Fomepizole
Fomepizole is an antidote medication used to treat poisoning from ethylene glycol and methanol by blocking the enzyme alcohol dehydrogenase, preventing the formation of toxic metabolites that can cause serious organ damage.
An antidote that blocks alcohol dehydrogenase to prevent toxic metabolite formation in ethylene glycol and methanol poisoning.
Key facts at a glance
- ATC
- V03AB34
- RxNorm
- 15226
- Generic
- Fomepizole
- Class
- atc-v03
- Brands
- —
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
8 groupspregnancy
first trimesteruse only if benefits outweigh risks
use only in life-threatening methanol or ethylene glycol poisoning
regular fetal monitoring and ultrasound
Use with caution and monitor for adverse effects.
pregnancy
second trimesteruse only if benefits outweigh risks
use only in life-threatening methanol or ethylene glycol poisoning
regular fetal monitoring
Use with caution and monitor for adverse effects.
pregnancy
third trimesteruse only if benefits outweigh risks
use only in life-threatening methanol or ethylene glycol poisoning
regular fetal monitoring and uterine activity monitoring
Use with caution and monitor for adverse effects.
lactation
breastfeedinguse with caution
discontinue breastfeeding or express and discard milk during treatment due to limited safety data
monitor infant for adverse effects
pediatric_age
neonates infantsweight-based dosing required
approved for use in pediatric patients, initial dose 15mg/kg then 10mg/kg every 12 hours
monitor renal function and methanol/ethylene glycol levels
geriatric
elderly 65reduce dose in renal impairment
use with caution due to potential age-related renal and hepatic function decline
monitor renal function, adjust dose based on creatinine clearance
Use with caution and monitor for adverse effects.
renal_impairment
severe renal impairmentdose adjustment may be required
use with caution, may require extended dosing interval in severe impairment
frequent monitoring of renal function and drug levels if available
Use with caution and monitor for adverse effects.
hepatic_impairment
moderate to severeuse with caution, no standard dose adjustment
monitor hepatic function closely during treatment
monitor liver enzymes and clinical status
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA Approval Year
FDA approved Fomepizole for ethylene glycol poisoning
Drug class
Antidote for toxic alcohol poisoning
Common uses
Primary therapeutic indication
Mechanism of action
Molecular mechanism of action
Treatment of suspected or confirmed ethylene glycol (antifreeze) and methanol (wood alcohol) poisoning, which can occur through accidental or intentional ingestion.
Fomepizole competitively inhibits alcohol dehydrogenase, the enzyme that converts ethylene glycol and methanol into their toxic metabolites (such as formic acid and oxalic acid) that cause severe organ damage, particularly to the kidneys and nervous system.
Administered intravenously in a hospital setting. Treatment typically continues until toxic alcohol levels are undetectable. Hemodialysis may be used alongside in severe cases. Common side effects include headache, nausea, and dizziness.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy