Fomepizole use reported to United States Poison Centers from 2010 to 2021

Figures & data

Figure 1. Use of fomepizole over time for toxic alcohol or non-toxic alcohol exposures.

Table 1. Patient overview, reason for exposure, level of care, and caller site.

	Toxic alcohol n = 14,636 (%)	Non-toxic alcohol n = 9,775 (%)	P value
Age, mean [standard deviation]	39.8 [18.0]	43.6 [16.7]	<0.001
Male	9,609 (65.7)	5,826 (59.6)	<0.001
Ethanol present	2,363 (16.1)	3,846 (39.3)	<0.001
Reason for exposure
Intentional	10,918 (74.6)	6,567 (67.2)	<0.001
Unintentional	2,955 (20.2)	1,093 (11.2)
Unknown	763 (5.2)	2,115 (21.6)
Level of care^a
Admitted to critical care unit	9,248 (63.3)	7,300 (74.7)	<0.001
Admitted to noncritical care unit	2,802 (19.2)	1,495 (15.3)
Admitted to psychiatric facility	584 (4)	177 (1.8)
Patient lost to follow-up / left against medical advice	286 (2)	169 (1.7)
Treated/evaluated and released	1,695 (11.6)	625 (6.4)
Caller site^b
Caller site healthcare facility	11,591 (79.2)	9,144 (93.5)	<0.001
Caller site own residence	1,451 (9.9)	240 (2.5)

^a Fifteen (0.1%) toxic alcohol exposures were coded with management site that was not a healthcare facility (other (11); unknown (2); managed on site (2)) and six had a disposition of “patient refused referral / did not arrive at healthcare facility.” Nine (0.06%) non-toxic alcohol exposures were coded with management site that was not a healthcare facility (other (3); unknown (4); managed on site (1)) and one had a disposition of “patient refused referral / did not arrive at healthcare facility.”

^b Additional caller sites for toxic alcohol exposures: other (1,361; 9.3%), other residence (83; 0.6%), public area (44; 0.3%), restaurant / food service (1; 0.01%), school (7; 0.1%), unknown (27; 0.2%) workplace (71; 0.5%). Additional caller sites for non-toxic alcohol exposures: other (343; 3.5%), other residence (14; 0.1%), public area (5; 0.1%), restaurant / food service (1; 0.01%), school (4; 0.04%), unknown (6; 0.1%); workplace (18; 0.2%).

Figure 2. Most common non-toxic alcohol exposures with fomepizole coded as a treatment.

Table 2. Key laboratory abnormalities reported.

	Toxic alcohol n = 14,636 (%)	Non-toxic alcohol n = 9,775 (%)	Odds Ratio (95% Confidence interval)
Acidosis	6,428 (43.9)	6,482 (66.3)	0.39 (0.38–0.42)
Increased creatinine concentration	3,091 (21.1)	3,449 (35.3)	0.49 (0.46–0.52)
Anion gap increased	4,166 (28.5)	4,663 (47.7)	0.44 (0.41–0.46)
Osmolal gap increased	3,271 (22.3)	2,601 (26.6)	0.79 (0.75–0.84)
Kidney failure	1,297 (8.9)	1,302 (13.3)	0.63 (0.58–0.69)
Oxalate crystals	568 (3.9)	108 (1.1)	3.61 (2.94–4.45)

Table 3. Key interventions performed.

	Toxic alcohol n = 14,636 (%)	Non-toxic alcohol n = 9,775 (%)	Odds Ratio (95% Confidence interval)
Hemodialysis	5,076 (34.7)	1,941 (19.9)	2.14 (2.02–2.28)
Sodium bicarbonate	3,736 (25.5)	3,296 (33.7)	0.67 (0.64–0.71)
Vasopressors	982 (6.7)	2,048 (21.0)	0.27 (0.25–0.29)

Data sharing

The data that support the findings of this study are available from the National Poison Data System. Restrictions apply to the availability of these data.