DISULFIRAM
Brand name Antabuse
Used in the following combined preparations None
GENERAL INFORMATION
Disulfiram is used to help alcoholics abstain from alcohol. It does not cure alcoholism but provides a powerful deterrent to drinking.
If you are taking disulfiram and drink even a small amount of alcohol, highly unpleasant reactions follow, such as flushing, throbbing headache, nausea, thirst, breathlessness, palpitations, dizziness, and fainting. Such reactions may last from 30 minutes to several hours, leaving you feeling drowsy and sleepy. Because the reactions can also
include unconsciousness, it is wise to carry a card stating the person to be notified in an emergency.
When disulfiram and alcohol are taken together, acetaldehyde (a toxic substance that is manufactured in the body and broken down) rises to higher concentrations in the blood, triggering the unwelcome reactions. It is important not to drink any alcohol for at least 24 hours before beginning disulfiram treatment; foods and medicines that contain alcohol should also be avoided.
INFORMATION FOR USERS
Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.
QUICK REFERENCE
Drug group Alcohol abuse deterrent
Overdose danger rating Medium
Dependence rating Low
Prescription needed Yes
Available as generic No
How taken.
Tablets.
Frequency and timing of doses
Once daily.
Adult dosage range
800mg initially, gradually reduced over 5 days to 100-200mg (maintenance dose).
Onset of effect
Interaction with alcohol occurs within a few minutes of taking alcohol.
Duration of action
Interaction with alcohol can occur for about 6 days after the last dose of disulfiram.
Diet advice
Avoid all alcoholic drinks, even in very small amounts. Food, fermented vinegar, medicines, mouthwashes, and lotions containing alcohol should also be avoided.
Storage
Keep in a closed container in a cool, dry place out of the reach of children. Protect from light.
Missed dose
Take as soon as you remember. If your next dose is due within 2 hours, take a single dose now and skip the next.
Stopping the drug
Do not stop taking the drug without consulting your doctor.
Exceeding the dose
An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause a temporary increase in adverse effects. Notify your doctor.
POSSIBLE ADVERSE EFFECTS
Adverse effects of disulfiram usually disappear when you get used to taking the drug. If they
persist or become severe, the dosage may need to be adjusted.
INTERACTIONS
General note
A number of drugs can produce an adverse reaction when taken with disulfiram. You are advised to check with your doctor or pharmacist before taking any other medication.
Phenytoin
Disulfiram increases the blood levels of this drug.
Anticoagulant drugs
Disulfiram increases the effect of these drugs.
Isoniazid
Disulfiram may markedly increase the adverse effects of this drug.
Metronidazole
A severe reaction can occur if this drug is taken with disulfiram.
SPECIAL PRECAUTIONS
Be sure to tell your doctor if:
You have long-term liver or kidney problems.
You have heart problems, coronary artery disease, or high blood pressure.
You have had epileptic fits.
You have diabetes.
You have breathing problems.
You are taking other medications.
Pregnancy
Safety in pregnancy not established. Discuss with your doctor.
Breast-feeding
The drug passes into the breast milk and may affect the baby adversely. Discuss with your doctor.
Over 60
Reduced dose may be necessary.
Driving and hazardous work
Avoid such activities until you have learned how disulfiram affects you because the drug can cause drowsiness and dizziness.
Alcohol
Never drink alcohol while under treatment with disulfiram, and avoid foods and medications containing alcohol. This drug may interact dangerously with alcohol.
PROLONGED USE
Not usually prescribed for longer than 6 months without review. It is wise to carry a card indicating you are taking disulfiram with instructions as to who should be notified in an emergency.
