Disulfiram: Addiction Uses, Side Effects, Dosage (original) (raw)
Generic Name: disulfiram
Brand Name: Antabuse
Drug Class: Psychiatry Agents Other
What is disulfiram, and what is it used for?
Disulfiram is an oral prescription drug used for treating alcoholism. Antabuse is used of treating alcoholism in combination with supportive care and psychotherapy.
Alcohol is converted in the body into acetaldehyde by an enzyme called alcohol dehydrogenase. Another enzyme called acetaldehyde dehydrogenase then converts acetaldehyde into acetic acid. Disulfiram prevents acetaldehyde dehydrogenase from converting acetaldehyde into acetic acid, leading to a buildup of acetaldehyde levels in the blood.
High acetaldehyde levels cause unpleasant symptoms after drinking alcohol such as:
- Palpitations
- Low blood pressure
- Chest pain
- Nausea
- Vertigo
- Thirst
- Flushing
- Headache
- Several other symptoms
These unpleasant side effects dissuade alcoholics from drinking.
What are the side effects of disulfiram?
When alcohol is consumed by a patient taking disulfiram, effects include:
- Flushing
- Nausea
- Vomiting
- Sweating
- Thirst
- Throbbing headache
- Fainting
- Dizziness
- Blurred vision
- Shortness of breath
- Confusion
- Abnormal heartbeats
- Heart attack
- Liver failure
Common side effects of disulfiram include:
- Drowsiness
- Tiredness
- Headache
- Acne
- Metallic or garlic-like taste in the mouth
- Skin rash
- Impotence
- Swollen or sore tongue
Possible serious side effects of disulfiram include:
- Polyneuritis
- Hepatitis
- Peripheral neuropathy
- Optic neuritis
- Psychotic disorder
- Acneiform eruptions
Antabuse should never be given to a patient who is intoxicated, or without his or her full knowledge. Relatives of patients should be advised about this warning also.
Patients should be fully informed about the Antabuse-alcohol reaction and must be strongly warned about drinking while taking Antabuse. Patients should avoid alcohol in all forms, including alcohol in sauces, vinegars, cough mixtures, mouth wash, aftershave lotions, and back rubs.
Antabuse may cause a reaction with alcohol up to 14 days after ingestion.
Antabuse should be used cautiously in patients with diabetes, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic impairment.
Antabuse should not be given to people with severe heart disease, people allergic to Antabuse, and people with psychosis.
QUESTION What are opioids used to treat? See Answer
What is the dosage for disulfiram, and how should it be taken?
Disulfiram should not be started unless a patient has stopped ingesting alcohol for at least 12 hours.
- The initial dose is 500 mg every day for 1 to 2 weeks.
- After two weeks a maintenance dose of 125 to 500 mg is given daily.
- The average maintenance dose is 250 mg daily.
- Treatment is continued until the patient develops self-control.
- Maintenance therapy may be required for months or even years.
Which drugs interact with this medication?
- Disulfiram may increase the effect of warfarin (Jantoven) and increase the risk of bleeding. The dose of warfarin may require adjustment.
- Patients taking isoniazid and disulfiram may develop unsteady gait or significant changes in mental status. Disulfiram should be stopped if such symptoms appear.
- Disulfiram may increase blood levels of phenytoin (Dilantin), leading to high blood levels of phenytoin. Blood levels of phenytoin should be monitored and the dose of phenytoin should be adjusted as needed.
- The liquid form of ritonavir (Norvir) contains alcohol which can cause a severe reaction in people taking disulfiram.
Health News
Pregnancy and breastfeeding
- Safe use of disulfiram by pregnant women has not been established.
- It is not known whether disulfiram is excreted in human milk
What else should I know about this drug?
What preparations of are available?
- This medication is available as tablets of 250 mg and 500 mg.
How should I keep this medication stored?
- This drug should be stored at room temperature, 20 C to 25 C (68 F to 77 F).
When was it approved by the FDA?
- The FDA approved disulfiram in August, 1951.
Summary
Disulfiram is an drug used to treat alcoholism by interfering with how the body breaks down the alcohol. If a patient drinks alcohol on the drug, he or she will experience a range of unpleasant and even dangerous side effects like vomiting, seating, throbbing headache, confusion, and shortness of breath; removing the urge to drink. Common side effects of disulfiram include drowsiness, tiredness, headache, acne, metallic or garlic-like taste in the mouth, skin rash, impotence, and swollen or sore tongue.
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Medically Reviewed on 4/4/2023
References
Medically reviewed by John P. Cunha, DO, FACOEP; Board Certified Emergency Medicine
REFERENCE:
FDA Prescribing Information