Ethanolamine Oleate
Mechanism :
Ethanolamine acts primarily by irritation of the intimal endothelium of the vein and produces a sterile dose-related inflammatory response. This results in fibrosis and possible occlusion of the vein. Ethanolamine oleate also rapidly diffuses through the venous wall and produces a dose-related extravascular inflammatory reaction.
The oleic acid component of ethanolamine oleate is responsible for the inflammatory response and may also activate coagulation in vivo by release of tissue factor and activation of Hageman factor. The ethanolamine component, however, may inhibit fibrin clot formation by chelating calcium, so that a procoagulant action of ethanolamine oleate has not been demonstrated.
Indication :
- Esophageal varices that have recently bled, to prevent re-bleeding.
Contraindications :
Known hypersensitivity to ethanolamine, oleic acid, or ethanolamine oleate.
Dosing :
1.5 to 5 mL per varix. The maximum dose per treatment session should not exceed 20 mL.
Adverse Effect :
Pleural effusion/infiltration, fever, esophageal ulcer, esophageal stricture, retrosternal pain, and pneumonia. Esophagitis, sloughing of the mucosa overlying the injected varix, ulceration, tearing of the esophagus, necrosis, stricture, periesophageal abscess and perforation have also been reported.
Interaction :
Not known.
Hepatic Dose :
Mild to moderate hepatic impairment: No dosage adjustment needed.
Severe hepatic impairment: These patients are more likely to develop esophageal ulceration. Doses less than the maximum (20 mL) per treatment session are recommended.