Effects of 4-methylpyrazole, methanol/ethylene glycol antidote, in healthy humans

Jacobsen, Dag; Sebastian, Cherian; Barron, Susan K.; Carriere, Edward; McMartin, Kenneth E.

doi:10.1016/0736-4679(90)90176-v

Cited by 68 publications

(34 citation statements)

References 20 publications

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“…This corresponds well to earlier published material (8,9,11). Since fomepizole induces its own metabolism over time, induction of metabolism resulting in subtherapeutic concentrations cannot be ruled out (13). There was a good correlation (R 2 ) to first-order elimination kinetics in six of our patients (Figs.…”

Section: Discussionsupporting

confidence: 91%

Methanol and Formate Kinetics During Treatment with Fomepizole

Hovda

Andersson

Urdal

et al. 2005

Clinical Toxicology

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Section: Discussionsupporting

confidence: 91%

Methanol and Formate Kinetics During Treatment with Fomepizole

Hovda

Andersson

Urdal

et al. 2005

Clinical Toxicology

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“…diluted in isotonic saline, and then 10 mg kg )1 every 12 h, all doses given over 30 min. From the fifth dose and on, 15 mg kg )1 was given in order to compensate for increased metabolism [8]. During dialysis, 10 mg kg )1 fomepizole was given every 4 h.…”

Section: Treatmentmentioning

confidence: 99%

Methanol outbreak in Norway 2002–2004: epidemiology, clinical features and prognostic signs

Hovda

Hunderi

et al. 2005

Journal of Internal Medicine

209

183

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The opposite trend was demonstrated in the dying; the difference was highly significant by linear regression analyses (P < 0.001).Conclusions. Methanol poisoning still has a high morbidity and mortality, mainly because of late diagnosis and treatment. Respiratory arrest, coma and severe metabolic acidosis (pH < 6.90, base deficit >28 mmol L )1 ) upon admission were strong predictors of poor outcome. Early admission and ability of respiratory compensation of metabolic acidosis was associated with survival.

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“…3,13 Fomepizole is well tolerated; adverse effects reported were headache (12% of patients), nausea (11%), vomiting (percentage not reported), dizziness (7%), and transient elevation of liver transaminases (up to 40%). 3,9,14,15 Skin rash rarely has been reported after fomepizole therapy. 3,14 Fomepizole has many advantages over ethanol as an inhibitor of alcohol dehydrogenase in treatment of ethylene glycol toxicity.…”

Section: Ethanol Cofactors and Hemodialysismentioning

confidence: 99%

Role of Fomepizole in the Management of Ethylene Glycol Toxicity

2002

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Objective. To systematically review English‐language articles on fomepizole administration in patients with ethylene glycol poisoning. Data Sources. MEDLINE, EMBASE, Current Contents, and PubMed. Search terms were fomepizole, 4‐methylpyrazole, and ethylene glycol. The search was supplemented with a bibliographic review of all relevant articles. Study Selection. All published reports of fomepizole administration in patients with ethylene glycol poisoning were reviewed, irrespective of study design. We identified one clinical trial and subsequent pharmacokinetic study, one case series, and 13 case reports. Results. Fomepizole has been investigated in 70 patients in open, unblinded studies. Most patients received an intravenous loading dose, with subsequent variable maintenance doses every 12 hours until plasma ethylene glycol levels became undetectable. Additional hemodialysis treatment generally was administered when patients had renal insufficiency or ethylene glycol levels above 50 mg/dl. Many patients had detectable ethanol levels either because of coadministration or as a result of adjunctive treatment at a referring center. Poorer patient outcomes, such as death and renal insufficiency, were associated with later clinical presentation time after ingestion. At therapeutic fomepizole levels (> 8.6 mg/ml), the half‐life of ethylene glycol was prolonged to over 19 hours. Fomepizole appeared to be well tolerated by most patients. Conclusion. Fomepizole is an effective alcohol dehydrogenase inhibitor that decreases production of ethylene glycol metabolites. Reduced mortality and morbidity are undetermined because of the small number of patients evaluated to date. Data on comparative efficacy of fomepizole versus ethanol and data on administration of fomepizole in children are limited.

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Effects of 4-methylpyrazole, methanol/ethylene glycol antidote, in healthy humans

Cited by 68 publications

References 20 publications

Methanol and Formate Kinetics During Treatment with Fomepizole

Methanol and Formate Kinetics During Treatment with Fomepizole

Methanol outbreak in Norway 2002–2004: epidemiology, clinical features and prognostic signs

Role of Fomepizole in the Management of Ethylene Glycol Toxicity

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