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Topic: Fomepizole

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	Fomepizole
		The concentration of fomepizole at which alcohol dehydrogenase is inhibited by 50% in vitro is approximately 0.1 μmol/L. In a study of dogs given a lethal dose of ethylene glycol, 3 animals each were administered fomepizole, ethanol, or left untreated (control group).
		Fomepizole is indicated as an antidote for ethylene glycol (such as antifreeze) or methanol poisoning, or for use in suspected ethylene glycol or methanol ingestion, either alone or in combination with hemodialysis (see DOSAGE AND ADMINISTRATION).
		Fomepizole injection is dialyzable and the frequency of dosing should be increased to every 4 hours during hemodialysis (see TABLE 1).
	www.orgyn.com /resources/genrx/D003373.asp (2266 words)

	Veterinary Products... fomepizole
		Fomepizole was administered intravenously in a polyethylene glycol-400 vehicle at a concentration of 50 mg/ml.
		Fomepizole was successfully used as a clinical antidote in the treatment of ethylene glycol poisoned dogs in an open-label study conducted by Dial, et al.
		Fomepizole was administered intravenously in a polyethylene glycol-400 vehicle at a concentration of 50 mg/mL at doses of 20 mg/kg upon presentation, 15 mg/kg, 17 hours later, and 5 mg/kg at 25 hours after presentation.
	www.betterchem.com /vet/fomepizole.htm (3431 words)

	fomepizole medical facts from Drugs.com
		Fomepizole is an antidote to certain types of poison.
		Fomepizole is used to treat poisoning with ethylene glycol (antifreeze) or methanol (contained in solvents, fuels, and other household or automotive chemicals).
		Fomepizole is sometimes used together with hemodialysis to rid the body of a poison.
	www.drugs.com /mtm/fomepizole.html (925 words)

	Ethylene Glycol Poisoning Treatment - UK Pharmacy Services (Site not responding. Last check: )
		Fomepizole, also known as 4-methylpyrazole (4-MP), is a competitive inhibitor of alcohol dehydrogenase, with an affinity for the enzyme 8,000 times that of ethanol.
		Fomepizole is effective in preventing the formation of toxic metabolites that are responsible for the metabolic and renal complications of ethylene glycol poisoning.
		The dosing regimen of fomepizole does not require the frequent monitoring and subsequent adjustment of therapy that are necessary with ethanol therapy.
	www.mc.uky.edu /pharmacy/dic/criteria/ethyleneglycol.htm (549 words)

	Fomepizole (92:00) - 398015
		Because length of time between last fomepizole dose and end of hemodialysis is 2 hours, patient should receive a dose of 5 mg/kg at the end of hemodialysis.
		Because length of time between the last fomepizole dose and end of hemodialysis is <1 hour, patient should receive a 10 mg/kg dose 12 hours after the dose given prior to initiation of hemodialysis.
		Fomepizole (4-methylpyrazole) in fatal methanol poisoning with early CT scan cerebral lesions.
	www.ashp.org /mngrphs/essentials/a398015e.htm (1685 words)

	CJEM \| JCMU 2002; 4(3) :: Pharmacotherapy (Site not responding. Last check: )
		Fomepizole was given intravenously at 9, 21, 33, 45 and 57 hours after ingestion in doses of 9.5, 7, 3.6, 1.2 and 0.6 mg/kg, respectively.
		Fomepizole was administered intravenously at a loading dose of 15 mg/kg, followed by 10 mg/kg every 12 hours for 48 hours, then 15 mg/kg every 12 hours until the plasma ethylene glycol concentration was less than 3.2 mmol/L. The mean time from ingestion to treatment was 11.4 hours.
		Utililty of the serum osmolal gap in the diagnosis of methanol or ethylene glycol ingestion.
	www.caep.ca /004.cjem-jcmu/004-00.cjem/vol-4.2002/v43-199.htm (2923 words)

	Antizol Efficacy: Ethylene Glycol
		Fomepizole is indicated for the treatment of ethylene glycol poisoning unless unavailable or the patient has a hypersensitivity to fomepizole.
		The authors concluded that administration of fomepizole early in the course of ethylene glycol poisoning inhibits the formation of toxic metabolites and thereby prevents renal injury.
		The authors suggested that, in the absence of renal insufficiency and acidosis, fomepizole alone may be sufficient to treat patients poisoned with ethylene glycol.
	www.antizol.com /efficacyethy.htm (453 words)

