A patient poisoned with either ethylene glycol or methanol can be treated with fomepizole (4-methylpyrazole), which inhibits alcohol dehydrogenase. This blocks the formation of toxic metabolites.
Therapeutic regimen:
(1) Initial loading dose of 15 mg per kilograms body weight.
(2) Bolus doses of 10 mg per kg are given every 12 hours for the first 48 hours (12, 24, 36, 48 hours).
(3) After 48 hours the dose is increased to 15 mg per kg every 12 hours until the toxin is < 20 mg/dL (for either methanol or ethylene glycol).
where:
• Although I used measured body weight in the implementation, ideal body weight needs to be considered as an alternative.
• The dose is increased after 48 hours to compensate for induction of fomepizole metabolism.
To read more or access our algorithms and calculators, please log in or register.
