UMEM Educational Pearls

Category: Toxicology

Title: Ethanol verses Fomepizole

Keywords: ethanol,fomepizole,toxic alcohols,ethylene glycol,methanol (PubMed Search)

Posted: 5/7/2009 by Ellen Lemkin, MD, PharmD (Updated: 6/17/2024)
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  • Recently, a study was published which compared adverse drug events in patients who had received either fomepizole or ethanol for ethylene glycol or methanol poisoning.
  • Importantly, this is the first trial which has compared these events head to head.
  • Retrospectively, 172 charts over a 9 year period were reviewed. Toxicologists identified at least 1 ADR in 74 of 130 ethanol treated cases (57%) versus 5 of 42 fomepizole treated cases (12%).
  • Severe ADRs occurred in 20% of ethanol treated patients vs 5% fomepizole treated patients.
  • This adds further data to support the use of choosing fomepizole over alcohol for treatment of toxic alcohol poisonings


1. Lepik KJ, Levy AR, Sobolev BG et al. Adverse drug events associated with the antidotes for methanol and ethylene glycol poisoning: A comparison of ethanol and fomepizole. Ann Emer Med April 2009;53(2):439-50.
2. Silvotti ML. Ethanol: Tastes Great! Fomepizole: Less Filling! Editorial. Ann Emer Med. April 2009;53(2):451-3.