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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Remaining methanol in the stomach is removed with gastric lavage.

Metabolic acidosis is corrected with a bicarbonate infusion.

Intravenous ethanol inhibits the production of formate by competing for the active site of alcohol dehydrogenase:

  • 50 g ethanol stat
  • 10 g/hr ethanol infusion to maintain the plasma level of ethanol at 1-2 g/l

If the initial blood methanol concentration exceeds 0.5 g/l then haemodyalysis should be combined with the ethanol infusion. In this case the ethanol infusion should be increased to maintain blood ethanol levels.

Intravenous folate may prevent optic nerve damage:

  • 1 mg/kg (50 mg max)
  • give 6 doses each separated by 4 hours

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