5/31/2023 0 Comments FomepizoleIn conclusion, fomepizole is an effective and safe first-line antidote for EG and methanol intoxications.Īlthough relatively uncommon, ethylene glycol (EG) and methanol poisonings remain important causes of suicide and epidemic poisonings, resulting in multiple deaths and serious sequelae. It is both efficacious and safe in the pediatric population, but is not recommended during pregnancy. Fomepizole is contraindicated in case of allergy to pyrazoles. Side-effects are rarely serious and with a lower occurrence than ethanol. When dialysis is indicated, 1 mg/kg/h-continuous infusion should be provided to compensate for its elimination. When administered prior to the onset of significant acidosis or organ injury, fomepizole may obviate the need for hemodialysis. Administered early, fomepizole prevents EG-related renal failure and methanol-related visual and neurological injuries. There is no need to monitor fomepizole concentrations. Administration is easy (15 mg/kg-loading dose, either intravenously or orally, independent of alcohol concentration, followed by intermittent 10 mg/kg-doses every 12 hours until alcohol concentrations are <30 mg/dL). Treatment should be started as soon as possible, based on history and initial findings including anion gap metabolic acidosis, while awaiting measurement of alcohol concentration. Although no study has compared its efficacy with ethanol, fomepizole is recommended as a first-line antidote. Fomepizole, a potent alcohol dehydrogenase (ADH) inhibitor, is an efficient and safe antidote that prevents or reduces toxic EG and methanol metabolism. Ethylene glycol (EG) and methanol are responsible for life-threatening poisonings.
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