A competitive inhibitor of alcohol dehydrogenase that prevents formation of metabolites of ethylene glycol and methanol.
Most useful when given early before significant quantities of metabolites are formed in ethylene or methanol poisoning.
Approved for treating ethylene and methanol toxicity.
Has superseded ethanol as the antidote of choice in most setting for ethylene glycol or methanol poisonings.
No contraindications for its use.
Use suggested with suspicion of ingestion of ethylene glycol or methanol or the presence of metabolic acidosis of unknown cause.
Administered intravenously.
For patients not undergoing hemodialysis a loading dose of 15 mg per kg of body weight followed by 0 mg per kg every 12 hours, after 48 hours 15 mg per kg every 12 hours.
For patients undergoing dialysis the same doses are given except the drug is given 6 hours after the first dose and every 4 ours thereafter.
Plasma levels required to inhibit alcohol dehydrogenase is approximately 0.8 microgm per mL. which is obtained with therapy.
Repeated doses induce cytochrome P-450 metabolism and an increased dose for patients is used who require more than 48 hours of treatment.
No dose adjustments for renal or liver disease and no interactions with other medications have been noted.