“Who has worries, also has liquor”, says the popular saying. One could also say: “Who has medication, has alcohol“. Many medications, especially herbal preparations in liquid form, contain alcohol. Colloquially, alcohol is understood to mean ethyl alcohol or ethanol. It is found in the classic alcoholic beverages beer, wine or high-proof spirits, but also as a preservative and extractant of various medications. Ethanol is therefore the best known representative of the large chemical group of alcohols.
Ethanol is an extractant…
For the production of herbal medicines, ethanol has always been used to achieve a high active ingredient content in the drug. For this purpose, for example, herbs or plant components are soaked in alcohol for a long period of time and then poured off. Ethanol is also a natural alcohol that occurs wherever wet substances containing sugar or starch are fermented by ubiquitous yeast cells.
Thus, alcohol is a natural component of many foods such as bread or fruit juices. Human blood also contains alcohol, and in concentrations of 0.002-0.003 percent – without the ingestion of alcohol.
…and preservative
At the same time, ethanol is a natural preservative, so the use of alcohol in medicines eliminates the need for other, artificial preservatives. Ethanol inactivates enzymes: this has a beneficial effect on remodeling and degradation reactions in cells, thus promoting the action of drugs.
Risks and side effects
The alcohol content of medicines is completely safe for most people, even when taking a herbal medicine over a long period of time. Alcohol in medicines is not considered by pharmacists to be a precursor to alcohol dependence. However, this does not mean that alcoholics should be allowed to take alcohol-containing medicines. Here, the requirement of absolute abstinence takes precedence. In the case of children, however, opinions are divided.
The preparations available today usually contain 30 to 50 percent alcohol by volume, which is taken in individual doses of about 2 ml or 2 g. The alcohol content of the preparation is then measured in terms of the time it is consumed. From this, an instantaneous blood alcohol level of 0.01 to 0.02% can then be derived, which is broken down again after just a few minutes.
Danger for children?
From a pharmaceutical perspective, therefore, there is no danger to children from alcohol-containing drugs. Rather, pharmacists and pharmacists point to what they consider to be the greater danger posed by the negligent handling of over-the-counter alcoholic beverages. In addition, parents and educators must ensure that any type of medication – i.e., not just those containing alcohol – is kept out of reach of children.
Alcohol substitutes are problematic
For pharmacists, ethanol is an undisputed ingredient in a wide variety of formulations. Its composition is precisely defined and regulated in the Medicines Act. According to this law, a drug containing a fluid extract or tincture must always contain ethanol and cannot be labeled “alcohol-free.” The physical, technological, and antimicrobial properties of ethanol complement those of water well, making ethanol-water mixtures easy to make and beneficial to the consumer. While substitutes exist, they are often just mixtures of higher alcohols.
Thus, these preparations are by no means “alcohol-free,” but merely “ethanol-free.” The use of other solvents for the herbal active ingredients is therefore not recommended by pharmacists. It should be noted that alcoholics should not consume alcohol in medications either.
For children, the intended use is considered completely safe – a bottle of beer in children’s hands is more dangerous.
