Approved in some European and Latin American countries, but not in the US (168), metadoxine is used to treat acute ethanol intoxication because it speeds ethanol clearance (300). The mechanism of action of this drug is incompletely understood, but it is likely through increased ALDH activity. Preliminary clinical trials also indicate that metadoxine may curb drinking and help maintain abstinence (301, 302). These early findings underscore the need for larger, double-randomized studies to establish its efficacy in AUD.
