What is fomepizole used for?
Fomepizole is a medication used to treat certain types of toxic alcohol poisoning—most commonly poisoning from methanol or ethylene glycol. It works by blocking the enzymes the body needs to convert these alcohols into their more harmful toxic metabolites. [1][2]
How does fomepizole work in alcohol poisoning?
Fomepizole inhibits alcohol dehydrogenase, the enzyme that metabolizes toxic alcohols. By preventing formation of toxic breakdown products (such as formic acid from methanol and glycolic/oxalic acids from ethylene glycol), it reduces tissue damage and improves outcomes. [1][2]
How is fomepizole given?
Fomepizole is given by injection/IV administration in acute poisoning situations, typically as a loading dose followed by additional doses over time. Exact dosing depends on the poison involved and the patient’s clinical status. [1][2]
How does it compare with fomepizole vs. ethanol for poisoning?
In toxic alcohol poisoning, fomepizole and ethanol both target alcohol metabolism. Fomepizole is commonly used because it avoids the high blood alcohol levels and monitoring burden associated with ethanol therapy, though local protocols determine which is preferred. [1][2]
When does fomepizole work best?
The medication works best when started early in the course of poisoning because it prevents formation of toxic metabolites. Treatment decisions in the emergency setting are usually guided by the suspected alcohol, symptoms, and lab findings. [1][2]
What side effects are associated with fomepizole?
Common side effects can include dizziness, headache, nausea/vomiting, and injection-site reactions. As with other acute therapies, clinicians monitor patients closely for adverse effects during treatment. [1][2]
Are there special situations that affect dosing?
Clinicians may adjust dosing and monitoring based on patient factors such as severity of poisoning, liver function, and changes in metabolism during treatment. Drug and toxin-specific protocols guide management. [1][2]
Sources
- https://www.ncbi.nlm.nih.gov/books/NBK470306/
- https://www.drugs.com/monograph/fomepizole-injection.html