Methanol is not toxic itself, but it is metabolized to become highly toxic formic acid and its anion formate. Formic acid can create a metabolic acidosis, and both formic acid and formate inhibit the respiration chain in the mitochondria of the cells in the human body. This results in a more severe acidosis and multiple organ failure, usually affecting the brain and the vision first.
Treatment is focused on blocking the enzyme alcohol dehydrogenase (ADH) with either ethanol or fomepizole, buffering the metabolic acidosis with bicarbonate, and using dialysis to remove methanol and formate, as well as to correct the metabolic acidosis. Folinic (or folic) acid may also be given to enhance the endogenous metabolism of formate.
Kyrre Lind, Head of Program