Safer Medication Use is a bulletin series jointly produced by the Regional Drug and Therapeutics Centre and the Yellow Card Centre Northern and Yorkshire, which aims to promote safer prescribing. It discusses specific drug related safety problems, provides guidance to ensure safe, appropriate prescribing and raises awareness of adverse drug reaction detection and reporting.

Ethanol is commonly used as an excipient in medicines, which is problematic in several patient groups but particularly so in children. The effects of chronic exposure to even small amounts of alcohol have not been well studied in children. In particular, phenobarbital elixir contains ethanol in such high amounts that children may ingest the equivalent of several units of alcohol per day, resulting in significant adverse effects or even intoxication. Other oral medicines are less likely to be problematic, but prescribers should be aware of these risks and choose medicines without ethanol where possible. Where ethanol-free alternatives are not available or not suitable, the individual needs of the patient should be considered, as should whether the benefits of the medicine outweigh the risks.

This review is older than 18 months; in view of the continued emergence of new evidence, readers are recommended to re-check the biomedical literature.