	Antizol Efficacy: Ethylene Glycol
		Fomepizole is indicated for the treatment of ethylene glycol poisoning unless unavailable or the patient has a hypersensitivity to fomepizole.
		The authors concluded that administration of fomepizole early in the course of ethylene glycol poisoning inhibits the formation of toxic metabolites and thereby prevents renal injury.
		The authors suggested that, in the absence of renal insufficiency and acidosis, fomepizole alone may be sufficient to treat patients poisoned with ethylene glycol.
	antizol.info /efficacyethy.htm (453 words)

	CJEM \| JCMU 2002; 4(1) :: Toxicology (Site not responding. Last check: )
		Fomepizole was assigned a frequency estimate equal to ethanol, and hydroxocobalamin equal to sodium thiosulfate.
		Fomepizole is superior to ethanol with regard to safety and ease of administration, and may obviate the need for hemodialysis when administered early after ethylene glycol ingestion.
		Ironically, it is in these small centres where fomepizole has the greatest potential benefit relative to ethanol, as these centres typically lack hemodialysis, intensive care facilities, familiarity with ethanol therapy, and the ability to measure methanol or ethylene glycol levels.
	www.caep.ca /004.cjem-jcmu/004-00.cjem/vol-4.2002/v41-023.htm (3454 words)

	American College of Medical Toxicology
		Twenty five years ago, it was shown that administration of fomepizole to man inhibits ethanol metabolism without significant adverse effects.(7) Fomepizole's potential as an antidote for toxic alcohol poisoning became quickly apparent, and in 1974 Mundy et al demonstrated that 4MP could protect against EG poisoning in animals.
		Simultaneous with the development of fomepizole as an antidote in animal models of EG poisoning was the development of its use in methanol toxicity.
		Simultaneously, Pietruszko (18) demonstrated in vitro that fomepizole inhibits methanol metabolism by human liver ADH with a micromolar Ki indicating that fomepizole is a potent inhibitor of methanol metabolism.
	www.ijmt.net /ijmt/1_1/1_1_2.html (2481 words)

	American Family Physician: Fomepizole for the Treatment of Ethylene Glycol Poisoning - Statistical Data Included (Site not responding. Last check: )
		Fomepizole (4- methylpyrazole) is an inhibitor of alcohol dehydrogenase but does not appear to have the adverse effects of ethanol.
		The average number of doses of fomepizole was 3.5, with a range of one to seven.
		The only adverse events possibly related to treatment with fomepizole were transient bradycardia (heart rate of 50 to 60 beats per minute) in two patients, headaches in two patients and brief seizures that occurred 15 minutes after the first dose of medication but not with subsequent dosing in two patients.
	www.findarticles.com /cf_dls/m3225/1_60/55391818/p1/article.jhtml (689 words)

	Fomepizole
		Please remember that fomepizole is also known as 4-methylpyrazole.
		Describe the mechanism of toxicity of ethylene glycol and the mechanism of action of fomepizole.
		Describe the pharmacokinetic characteristics of ethylene glycol and fomepizole.
	www.urmc.rochester.edu /URMC/AAPCC/Fomepizole.htm (204 words)

	p030108a - Ethylene Glycol Poisoning - Fomepizole
		Abstract: Fomepizole (4-methylpyrazole, 4-MP, Antizol) is a potent inhibitor of alcohol dehydrogenase that was approved recently by the US Food and Drug Administration (FDA) for the treatment of ethylene glycol poisoning.
		Case reports and a prospective case series indicate that the intravenous (i.v.) administration of fomepizole every 12 hours prevents renal damage and metabolic abnormalities associated with the conversion of ethylene glycol to toxic metabolites.
		Fomepizole has clear advantages over ethanol in terms of validated efficacy, predictable pharmacokinetics, ease of administration, and lack of adverse effects, whereas ethanol has clear advantages over fomepizole in terms of long-term clinical experience and acquisition cost.
	www.emory.edu /WHSCL/grady/amreport/litsrch02/p030108a.html (899 words)

	Daily Nation On the Web
		The scientists writing in the authoritative Journal say that fomepizole was administered at hospitals around the United States to 11 individuals suffering from methanol poisoning.
		But the company that makes the drug says it is willing to provide fomepizole at much lower prices in emergencies such as the mass poisoning that occurred in Nairobi and environs three months ago.
		A supply of fomepizole was flown to Cambodia a couple of years ago after an outbreak of poisoning there from illicit brews, says Dave Folkens, a spokesman for Orphan Medical.
	www.nationaudio.com /News/DailyNation/15022001/Features/Features3.html (413 words)

