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Monroe Community College
Rochester, New York


MCC Paramedic Program

FOMEPIZOLE

4-Methylpyrazole

AntizolŪ

(FDA Category 1S)

Fomepizole is an alcohol dehydrogenase inhibitor.

Dosing Information: For ethylene glycol intoxication, intravenous fomepizole should be administered as a loading dose of 15 mg/kg followed by 10 mg/kg every 12 hours for 4 doses, then 15 mg/kg every 12 hours thereafter until ethylene glycol levels are below 20 mg/dL. All doses should be administered via slow intravenous infusion over 30 minutes. During hemodialysis, the frequency of dosing is increased to every 4 hours.

Pharmacokinetics: Therapeutic serum levels in ethylene glycol poisoning are 100 to 300 mcmol/L (8 to 24.6 mg/L). Protein binding is minimal; volume of distribution is between 0.6 and 1.02 L/kg. Urinary excretion of unchanged compound is 1% to 4%, indicating that metabolism is the primary route of clearance. Fomepizole is metabolized in the liver. Hemodialysis removes significant amounts of the drug.

Clinical Applications: Fomepizole has shown efficacy as an ethanol alternative for the early or late treatment of ethylene glycol intoxication. Clinical data regarding its use in methanol poisoning are emerging.

learn more about ethylene glycol poisoning


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Updated: August 26, 1998
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