It is not unlike ethanol in its ability to competitively inhibit alcohol dehydrogenase and clinical trials have proven it's effectiveness in preventing the formation of the toxic metabolites formed after ethylene glycol and methanol poisoning. The advantages of fomepizole over ethanol include ease of administration, lack of blood level monitoring, and lack of significant adverse effects. However, fomepizole has a significantly increased cost over traditional ethanol treatment and there is no outcome data to suggest that fomepizole is better at treating ethylene glycol or methanol poisoning. As more clinical experience accumulates, the relative role of fomepizole versus ethanol in the treatment of ethylene glycol and methanol poisoning will become more clear.
Methanol is excreted almost exclusively through renal elimination.
It could take weeks for a patient to eliminate enough methanol not to require hemodialysis, therefore, such a patient should be transferred to a facility that can perform hemodialysis as soon as possible. This option should be considered in cases where it is difficult to transfer patients or where there is a contraindication to hemodialysis. Ask Health Connections For more information about the Department of Emergency Medicine at University Hospital, use this form to connect with a Health Connections nurse. A Health Connections nurse will respond shortly. Health Connections is a free and confidential health information and referral service for University Hospital.