Fomepizole

Administration

• Type: Alcohol dehydrogenase inhibitor, antidote
• Routes of Administration: Intravenous
• Common Trade Names: Antizol

Adult Dosing

• Loading: 15 mg/kg
• Maintenance: 10 mg/kg every 12 hours

Pediatric Dosing

• Loading: 15 mg/kg
• Maintenance: 10 mg/kg every 12 hours

Special Populations

• Pregnancy Rating: C
• Lactation risk: Unknown if excreted in breast mild

Hemodialysis Dosing

• For patients undergoing hemodialysis for complications associated with toxic alcohol ingestion, dosing should be adjusted in consultation with a nephrologist.

Hepatic Dosing

• Fomepizole is metabolized in the liver, specific dosing adjustments for hepatic impairment have not been developed.

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• Bradycardia
• Hypotension
• Shock
• Anemia
• Disseminated intravascular coagulation (DIC)

Common

• Headache
• Nausea

Pharmacology

• Half-life: Not calculated
• Metabolism: Hepatic
• Excretion: Urine

Mechanism of Action

• Competitively inhibits alcohol dehydrogenase.

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Ethylene glycol toxicity	15 mg/kg IV load, then 10 mg/kg q12hr	ADH inhibitor (1st line antidote)	IV	Adult
Methanol toxicity	15 mg/kg IV load, then 10 mg/kg q12hr	ADH inhibitor (1st line antidote)	IV	Adult

See Also

Toxic Alcohols

References

1. Lexicomp