Methanol poisoning: the duality between ‘fast and cheap’ and ‘slow and expensive’

  title={Methanol poisoning: the duality between ‘fast and cheap’ and ‘slow and expensive’},
  author={Kurt Anseeuw and Marc B. Sabbe and Annemie Legrand},
  journal={European Journal of Emergency Medicine},
The management of methanol poisoning includes early antidote therapy to inhibit the metabolism of methanol to formate. Ethanol and fomepizole are both effective, but recently fomepizole has been preferred, although there is no scientific evidence that the use of fomepizole is a superior therapeutic strategy compared with the use of ethanol combined with haemodialysis. The same patient was admitted twice to our emergency department with methanol poisoning. The first time (methanol 3.24 g/l), she… 
Treatment of patients with ethylene glycol or methanol poisoning: focus on fomepizole
Fomepizole is an effective and safe first-line antidote for EG and methanol intoxications and is both efficacious and safe in the pediatric population, but is not recommended during pregnancy.
Treatment of ethylene glycol and methanol poisoning : why ethanol ?
It is believed that ethanol still is the antidote of choice for poisoning with ethylene glycol and methanol, and it is contrary to many authors, that fomepizole will prove unable to obviate the need for haemodialysis.
A Systematic Review of Ethanol and Fomepizole Use in Toxic Alcohol Ingestions
The data supporting the use of one antidote for the treatment of ethylene glycol or methanol intoxication is inconclusive and further investigation is warranted.
Recommendations for the Role of Extracorporeal Treatments in the Management of Acute Methanol Poisoning: A Systematic Review and Consensus Statement
Extracorporeal treatment has a valuable role in the treatment of patients with methanol poisoning and a range of clinical indications for extracorpreal treatment is provided and duration of therapy can be guided through the careful monitoring of biomarkers of exposure and toxicity.
Methanol poisoning as a new world challenge: A review
Een patiënte gered door alcohol
Management involves supportive care, administration of sodium bicarbonate to correct systemic acidosis, inhibition of the enzyme alcohol dehydrogenase with either fomepizole or ethanol, haemodialysis and treatment with cofactors to optimize nontoxic metabolic pathways to avoid formation of the metabolites.
Kinetics of fomepizole in pregnant rats
Elevated concentrations of fomepizole were detected in the fetus following maternal administration, which would imply significant protection against fetal formation of toxic alcohol metabolites.
Fomepizole for ethylene glycol and methanol poisoning.
  • J. Brent
  • Medicine, Chemistry
    The New England journal of medicine
  • 2009
A 35-year-old man is brought to the emergency department after ingesting automobile antifreeze. His pH is 7.30, and his urinalysis reveals calcium oxalate crystals, findings consistent with ethylene
109: Toxic Alcohols
Most reported cases of methanol poisoning in the United States involve ingestions of one of the above products, with more than 60% involving windshield washer fluid, although most inhalational exposures involve carburetor cleaner.
Estimation of long-term costs of postacute care in survivors of the methanol poisoning outbreak
In 2013–2019 the highest costs per patient related to postacute care were found in the first year; the average costs decreased afterwards, and remained almost constant for the rest of the studied period of time.


Treatment of acute methanol poisoning with fomepizole
Fomepizole appears safe and effective in the treatment of methanol-poisoned patients and may prove unnecessary in patients presenting without visual impairment or severe acidosis, if results are confirmed in prospective analyses.
Ethanol therapy for methanol poisoning: duration and problems.
Ethanol, as a widely available and cheap antidote, is still considered as the cornerstone of the treatment of methanol poisoning, although it has been recently shown that the administration of
Fomepizole for the treatment of methanol poisoning.
Fomepizole appears to be safe and effective in the treatment of methanol poisoning and nine patients survived and two patients who died had anoxic brain injury that was present at the time of enrollment.
Current recommendations for treatment of severe toxic alcohol poisonings
Fomepizole is an effective and safe first-line recommended antidote for EG and methanol intoxication and may obviate the need for hemodialysis in selected patients.
What Are the Adverse Effects of Ethanol Used as an Antidote in the Treatment of Suspected Methanol Poisoning in Children?
The results suggest that with appropriate monitoring and intravenous glucose intake in a controlled environment such as a pediatric intensive care unit, ethanol therapy does not carry as many risks as currently believed.
Methanol mass poisoning in Estonia: Outbreak in 154 patients
Given limited resources, triage and use age of tertiary care centers allowed a small community hospital to treat a high number of methanol-poisoned patients, and critical resources were ventilators and dialyzing machines, whereas stores of antidote and bicarbonate were sufficient.
Treatment of the alcohol intoxications: ethylene glycol, methanol and isopropanol
Fomepizole, an inhibitor of alcohol dehydrogenase, slows the metabolism of these substances and is now approved by the US Food and Drug Administration for use in ethylene glycol intoxication.
American Academy of Clinical Toxicology Practice Guidelines on the Treatment of Methanol Poisoning
Fomepizole is the preferred antidote for methanol poisoning and although there are no clinical outcome data confirming the superiority of either of these antidotes over the other, there are significant disadvantages associated with ethanol.
Pancreatic Injury Following Acute Methanol Poisoning
Clinical, biological, and radiographic signs of acute pancreatic injury may be more common than previously realized and fomepizole (4-methylpyrazole) may be the preferable antidote in acute methanol poisoning.