Ethchlorvynol

A to Z Drug Facts

 Action Unknown; produces CNS depressant effects similar to those of barbiturates.

 Indications Short-term therapy in management of insomnia (up to 1 wk). Unlabeled use(s): Sedation.

 Contraindications Porphyria.

 Route/Dosage

ADULTS: PO 500–1000 mg at bedtime. If patient awakens in early morning, give additional 200 mg.

 Interactions

Alcohol and CNS depressants: Enhances CNS depressant effects. Anticoagulants: May decrease anticoagulant activity.

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: Hypotension. CNS: Dizziness; facial numbness; paradoxical reaction (eg, excitement, restlessness). EENT: Blurred vision. GI: Nausea; vomiting; gastric upset; unpleasant taste in mouth. HEMA: Thrombocytopenia. OTHER: Hangover; muscle weakness; symptoms of acute toxicity (eg, low body temperature, shortness of breath, slow heart beat); symptoms of chronic toxicity (eg, confusion, slurred speech, double vision, tingling, trembling, staggering); hypersensitivity reactions (eg, rash, itching, cholestatic jaundice).

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Elderly or debilitated patients: Should receive smallest effective dose. Dependency: Do not administer for periods longer than 1 wk. Prolonged use may lead to tolerance or physical and psychological dependence; withdrawal symptoms (including intoxication, tremors, slurred speech, diplopia, muscle weakness) may occur after prolonged use. Use with caution or avoid in patients with history of drug/alcohol abuse. Mental depression: Use with caution in depressed patients with or without suicidal tendencies. Renal and hepatic impairment: Use with caution. Tartrazine sensitivity: Some products contain tartrazine, which may cause allergic-type reactions in susceptible individuals.

 Administration/Storage

• Obtain baseline vital signs before administering drug. If respiratory rate is < 12–14 breaths/min, do not administer medication.
• Administer with snack and full glass of water, milk or fruit juice to reduce potential giddiness and ataxia.
• Instruct patient to swallow capsule whole and not to chew.
• Supplemental dose of 200 mg may be given if patient reawakens during early morning hrs following bedtime dose.
• Store in tightly closed, light-resistant container at room temperature.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Note use of CNS depressants or anticoagulants, drug or alcohol abuse, depression, suicidal tendencies, porphyria, renal or liver disease and hypersensitivity reactions, especially to ethchlorvynol, aspirin and tartrazine.
• Assess usual sleep patterns, nature of sleep disturbance and drug effectiveness.
• Provide pain-relieving measures prior to administering drug to patient experiencing pain.
• Adjust dosage of anticoagulants at initiation and discontinuance of treatment.
• Enhance effectiveness of drug by encouraging usual sleep patterns and routines.
• Provide relaxing environment that facilitates sleep induction.
• Eliminate stimuli that inhibit sleep.
• Utilize safety precautions to prevent injury such as keeping bed in low position with siderails up.
• Inform patient to call for assistance when getting up in the night because patient may experience dizziness.
• Monitor coagulation laboratory results if patient is taking anticoagulants.
• Observe for side effects such as hypotension, dizziness, weakness, unpleasant aftertaste, hangover, vomiting or paradoxical reaction.
• In patients receiving daytime sedation, report appearance of mental confusion, hallucinations or drowsiness to physician.

 Patient/Family Education

• Instruct patient that drug is for short-term use only and that its use can lead to tolerance and physical and psychological dependency.
• Warn patient that if drug is taken > 2 wk, withdrawal symptoms may be experienced.
• Instruct patient on how drug should be taken and that it should be taken in prescribed dose only.
• Inform patient that some side effects can be reduced if drug is taken with food.
• If medication is to be taken at bedtime, remind patient to take before midnight. Explain that if medication is being used as sedative it should not be taken in middle of night or early in morning.
• Instruct patient to report these symptoms to physician: visual changes, irregular heart beats, chest pains, yellowing of skin and eyes, rash or unusual bleeding or bruising.
• Instruct patient to avoid intake of alcoholic beverages or other CNS depressants.
• Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts