What is the best antidote for methanol poisoning?

Fomepizole is the best antidote for methanol poisoning because it acts as an alcohol dehydrogenase inhibitor. This enzyme is responsible for converting methanol into its toxic metabolites, namely formaldehyde and formic acid, which are primarily responsible for the harmful effects associated with methanol poisoning. By inhibiting this enzyme, fomepizole effectively reduces the formation of these harmful metabolites, thereby mitigating the toxicity of methanol.

In cases of methanol poisoning, prompt administration of fomepizole can prevent severe metabolic acidosis, central nervous system depression, and potential organ damage, leading to better clinical outcomes for the patient. Other treatment approaches may still be relevant, such as supportive care and, in some situations, hemodialysis, but fomepizole remains the primary pharmacological intervention specifically designed to counteract the effects of methanol.