Use of fomepizole as an adjunct in the treatment of acetaminophen overdose: a case series

Figures & data

Figure 1. Acetaminophen concentrations (µg/mL) plotted over time (hours after ingestion) – Time either confirmed or estimated on clinical history. Concentrations plotted on a standard Rumack Matthew nomogram with Rumack-Matthew line and treatment line shown. All laboratory studies were performed at a single institution.

Table 1. AST and ALT over time from estimated or confirmed ingestion.

Case 1			Case 2			Case 3
Time	ALT (U/L)	AST (U/L)	Time	ALT (U/L)	AST (U/L)	Time	ALT (U/L)	AST (U/L)
4	22	20	4	7	19	4	11	30
6	62	26	6	Fomepizole Given		6	Fomepizole Given
6	Fomepizole Given		27	9	18	20	34	47
17	61	22	52	7	14	28	37	32
40	66	38	102	12	14	40	41	34
62	79	51
86	76	38
110	60	26
Case 4			Case 5			Case 6
Time	ALT (U/L)	AST (U/L)	Time	ALT (U/L)	AST (U/L)	Time	ALT (U/L)	AST (U/L)
2	12	13	5	23	27	6	Fomepizole Given
9	13	14	6	Fomepizole Given		9	18	10
9	Fomepizole Given		12	29	54	13	19	10
16	15	16	22	21	15	34	14	9
21	12	13	46	19	18
35	12	14
53	12	12

Time in hours from estimated or confirmed ingestion, rounded.

ALT reference range 6-46 U/L; AST reference range 3–35 U/L.