Fomepizole Dosage

Medically reviewed by Drugs.com. Last updated on Aug 16, 2023.

Usual Adult Dose for Methanol Poisoning

Patients not requiring hemodialysis:

Initial dose: 15 mg/kg, IV, followed by 10 mg/kg, IV every 12 hours for 4 doses
Maintenance dose: 15 mg/kg, IV, every 12 hours, until ethylene glycol/methanol concentrations are undetectable, or below 20 mg/dL and patient is asymptomatic with normal pH

Comments:

• Begin treatment immediately upon suspicion of ethylene glycol or methanol ingestion.
• Consider concomitant dialysis for renal failure, metabolic acidosis, or ethylene glycol/methanol concentrations of 50 mg/dL or higher.
• Discontinue this drug when ethylene glycol/methanol concentrations are undetectable, or below 20 mg/dL and patient is asymptomatic with normal pH.

Usual Adult Dose for Ethylene Glycol Poisoning

Patients not requiring hemodialysis:

Initial dose: 15 mg/kg, IV, followed by 10 mg/kg, IV every 12 hours for 4 doses
Maintenance dose: 15 mg/kg, IV, every 12 hours, until ethylene glycol/methanol concentrations are undetectable, or below 20 mg/dL and patient is asymptomatic with normal pH

Comments:

• Begin treatment immediately upon suspicion of ethylene glycol or methanol ingestion.
• Consider concomitant dialysis for renal failure, metabolic acidosis, or ethylene glycol/methanol concentrations of 50 mg/dL or higher.
• Discontinue this drug when ethylene glycol/methanol concentrations are undetectable, or below 20 mg/dL and patient is asymptomatic with normal pH.

Usual Pediatric Dose for Methanol Poisoning

Not approved for pediatric use, however safe and effective use in pediatrics has been reported in medical literature.

Patients not requiring hemodialysis:

Initial dose: 15 mg/kg, slow IV over 30 minutes, followed by 10 mg/kg, IV every 12 hours for 4 doses
Maintenance dose: 15 mg/kg, IV, every 12 hours, until ethylene glycol/methanol concentrations are undetectable, or below 20 mg/dL and patient is asymptomatic with normal pH

Comments:

• All doses should be administered slow IV over 30 minutes.
• Begin treatment immediately upon suspicion of ethylene glycol or methanol ingestion.
• Consider concomitant dialysis for renal failure, metabolic acidosis, or ethylene glycol/methanol concentrations of 50 mg/dL or higher.
• Discontinue this drug when ethylene glycol/methanol concentrations are undetectable, or below 20 mg/dL and patient is asymptomatic with normal pH.

Usual Pediatric Dose for Ethylene Glycol Poisoning

Not approved for pediatric use, however safe and effective use in pediatrics has been reported in medical literature.

Patients not requiring hemodialysis:

Initial dose: 15 mg/kg, slow IV over 30 minutes, followed by 10 mg/kg, IV every 12 hours for 4 doses
Maintenance dose: 15 mg/kg, IV, every 12 hours, until ethylene glycol/methanol concentrations are undetectable, or below 20 mg/dL and patient is asymptomatic with normal pH

Comments:

• All doses should be administered slow IV over 30 minutes.
• Begin treatment immediately upon suspicion of ethylene glycol or methanol ingestion.
• Consider concomitant dialysis for renal failure, metabolic acidosis, or ethylene glycol/methanol concentrations of 50 mg/dL or higher.
• Discontinue this drug when ethylene glycol/methanol concentrations are undetectable, or below 20 mg/dL and patient is asymptomatic with normal pH.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Patients requiring hemodialysis: (see usual adult dosing)
Dose at the beginning of hemodialysis:
Less than 6 hours since last dose: Do not administer dose
6 hours or more since last dose: Administer next scheduled dose

Dose during hemodialysis: Administer every 4 hours or as a continuous infusion 1 to 1.5 mg/kg/hour.

Dose at the time hemodialysis is completed:
Less than 1 hour between last dose and the end of hemodialysis: Do not administer dose at the end of hemodialysis.
1 to 3 hours between last dose and the end of hemodialysis: Administer half of next scheduled dose.
Greater than 3 hours between last dose and end of hemodialysis: Administer next scheduled dose.

Maintenance dose off hemodialysis: Give next scheduled dose 12 hours from last dose administered.

Peritoneal dialysis: Data not available

Comments:

• All doses should be administered slow IV over 30 minutes.
• Begin treatment immediately upon suspicion of ethylene glycol or methanol ingestion.
• Consider concomitant dialysis for renal failure, metabolic acidosis, or ethylene glycol/methanol concentrations of 50 mg/dL or higher.
• Discontinue this drug when ethylene glycol/methanol concentrations are undetectable, or below 20 mg/dL and patient is asymptomatic with normal pH.

Other Comments

Administration advice:

• Infuse over 30 minutes.

Storage requirements:

• Store at controlled room temperature.

Reconstitution/preparation techniques:

• This drug solidifies at temperatures less than 25C (77F).
• If drug has solidified, liquefy by running vial under warm water or holding in the hand.
• Solidification does not affect efficacy, safety, or stability.
• Mix dose in at least 100 mL of 0.9% sodium chloride or 5% dextrose for injection; mix well.
• Diluted drug is stable for up to 24 hours.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer