Public Safety Training Facility
Monroe Community College
Rochester, New York
MCC Paramedic Program
(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