Paraldehyde [Paracetaldehyde]

The paraldehyde injectable formulation is not commercially available in the United States and must be prepared freshly under sterile conditions in the pharmacy department of a hospital prior to use. Paraldehyde solution is absorbed rapidly and well from the GI tract following oral ingestion. Paraldehyde is depolymerized to acetaldehyde, which is oxidized by acetaldehyde dehydrogenase to acetic acid and, subsequently, carbon dioxide and water. Paraldehyde pharmacotherapy commonly has been associated with erythematous rash and gastric irritation. Paraldehyde pharmacotherapy also has been associated with metabolic acidosis. Signs and symptoms of paraldehyde overdosage include pulmonary edema and respiratory depression. Metabolic acidosis also may occur. A characteristic odor of paraldehyde on the breath facilitates diagnosis. Paraldehyde overdosage requires emergency symptomatic medical support of body systems with attention to increasing paraldehyde elimination. Paraldehyde pharmacotherapy commonly has been associated with erythematous rash and gastric irritation. Paraldehyde pharmacotherapy also has been associated with metabolic acidosis.