	Acid-Base Physiology - Selected References Chapter 8 (Site not responding. Last check: )
		Unlike ethanol, fomepizole is metabolised in a predictable manner, allowing for the use of a standard, validated administration regimen.
		Fomepizole therapy eliminates the need for the haemodialysis that is required in selected patients who are non-acidotic and have adequate renal function.
		Although the roles of alcohol dehydrogenase inhibition with ethanol or fomepizole and hemodialysis are clear in the case of toxic ingestions of methanol and ethylene glycol, they remain poorly defined for butoxyethanol poisoning.
	www.qldanaesthesia.com /AcidBaseBook/ABRefChap8.htm (1632 words)

	s030108a - Ethylene Glycol Poisoning - Fomepizole
		Abstract: Fomepizole (4-Methylpyrazole, 4MP) is used as an antidote for ethylene glycol and methanol poisoning.
		In the past year, fomepizole (4-methylpyrazole) has been approved for use as an antidote in the treatment of ethylene glycol poisoning in adults, and the first article reporting the use of fomepizole in a pediatric ethylene glycol exposure was published.
		As a result, the therapy of ethylene glycol poisoning in children is likely to change from the traditional approach of ethanol administration coupled with hemodialysis to the administration of fomepizole with or without hemodialysis.
	www.emory.edu /WHSCL/grady/amreport/litsrch02/s030108a.html (1445 words)

	American Family Physician: Treatment of ethylene glycol poisoning
		Fomepizole is a new agent with a specific indication by the U.S. Food and Drug Administration for the treatment of ethylene glycol poisoning.
		In the absence of renal dysfunction and significant metabolic acidosis, the use of fomepizole should eliminate the need for hemodialysis in patients with high serum ethylene glycol concentrations; in these patients, frequent monitoring of acid-base balance is necessary.
		Prolonged dialysis may not be necessary in patients treated with fomepizole or ethanol; the end point for dialysis in these patients is correction of the anion and osmolar gaps.
	www.findarticles.com /p/articles/mi_m3225/is_5_66/ai_92233596/pg_2 (980 words)

	FOMEPIZOLE — Fomepizole (4-methylpyrazole, Antizol®) rapidly and competitively inhibits alcohol
		Because other alcohols are also metabolized to toxic products by alcohol dehydrogenase, fomepizole is effective for the management of methanol, isopropanol, or diethylene glycol intoxication, and was approved by the United States Food and Drug Administration for treatment of methanol intoxication in late 2000.
		Treatment with fomepizole should be initiated as quickly as possible when there is a suspicion of methanol or ethylene glycol poisoning.
		Fomepizole is dialyzable and the frequency of its dosing should be increased to every 4 hours during hemodialysis.
	intmedweb.wfubmc.edu /blurbs/overdoses/methanol.html (1306 words)

	Fomepizole detail at IndyaPharma (Site not responding. Last check: )
		The concentration of fomepizole at which alcohol dehydrogenase is inhibited by 50% in vitro is approximately 0.1 µmol/L. In a study of dogs given a lethal dose of ethylene glycol, three animals each were administered fomepizole, ethanol, or left untreated (control group).
		Fomepizole or ethanol, given 3 hours after ethylene glycol ingestion, attenuated the metabolic acidosis and prevented the renal tubular damage associated with ethylene glycol intoxication.
		When fomepizole was given in combination with ethanol, the decrease in testicular mass was significantly greater (approximately 30% reduction) compared to those rats treated exclusively with fomepizole or ethanol.
	www.indyapharma.com /Fomepizole-detail.htm (2338 words)

	FAQs
		A: Fomepizole is a competitive inhibitor of alcohol dehydrogenase, which normally oxidizes ethylene glycol and methanol to their respective toxic metabolites.
		Because fomepizole is considered a more effective inhibitor of alcohol dehydrogenase than ethanol, Antizol administration should be immediately initiated at normally recommended doses.
		There are reports of orally administered fomepizole in the literature and it appears to be highly bioavailable by that route.
	antizol.info /faq.htm (827 words)

	Fomepizole as an antidote for ethylene glycol poisoning -- Battistella 36 (6): 1085 -- The Annals of Pharmacotherapy
		Fomepizole as an antidote for ethylene glycol poisoning -- Battistella 36 (6): 1085 -- The Annals of Pharmacotherapy
		Fomepizole as an antidote for ethylene glycol poisoning
		OBJECTIVE: To assess the use of fomepizole in the treatment of ethylene glycol poisoning in the absence of hemodialysis.
	www.theannals.com /cgi/content/abstract/36/6/1085 (199 words)

