What is the primary treatment for methanol toxicity?

Fomepizole is the primary treatment for methanol toxicity because it acts as a competitive inhibitor of alcohol dehydrogenase, the enzyme responsible for converting methanol into its toxic metabolites, formaldehyde and formic acid. By inhibiting this enzyme, fomepizole effectively prevents further production of these harmful substances, allowing the body to eliminate methanol more safely. The earlier the administration of fomepizole occurs after methanol exposure, the better the outcome, as it helps mitigate the risk of metabolic acidosis and other severe complications associated with methanol poisoning.

In cases of methanol toxicity, supportive care and monitoring are also critical, but fomepizole is specifically indicated because it directly targets the mechanism of toxicity. In contrast, activated charcoal is generally not effective once methanol ingestion has already occurred, especially after several hours, since it may not bind sufficiently to methanol. Bicarbonate is used in the management of metabolic acidosis but does not address the underlying cause of methanol toxicity, which is the accumulation of its toxic metabolites. N-acetylcysteine is effective for acetaminophen overdose and provides antioxidant benefits, but it is not indicated for methanol poisoning. Thus, fomepizole remains the