From the Research
Folic acid treatment in methanol poisoning is typically administered for 24-48 hours, with the most recent and highest quality study suggesting its use as an adjunctive therapy to enhance formic acid metabolism 1. The recommended regimen is 50 mg of folic acid given intravenously every 4 hours for a total of 6 doses, though some protocols may extend treatment until clinical improvement is observed or methanol levels decrease to non-toxic ranges.
- Folic acid works by enhancing the conversion of formic acid (the toxic metabolite of methanol) to carbon dioxide and water, thereby reducing its accumulation and toxicity.
- This treatment should be initiated as soon as methanol poisoning is suspected, alongside other critical interventions such as alcohol dehydrogenase inhibition with ethanol or fomepizole, and hemodialysis for severe cases.
- The duration may be adjusted based on clinical response, serum methanol levels, acid-base status, and visual symptoms.
- Patients should be monitored for resolution of metabolic acidosis and improvement in visual disturbances during treatment, as noted in previous studies 2, 3, 4, 5. However, the most recent study 1 provides the most relevant and up-to-date guidance on the use of folic acid in methanol poisoning.