	Antizol Online, Description, Chemistry, Ingredients - Fomepizole - RxList Monographs
		(fomepizole) Injection is a competitive inhibitor of alcohol dehydrogenase.
		Its melting point is 25°C (77°F) and it may present in a solid form at room temperature.
		Fomepizole is soluble in water and very soluble in ethanol, diethyl ether, and chloroform.
	www.rxlist.com /cgi/generic/antizol.htm (173 words)

	PedsCCM: EB Journal Club Review (Site not responding. Last check: )
		The hemodialysis patients received a median of one fomepizole treatment vs. a median of 4 doses in the patients who did not have hemodialysis.
		The authors concluded that "in response to fomepizole, plama formic acid levels fell and metabolic abnormalities resolved in all patients." They present data on formic acid and methanol levels over time in 5 patients who underwent hemodialysis and 3 patients who did not.
		Finally the authors report success in obtaining fomepizole levels above 0.8 mcg in 152 out of 155 blood samples with their dosing strategy (but it is unclear if they were peak or trough levels).
	pedsccm.wustl.edu /EBJ/THERAPY/Brent-Fomepizole.html (1392 words)

	Fomepizole
		FOMEPIZOLE (Antizolâ¢) is used to treat ethylene glycol or methanol poisoning.
		It is given by a health-care professional in a hospital or clinic setting.
		Your condition will be closely monitored while you receive fomepizole.
	www.stjohn.org /HealthInfoLib/swArticle.aspx?26,2104 (266 words)

	Fomepizole Treatment of Ethylene Glycol Poisoning in an Infant -- Baum et al. 106 (6): 1489 -- Pediatrics
		Fomepizole Treatment of Ethylene Glycol Poisoning in an Infant -- Baum et al.
		We present the case of an 8-month-old male infant who drank EG and was treated with fomepizole and hemodialysis.
		The cause of the decreased hemoglobin is unclear.
	pediatrics.aappublications.org /cgi/content/full/106/6/1489 (1207 words)

	Fomepizole Treats Ethylene Glycol Poisoning - Journal Watch Emergency Medicine
		Fomepizole (4-methylpyrazole) also inhibits alcohol dehydrogenase but does not appear to have the side effects or unpredictability of ethanol.
		Comment: Fomepizole appears to be safe and effective for ethylene glycol poisoning, but a prospective, randomized trial is needed.
		Ethical considerations may make such a trial difficult to conduct, but this report is not sufficient to make fomepizole the standard of care.
	emergency-medicine.jwatch.org /cgi/content/full/1999/401/1 (279 words)

	Childhood Methanol Ingestion Treated With Fomepizole and Hemodialysis -- Brown et al. 108 (4): 77 -- Pediatrics
		Fomepizole (4-methylpyrazole; Antizol) is used increasingly in the treatment of methanol toxicity in adults.
		Fomepizole, a competitive inhibitor of ADH, was approved recently as an antidote for methanol intoxication in adults.
		As pediatric experience with fomepizole grows, the drug is being shown to be safe and effective.
	pediatrics.aappublications.org /cgi/content/full/108/4/e77 (1252 words)

	pg7
		A drug called fomepizole is a safe, effective antidote to antifreeze poisoning, & offers advantages over current therapy, US researchers report.
		They report that 18 patients survived without any serious side effects, & the one patient who died did not get to the hospital in time for any treatment to be effective.
		In an accompanying editorial, Dr. Dag Jacobsen of the Ullevaal University Hospital in Oslo, Norway, points out that although fomepizole is the better choice for ethylene glycol poisoning, ethanol treatment is cheaper.
	www.geocities.com /Petsburgh/Zoo/1111/danger.html (332 words)

	Pediatrics : Fomepizole Treatment of Ethylene Glycol Poisoning in an Infant. @ HighBeam Research (Site not responding. Last check: )
		Pediatrics : Fomepizole Treatment of Ethylene Glycol Poisoning in an Infant.
		Start / P / Pediatrics / December 01, 2000 / Fomepizole Treatment of Ethylene Glycol Poisoning in an Infant.
		Fomepizole Treatment of Ethylene Glycol Poisoning in an Infant.
	static.highbeam.com /p/pediatrics/december012000/fomepizoletreatmentofethyleneglycolpoisoninginanin/index.html (229 words)

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