Efficacy in Ethylene Glycol Poisoning

Ethylene Glycol

Brent J, et al. New Engl J Med 1999; 340:832.

The results of this prospective, multicenter clinical trial evaluating the efficacy of fomepizole in 19 patients with serum ethylene glycol concentrations > 20 mg/dL, demonstrated that fomepizole administration early in the course of treatment inhibits the formation of toxic metabolites and prevents renal injury.

Barceloux DG, et al. J Toxicol Clin Toxicol 1999; 37:537.

The authors provide a thorough review of ethylene glycol poisoning and its treatment with fomepizole and ethanol and compare the efficacy, safety and administration of both antidotes. They found the advantages of fomepizole over ethanol, including validated efficacy, predictable pharmacokinetics, ease of administration and superior safety profile. The primary disadvantages of fomepizole were the relatively high acquisition cost and limited clinical experience at that time.

Borron SW, et al. Lancet 1999; 354:831.

Based on a case series of 38 patients, these authors suggested that, in the absence of renal insufficiency and acidosis, fomepizole alone may be sufficient to treat ethylene glycol-poisoned patients.

Sivilotti MLA, et al. Ann Emerg Med 2000; 36: 114.

These investigators found that serum creatinine in ethylene glyco lpoisoned patients treated with fomepizole can be used to determine which patients require hemodialysis, concluding that a serum ethylene glycol concentration of 50 mg/dL should no longer be used as sole criteria for hemodialysis.

Antizol is Effective for the Treatment of Ethylene Glycol Poisoning

• In clinical trials, Antizol effectively inhibited the metabolism of ethylene glycol and methanol to their respective toxic metabolites. ^{5, 17}
• Antizol is effective when used with and without hemodialysis.^*
• The use of Antizol may make hemodialysis unnecessary for treating ethylene glycol poisonings if patients meet special criteria. ^{18, 20}

Change in plasma glycolate concentrations following antizol administration

In a series of 14 ethylene glycol-poisoned patients, the administration of Antizol effectively inhibited further metabolism of ethylene glycol to glycolate. Initial values obtained within an hour of Antizol administration (Mean ± SD). ¹⁶

The most frequent adverse events reported as drug-related or unknown relationship to study drug in the 78 patients and 63 normal volunteers who received Antizol were headache (14%), nausea (11%), and dizziness, increased drowsiness, and bad taste/metallic taste (6% each). All other adverse events in this population were reported in approximately 3% or fewer of those receiving Antizol. ¹²

* The dosing frequency of Antizol must be increased during hemodialysis. Click here for additional dosing information.

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