Which medications in the drug class Antidotes, Other are used in the treatment of Methanol Toxicity?

Updated: Nov 05, 2018
  • Author: Kalyani Korabathina, MD; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Answer

Antidotes, Other

These agents inhibit the toxic effects of methanol via competitive inhibition.

Ethanol

Ethanol is believed to compete with methanol for ADH, thus preventing metabolism of methanol to its toxic by-products. ADH has a 10- to 20-fold greater affinity for ethanol than for methanol. By slowing the degradation of methanol, ethanol is assumed to prevent the accumulation of high levels of formic acid.

The goal of ethanol therapy is to achieve an ethanol blood concentration of 100 mg/dL. At this level, ethanol is thought to become a competitive substrate for ADH and to be sufficient to block methanol metabolism.

Fomepizole/4-methylpyrazole (Antizol)

Fomepizole acts similarly to ethanol. It is a stronger competitive inhibitor of ADH and, in addition, does not cause hypoglycemia or sedation. Fomepizole is relatively easier to administer than ethanol. It does not require monitoring of serum concentrations.


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