock, has been reported after injecting a larger-than-normal volume of ethanolamine oleate.
• This highlights the importance of administering the medication carefully and using the appropriate dosage to minimize the risk of such reactions.

Injection necrosis:

• Injection necrosis, which is severe tissue death at the injection site, can occur if sclerosing agents like ethanolamine oleate are injected directly and in excessive amounts.
• There have been reports of severe cases of injection necrosis, including a fatal instance of extensive esophageal necrosis resulting in death.
• This underscores the importance of careful administration of sclerosing agents, using appropriate volumes, and ensuring that healthcare providers are trained to minimize the risk of such complications.
• Any signs of tissue damage or adverse reactions should be promptly addressed to prevent serious consequences.

Effects on the renal system:

• There have been reports of acute renal failure occurring with the use of ethanolamine oleate.
• However, it's important to note that in some cases, patients have experienced spontaneous recovery from this condition.

Cardiorespiratory disease

• In individuals with pre-existing cardiorespiratory conditions, it's essential to use ethanolamine oleate with caution.
• Healthcare providers should minimize the total dose given during each treatment session and closely monitor patients for any adverse effects.
• This approach helps to mitigate the potential risks associated with the use of ethanolamine oleate in patients with underlying cardiorespiratory disease and ensures their safety during the treatment process.

Hepatic impairment

• In patients with severe hepatic impairment, specifically those classified as Child-Pugh class C, the use of ethanolamine oleate should be approached with caution.
• These patients are at a higher risk of developing esophageal ulceration.
• Therefore, it is recommended to administer a dose lower than the maximum to minimize the potential for adverse effects.

Monitoring Parameters:

Observe the patient for retrosternal chest pain and signs of upper GI bleed (melena, hypotension, and tachycardia).

How to administer Ethanolamine oleate (Ethamolin)?

• To prevent injection necrosis, which can occur with the direct injection of sclerosing agents like ethanolamine oleate, it's crucial to use an acceptable injection technique.
• This means being careful not to use excessive volumes of the medication.
• Additionally, it's important to avoid injecting the medication into the submucosal layer, as this can increase the risk of ulceration and necrosis.

Mechanism of action of Ethanolamine oleate (Ethamolin):

• Ethanolamine oleate triggers a sterile inflammatory response that is related to the dosage administered.
• This response leads to the development of fibrosis, which can eventually block the vein.
• Additionally, there's a dose-dependent inflammatory reaction that occurs outside the vein when the medication diffuses through the venous wall.
• These effects contribute to the therapeutic action of ethanolamine oleate in sclerotherapy, where the goal is to close off abnormal veins by inducing controlled inflammation and scarring.

International Brand Names of Ethanolamine oleate:

• Ethamolin

Ethanolamine oleate Brand Names in Pakistan:

Not available.