Annals of emergency medicine
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Multicenter Study Comparative Study Clinical Trial
Toxicokinetics of ethylene glycol during fomepizole therapy: Implications for management.
The elimination kinetics of ethylene glycol (EG) in human subjects treated with fomepizole (4-methylpyrazole) were analyzed to establish the efficacy of alcohol dehydrogenase (ADH) inhibition and to characterize elimination pathways. ⋯ At doses used, fomepizole effectively inhibits ADH-mediated metabolism of EG. Serum creatinine concentration at presentation and creatinine clearance can be used to predict EG elimination during fomepizole therapy and can help determine which patients will require hemodialysis to expedite EG elimination. An absolute EG concentration above 50 mg/dL should no longer be used as an independent criterion for hemodialysis in patients treated with fomepizole. [Sivilotti MLA, Burns MJ, McMartin KE, Brent J, for the Methylpyrazole for Toxic Alcohols Study Group. Toxicokinetics of ethylene glycol during fomepizole therapy: implications for management. Ann Emerg Med. August 2000;36:114-125.].