Meds and you

Updated 11 February 2013

Disulfiram

Disulfiram is prescribed in the treatment of those persons with alcoholism. It is however not a cure for alcoholism, but merely a deterrent to help one abstain from alcohol.

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Disulfiram is the active ingredient of Antabuse.

General Information

Disulfiram is prescribed in the treatment of those persons with alcoholism. It is however not a cure for alcoholism, but merely a deterrent to help one abstain from alcohol. It is advised that disulfiram should not be used on its own, but as part of a programme that includes supportive counselling and psychotherapy.

This medicine should not be 'fed' to alcoholics without their knowledge, as side effects may be dangerous if used with large quantities of alcohol.

If you consume alcohol, even in small quantities, while being treated with disulfiram, symptoms such as nausea, a throbbing headache, breathlessness, heart palpitations and dizziness and/or fainting may occur. This may last for up to several hours. To prevent 'accidental punishment', you should avoid taking alcohol for at least 24 hours prior to starting disulfiram, and for at least a week thereafter. Any food, medicine or cosmetic products containing alcohol should be avoided.

How does disulfiram work?

In the human body alcohol is broken down to acetaldehyde. An enzyme then breaks acetaldehyde down to a form that can be easily eliminated form the body. Disulfiram blocks this enzyme, which leads to an accumulation of acetaldehyde in the body. This then causes the unpleasant symptoms associated with the concurrent use of alcohol with acetaldehyde.

Fast facts

Drug schedule: Schedule 4

Available as: Disulfiram is available as dispersible tablets

What does it do? Disulfiram helps alcoholics to abstain from alcohol used

Overdose risk: Medium

Dependence risk: Low

Is disulfiram available as a generic? No

Is disulfiram available on prescription only? Yes

User information

Onset of effect: Within 60 minutes after ingesting alcohol

Duration of action: Alcohol may still trigger a response for up to 2 days after taking the medication.

Dietary advice: Any food, medicine or cosmetic products containing alcohol should be avoided.

Stopping this medicine: You should only stop taking this medication after consulting your prescriber.

Prolonged use: This drug is generally not prescribed for longer than 6 months. Your progress should be monitored frequently.

Special precautions

Consult your doctor before using this drug if:

  • You have heart disease
  • You have liver of kidney disease
  • You have epilepsy
  • You have diabetes mellitus
  • You are taking other medication.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.

Porphyria: Avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.

Infants and children: This medication is not intended for use in children.

Elderly: Caution is advised in the elderly as a reduction in dose may be needed.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Alcohol: Avoid concomitant use of alcohol with this medication, as dangerous interactions may occur.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Drowsiness

X

X

Headache

X

X

Diarrhoea

X

X

Nausea/ vomiting

X

X

Unpleasant taste

X

X

Impotence

X

X

Reduced libido

X

X

Psychosis

X

X

Interactions:

Drug interactions:

Medicine, foods or toiletries that contains alcohol

May trigger disulfiram effects

Antihistamine

Possible disulfiram toxicity

Barbiturates

Possible barbiturate toxicity

Warfarin

Possible enhanced effect of warfarin

Isoniazid

Increased risk of CNS effects

Metronidazole

Severe interactions including psychosis and confusion

Phenytoin

Possible phenytoin toxicity

Theophylline

Possible theophylline toxicity

Tricyclic antidepressants

Possible antidepressant toxicity

Disease interactions

Consult your doctor before using this drug if you have heart disease, liver or kidney disease, epilepsy, or if you have diabetes mellitus.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage

Adults: 200-400 mg once a day or 400 mg on alternate days as needed

Interesting fact

Disulfiram was originally intended to treat parasitic infestations; however, workers testing the substance on themselves, reported severe symptoms after alcohol consumption.

 

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