Paraldehyde is a type of sedative. This drug can be used to treat seizures or relieve anxiety caused by withdrawal symptoms in drug or alcohol addicts .

The exact mechanism of action of paraldehyde is not yet known. However, this drug is believed to work by depressing the central nervous system, causing a calming and drowsiness effect.

However, this drug is usually only used in certain conditions, for example in seizures due to tetanus, status epilepticus, or anticonvulsant drug poisoning . Paraldehyde is also used to relieve anxiety only when other medications are not working.

Paraldehyde trademark :-

What is Paraldehyde

class Prescription drug
Category Anticonvulsant/Anxiety/Hypnotic/Sedative
Benefit Overcome seizures and anxiety in withdrawal symptoms
Used by Adults and children >3 months of age
Paraldehyde for pregnant and lactating women Category D:  There is positive evidence of risk to the human fetus, but the benefits may outweigh the risks, for example in dealing with a life-threatening situation. Paraldehyde is not recommended for use in pregnant women. It is not known whether paraldehyde is absorbed into breast milk or not. In addition, there is no adequate data regarding the safety of using paraldehyde in nursing mothers. If you are breastfeeding, discuss with your doctor first about the benefits and risks of using this drug.
Drug form Injectable fluids, solutions to drink, and fluids to insert into the rectum (1 gram/ml concentration)

Warning Before Using Paraldehyde

Paraldehyde should only be used according to a doctor's prescription. There are several things that need to be considered before undergoing treatment with paraldehyde, namely:

  • Tell your doctor about any history of allergies you have. Paraldehyde should not be given to patients who are allergic to this drug.
  • Tell your doctor if you have chronic obstructive pulmonary disease (COPD) or severe liver disease. Paraldehyde should not be used by patients with these conditions.
  • Tell your doctor if you have or have had enteritis, gastroenteritis ( vomiting ), stomach ulcers, alcoholism , drug abuse , asthma, emphysema, or bronchitis.
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy. Paraldehyde should not be used in pregnant women.
  • Tell your doctor about any other medications, supplements, or herbal products you are currently taking.
  • Tell your doctor if you are taking drugs that can also depress the central nervous system, such as opioids or narcotics. Paraldehyde should not be used with these drugs as it can cause respiratory failure and death.
  • Avoid consuming alcoholic beverages while using paraldehyde, because it can make side effects worse.
  • Tell your doctor that you are being treated with paraldehyde if you are planning to have any surgery or medical exam.
  • Do not drive a vehicle, operate heavy machinery, or do activities that require alertness after using paraldehyde, because this drug can cause drowsiness.
  • Do not use paraldehyde in eyes and avoid contact with skin or clothing. In case of contact with eyes or skin, rinse immediately with cold water for at least 10 minutes.
  • See a doctor immediately if you experience a drug allergic reaction , overdose, or serious side effects after using paraldehyde.

Dosage and Rules for Using Paraldehyde

The dosage of paraldehyde depends on the dosage form of the drug, the patient's condition and response to treatment, and the patient's weight (in children).

In general, the following is the dosage of paraldehyde according to the form of the drug and its intended use:

Solution to drink

Purpose: Provides a calming effect for anxiety in withdrawal symptoms

  • Adult: 4–8 mg, dissolved in a glass of milk or a glass of fruit juice.
  • Children: 0.15–0.3 mg/kg, dissolved in a glass of milk or a glass of fruit juice.

Fluid to put into the rectum (enema)

Purpose: Treat status epilepticus

  • Adult: 10–20 ml mixed with 5–10 ml olive oil (ratio 2:1).
  • Children: Age 3–6 months 0.5–1 ml dose, Age 6–12 months 1.5 ml dose, Age 1–2 years 2 ml dose, Age 3–5 years 3–4 ml dose, Age 6 –12 years dose 5–6 ml.
    Use paraldehyde mixed with olive oil (2:1 ratio).

