Not Just for Antifreeze: Fomepizole for Massive Acetaminophen Poisoning

Every year hundreds of Americans die from acetaminophen overdose, despite ready access to N-acetylcysteine and liver transplantation. While NAC can be life saving, it’s not uncommon to have treatment failure in massive ingestion or late presentation. What if we could block the conversion of acetaminophen to toxic products and save more livers and more lives? Experience with fomepizole, historically used for toxic alcohol poisoning, demonstrates that it can shut down CYP2E1 and improve care for patients with acetaminophen toxicity. It’s safe and readily available in most hospitals, but attendees will learn when and how to use it in their department.