Indications for Fomepizole:
Ethylene glycol or methanol poisoning; or suspected ethylene glycol or methanol ingestion, either alone or in combination with hemodialysis.
Give by slow IV infusion over 30mins. Loading dose of 15mg/kg, followed by 10mg/kg every 12hrs for 4 doses, then 15mg/kg every 12hrs until ethylene glycol or methanol concentration is <20mg/dL and patient is asymptomatic with normal pH. Hemodialysis: see full labeling.
Allergy to pyrazoles.
For dilution/administration: do not use polycarbonate syringes or polycarbonate-containing needles. Renal or hepatic impairment. Renal failure, significant or worsening metabolic acidosis, or high ethylene glycol or methanol concentrations (≥50mg/dL); consider hemodialysis in addition to fomepizole. Obtain blood gases, pH, electrolytes, liver enzymes, BUN, creatinine, urinalysis, ECG, WBCs frequently during therapy. Monitor serum and urine ethylene glycol concentrations and presence of urinary oxalate crystals; or serum methanol concentrations. Monitor for allergic reactions. Elderly. Pregnancy (Cat.C). Nursing mothers.
Alcohol dehydrogenase inhibitor.
Potentiates or potentiated by ethanol. May affect or be affected by CYP450 inducers/inhibitors (eg, phenytoin, carbamazepine, cimetidine, ketoconazole).
Headache, nausea, dizziness, drowsiness, bad taste/metallic taste; rare: mild rash, eosinophilia.