Paraldehyde in injectable form is used to treat seizures due to tetanus , status epilepticus, anticonvulsant drug poisoning, and treat acute anxiety or delirium in withdrawal symptoms. The dose of injectable paraldehyde is determined by the doctor based on the symptoms that occur and the patient's weight.

How to Use Paraldehyde Properly

Follow the doctor's advice and read the information printed on the drug packaging label before using paraldehyde. Do not reduce or increase the dose, and use the drug beyond the timeframe recommended by the doctor. The use of paraldehyde in large doses and long term can lead to dependence.

The injectable type of paraldehyde will be given directly by a doctor or medical officer under the supervision of a doctor. The doctor will inject it into the muscle in the patient's buttocks.

Paraldehyde is a clear liquid with a pleasant aroma. Do not use if the liquid medicine has changed color or smells of vinegar. Do not use a plastic spoon, plastic cup, or other plastic container, because this medication can melt the plastic.

For paraldehyde in the form of a solution to drink, use a metal spoon or glass cup. Take the drug according to the dosage recommended by the doctor, then mix it into a glass of milk or fruit juice. The goal is to make it taste better and to reduce the risk of stomach discomfort.

For patients using paraldehyde in the form of liquid enemas, be sure to understand how to use it or if necessary ask a doctor. Generally, this drug needs to be diluted before use.

Here's how to use paraldehyde in enema form:

  • Wash hands before and after using this medicine.
  • Prepare gloves and an enema tool, namely in the form of an enema bottle and a tube. This tool can be purchased at the pharmacy.
  • Prepare a liquid enema made from a mixture of paraldehyde and olive oil, or as directed by your doctor. After that, fill the enema bottle with the solution.
  • Take a side lying position like curling up, then slowly insert the end of the enema tube into the anus, and press the enema bottle until the medicine enters the anus completely.
  • When all of the enema fluid has gone in, slowly release the enema. Remain lying down for a few minutes to prevent the medicine from coming back out.

If you forget to use paraldehyde in time, it is recommended to use it immediately as soon as you remember if the break with the next scheduled use is not too close. If it's close, ignore it and don't double the dose.

Do not stop medication without consulting your doctor first. The doctor will reduce the dose of paraldehyde gradually.

While undergoing treatment with paraldehyde, follow the treatment schedule set by the doctor. You need to undergo regular health checks to monitor the development of the condition and response to therapy.

Store liquid or paraldehyde solution in a closed container in a room with a cool temperature. Keep this medicine away from heat sources, direct sunlight and out of reach of children.

Interactions of Paraldehyde with Other Drugs

The use of paraldehyde together with other drugs can cause interactions between drugs, including:

  • Increased effect of drowsiness and defocus when used with barbiturate drugs , antidepressants, benzodiazepines , or other types of sedative drugs
  • Increased risk of paraldehyde drug poisoning when used with disulfiram drugs
  • Increased risk of developing hypotension when used with diuretic drugs , such as furosemide and hydrochlorothiazide

Avoid consuming alcoholic beverages while on treatment with paraldehyde because it can make side effects worse. Also, avoid herbal supplements that contain ginkgo biloba because they can reduce the effectiveness of paraldehyde.

Side Effects and Dangers of Paraldehyde

Side effects that may arise after using paraldehyde are:

  • Sleepy
  • Nausea or vomiting
  • Stomach ache or heartburn
  • Bad breath
  • Dizzy, unsteady
  • Cough
  • skin rash
  • Redness, swelling, or pain at the injection site
  • Rash and irritation in the rectum or anal area

Generally, the side effects above are mild and gradually disappear after several uses of the drug. Doctors can prescribe medication or recommend ways to prevent and reduce these side effects.

Check with your doctor if the side effects mentioned above do not go away or get worse. Tell your doctor right away if you have any of the following allergic reactions or signs of an overdose:

  • Excessive sweating
  • Tremors
  • Severe muscle cramps or stomach cramps
  • Infrequent urination, cloudy urine
  • Hard to breathe
  • Nervousness, restlessness, irritability, confusion
  • Heart rate slows down
  • The skin and eyes are yellowish
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