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Fomepizole is a potent competitive inhibitor of ADH that inhibits the metabolism of methanol, ethylene glycol, diethylene glycol and other xenobiotics that use ADH in the formation of toxic metabolites.
Doses:
*The loading dose of fomepizole is 15 mg/kg IV, followed in 12 hours by 10 mg/kg every 12 hours for 4 doses. If therapy is necessary beyond 48 hours, the dose is then increased to 15 mg/kg every 12 hours, for as long as necessary.
*This increase is recommended because fomepizole stimulates its own metabolism. Patients undergoing hemodialysis require additional doses of fomepizole to replace the amount removed during hemodialysis
*It is recommended to administer fomepizole at the beginning of hemodialysis if the last dose was given more than 6 hours earlier. At the completion of hemodialysis, the administration of the next scheduled dose if more than 3 hours have transpired, or one half of the dose if 1 to 3 hours have passed.
Side Effects :
Fomepizole is safe and, although it has been used successfully orally, only an IV dosing regimen is approved and available but it is more costly than ethanol, but its many advantages over ethanol
*The most common laboratory abnormality after fomepizole administration is a transient elevation of aminotransferase concentrations
* It also prolong the half life of toxic alcohol ,The half-life of methanol is approximately 54 hours in the presence of fomepizole with a range of 22 to 87 hours.
The half-life of ethylene glycol in the presence of fomepizole is approximately 14 to 17 hours in patients with normal kidney function, and 49 hours in patients with impaired kidney function.
Q1.What are the indications and dose?=Antidote for ethylene glycol (antifreeze) or methanol (windshield washer fluid) poisoning . It works to Inhibits initial metabolism of ethylene glycol or methanol to toxic metabolites=Dose : IV (Adults): Loading dose– 15 mg/kg, then 10 mg/kg every 12 hours for four doses, then 15 mg/kg every 12 hours until levels of methanol or ethylene glycol are undetectable or <20 mg/dL and patient is asymptomatic with normal pH
Q2.What are the precautions and side effects?=Contraindicated in: Hypersensitivity to fomepizole or other pyrazoles.
=Use Cautiously in: -OB: Use during pregnancy only if potential maternal benefit justifies potential fetal riskLactation-Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;=Side effect:CNS: headache, dizziness, drowsiness, dysgeusiaGI: nauseaMisc : allergic reactions (mild rash, eosinophilia)
Good one great! article. Thanks for sharing these fantastic! home decoring tips. I just worship the tips that you have shared these are very good ideas! for home recording...
Medication Round Cont'
Fomepizole is a potent competitive inhibitor of ADH that inhibits the metabolism of methanol, ethylene glycol, diethylene glycol and other xenobiotics that use ADH in the formation of toxic metabolites.
Doses:
*The loading dose of fomepizole is 15 mg/kg IV, followed in 12 hours by 10 mg/kg every 12 hours for 4 doses. If therapy is necessary beyond 48 hours, the dose is then increased to 15 mg/kg every 12 hours, for as long as necessary.
*This increase is recommended because fomepizole stimulates its own metabolism. Patients undergoing hemodialysis require additional doses of fomepizole to replace the amount removed during hemodialysis
*It is recommended to administer fomepizole at the beginning of hemodialysis if the last dose was given more than 6 hours earlier. At the completion of hemodialysis, the administration of the next scheduled dose if more than 3 hours have transpired, or one half of the dose if 1 to 3 hours have passed.
Side Effects :
Fomepizole is safe and, although it has been used successfully orally, only an IV dosing regimen is approved and available but it is more costly than ethanol, but its many advantages over ethanol
*The most common laboratory abnormality after fomepizole administration is a transient elevation of aminotransferase concentrations
* It also prolong the half life of toxic alcohol ,The half-life of methanol is approximately 54 hours in the presence of fomepizole with a range of 22 to 87 hours.
The half-life of ethylene glycol in the presence of fomepizole is approximately 14 to 17 hours in patients with normal kidney function, and 49 hours in patients with impaired kidney function.
References:
Goldfrank’s Toxicologic Emergencies 11th edition
Q1.What are the indications and dose? =Antidote for ethylene glycol (antifreeze) or methanol (windshield washer fluid) poisoning . It works to Inhibits initial metabolism of ethylene glycol or methanol to toxic metabolites =Dose : IV (Adults): Loading dose– 15 mg/kg, then 10 mg/kg every 12 hours for four doses, then 15 mg/kg every 12 hours until levels of methanol or ethylene glycol are undetectable or <20 mg/dL and patient is asymptomatic with normal pH
Q2.What are the precautions and side effects? =Contraindicated in: Hypersensitivity to fomepizole or other pyrazoles.
=Use Cautiously in: -OB: Use during pregnancy only if potential maternal benefit justifies potential fetal riskLactation -Use while breastfeeding only if potential maternal benefit justifies potential risk to infant; =Side effect: CNS: headache, dizziness, drowsiness, dysgeusia GI: nausea Misc : allergic reactions (mild rash, eosinophilia)