Esophageal varices

Most common adverse reactions are-

Pleural effusion /infiltration 2%     esophageal ulcer  2%    pyrexia 1%    retrosternal pain 1%

Osephageal stricture 1%   and pneumonia 1%

Known hypersensitivity

Special Precautions-
 Varicosities of the leg-  the practice of injecting variosities of the leg with ethalnomine oleate
is not supported by adequately controlled trials.
Therefore such use is not recommended

Severe injection necrosis- the physician should bear in mind that severe injection necrosis
may result from direct injection of sclerosing agents, especially if excessive volumes are used

Cardiorespiratory disease - in patients with concomittant cardioprespiratory disease  careful
momitoring and minimization of total dose per session is recommended

Hypersensitivity reactions- fatal hypersensitivity shock was reported following injection of
larger than normal volume of ethanolamine injection into a man who had known allergic
disposition. possdibilty of anaphyltic reaction should be kept in mind.

Renal function impairment- acute renal failure with spontaneous recovery followed injection
of 15 to 20 ml of ethanolamine oleate injection in  a few cases

Pregnancy-  should be used in pregnant woman only if needed

Lactation-  should be given to nursing mothers only if clearly needed

Children- safety and efficacy for use inchildren have not been established

Elderly- fatal spiration pneumonia has occcurred in elderly patients undergoing  esophageal
sclerotherapy with ethalnolamine oleate. Special precautions should be taken especially in
elderly  and critically ill patients

Indication-
Esophageal varices

Dosage-
Local ethanolamine oleate injections sclerotherapy  of esophageal varices should be performed
by physicians who are familiar with an acceptable techniques

The usual IV dose is 1.5 to 5ml per varix .
The maximum dose per treatment session should not exceed 20ml.
Patients with significant liver dysfunction or concomittant cardiopulmonary discease usually receive
less than the recommended maximum dose 

Pregnancy- 
Should be used in pregnant woman only if needed

Lactation- 
Should be given to nursing mothers only if clearly needed

Children-
Safety and efficacy for use inchildren have not been established

Elderly-
Fatal spiration pneumonia has occcurred in elderly patients undergoing  esophageal
sclerotherapy with ethalnolamine oleate. Special precautions should be taken especially in
elderly  and critically ill patients