1,4-butanediol - Ethanol Interaction

Interaction Details

Ethanol is classified as belonging to the following category: Alcohol (Ethanol)

Theoretically, alcohol may increase or decrease the therapeutic and adverse effects of 1,4-butanediol.
1,4-Butanediol is metabolized to gamma-hydroxybutyrate (GHB) by hepatic alcohol dehydrogenase enzymes. Alcohol competitively inhibits alcohol dehydrogenase, which leads to higher blood levels of 1,4-butanediol and lower blood levels of GHB. The clinical effects of this change are not well understood. Most researchers believe that the pharmacologic activity of 1,4-butanediol is dependent on conversion to GHB; however, animal research shows that 1,4-butanediol may also act independently. Also, in humans, concomitant use of GHB and alcohol increases the adverse effects of GHB, possibly by reducing the elimination of GHB. Concomitant use of GHB and alcohol may also cause additive respiratory and central nervous system depression. Therefore, concomitant use of 1,4-butanediol and alcohol may either increase or decrease the risk of adverse effects.

Interaction Rating

Likelihood of Occurrence

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.

References

• Anon. Adverse events associated with ingestion of gamma-butyrolactone--Minnesota, New Mexico, and Texas, 1998-1999. MMWR Morb Mortal Wkly Rep 1999;48:137-40.
• Anon. FDA alert on misuse of consumer products containing GHB, GBL and BD. Food and Drug Administration, Rockville, MD. June 15, 1999.
• Poldrugo, F., Barker, S., Basa, M., Mallardi, F., and Snead, O. C. Ethanol potentiates the toxic effects of 1,4-butanediol. Alcohol Clin.Exp.Res 1985;9(6):493-497.
• Thai D, Dyer JE, Benowitz NL, Haller CA. Gamma-hydroxybutyrate and ethanol effects and interactions in humans. J Clin Psychopharmacol. 2006 Oct;26(5):524-9.
• Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.
• Liakoni E, Gugelmann H, Dempsey DA, et al. Butanediol conversion to gamma-hydroxybutyrate markedly reduced by the alcohol dehydrogenase blocker fomepizole. Clin Pharmacol Ther 2019;105(5):1196-203. doi: 10.1002/cpt.1306.

1,4-butanediol - More Interactions

1,4-butanediol interacts with 268 drugs

Interaction Rating Key

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