This is an FDA-approved drug for the treatment of acute ethylene glycol or methanol poisoning. Fomepizole works as an antidote by competitively inhibiting ADH (303). Interestingly, in ethanol-preferring rats, fomepizole reduces alcohol intake (304), hinting at possible therapeutic value for heavy drinking. However, ADH inhibition also diverts ethanol toward non-oxidative pathways, which are implicated in pancreatitis and hepatic damage (see above). This toxicity risk would need careful evaluation before fomepizole or similar ADH inhibitors could be considered as an AUD treatment.
