Fomepizole

 Q: Fomepizole can be given orally? (select one) 

A) True 

B) False 

 

Answer: A 

Fomepizole is the best available antidote for Ethylene Glycol and Methanol poisoning. It is preferred to be given intravenously (IV). The loading dose is 15 mg/kg followed by 10 mg/kg every 12 hours. It is dialyzable and the dose needs to be adjusted for hemodialysis. If an IV line can not be obtained it can be given orally. The bioavailability is almost equivalent. Also, the dose is similar. In a crossover trial of PO and IV route of administration, similar blood levels were obtained 2.

#toxicology

References:

1. Mégarbane B, Houzé P, Baud FJ. Oral fomepizole administration to treat ethylene glycol and methanol poisonings: advantages and limitations. Clin Toxicol (Phila) 2008; 46:1097; author reply 1097.

2. Marraffa J, Forrest A, Grant W, Stork C, McMartin K, Howland MA. Oral administration of fomepizole produces similar blood levels as identical intravenous dose. Clin Toxicol (Phila). 2008 Mar;46(3):181-6. doi: 10.1080/15563650701373796. PMID: 18344099.