What is Disulfiram?
Disulfiram is used to treat alcohol abuse disorder, also known as chronic alcoholism. It works by blocking the enzyme involved in the breakdown of alcohol. When combined with alcohol, disulfiram can cause unpleasant side effects that may help you avoid drinking. The use of disulfiram alone is not enough to treat alcoholism. Other non-drug therapies, including behavior modification, counseling, psychotherapy, and support, are necessary to help you stop drinking.
Warnings
Disulfiram should not be used if you recently took metronidazole or paraaldehyde or have consumed foods or products containing alcohol (mouthwashes, cough medicines, cooking wine, vinegar, desserts, and other items). If you have consumed alcohol in the last 12 hours, do not take disulfiram. You should not drink alcohol when taking disulfiram and for 14 days following the end of treatment. Never give disulfiram to someone without their knowledge.
Before you take this drug
If you have consumed alcohol in the last 12 hours, do not take disulfiram. Do not drink alcohol while taking disulfiram. This applies for 14 days following the cessation of disulfiram.
If you have an allergy to disulfiram, or:
- You have recently taken flagyl or metronidazole.
- You have consumed alcohol-containing foods and products (mouthwashes, cough medicines, cooking wines or vinegars, certain desserts).
Tell your doctor about any of the following to ensure that disulfiram will be safe for you:
- Liver or kidney disease
- Heart disease: high blood pressure; history of a heart attack
- Underactive thyroid
- Diabetes;
- Seizures or epilepsy;
- Head injury or brain damage;
- A history of psychosis or mental illness;
- Rubber allergy
- If you are taking phenytoin, tuberculosis medication (Dilantin), or a blood-thinning medicine (Warfarin, Coumadin, Jantoven),
FDA pregnancy class C There is no information on whether disulfiram can harm an unborn child. You should tell your doctor if disulfiram is causing you to become pregnant or if this is something that you plan on doing. You should not breastfeed while taking disulfiram. It is unknown if the drug passes into breastmilk or if it can harm a baby who is nursing. Disulfiram should not be given to anyone younger than 18 without consulting a doctor.
Similar/related drugs
Naltrexone, acamprosate, Vivitrol, Antabuse, Campral, and Revia
How to take Disulfiram?
Disulfiram is a medication that must be taken according to the instructions on the label. Your physician may adjust your dosage at times so as to obtain optimal results.Disulfiram should not be taken in higher or lower doses or for longer than prescribed. Your liver will require frequent blood tests. Wear a medical ID tag or carry a card that states that you take disulfiram, so that anyone who treats you will know that you're taking it. Your doctor may suggest that you receive disulfiram from a caregiver or family member as part of an alcohol detoxification or addiction treatment program. You want to be sure that you're using the medication as prescribed. During treatment with disulfiram, additional forms of counseling or monitoring may be recommended. For best results, keep using disulfiram as directed. Sometimes, disulfiram can be given for several months or even years. Store disulfiram away from moisture, heat, and light at room temperature.
What happens if I miss the dose?
Disulfiram should be taken as soon as possible after you have forgotten. If your doctor has not prescribed otherwise, take the remaining doses of the day at regular intervals.
What happens if I overdose?
Call 1-800-222-1222 for poison help or seek immediate medical attention.
What should be avoided?
Stay away from situations in which alcohol could tempt you. Be aware that many products, even those with small amounts of alcohol in them, can cause a reaction to disulfiram. These products include mouthwash, aftershaves, colognes, perfumes, antiperspirants, astringents for the skin, antiseptics, and hair dyes. You can check the label of any medicine or food product to determine if it contains alcohol. Should you have any inquiries, don't hesitate to consult your pharmacist. Avoid contact with products such as paint thinners and solvents. Avoid inhaling or touching fumes from pesticides and chemicals used by manufacturers or other industries. (Waxes, dyes, resins, and gums)
Side effects of Disulfiram
If you suspect an allergic reaction, seek medical assistance immediately: hives, difficulty breathing, swelling of lips, face, tongue or throat.
Disulfiram can cause unpleasant symptoms even when you drink small amounts of alcohol. These symptoms include:
- Flushing (warmth, redness, or tingling feeling);
- Increased thirst, rapid weight gain, sweating
- Nausea, severe vomiting;
- Headache, neck pain, and blurred vision
- Chest pain and shortness of breath, even with mild exercise
- Fast or pounding pulses; fluttering or rapid heartbeats in the chest
- Feeling unsteady, confusion, and weakness are all symptoms of feeling unsteady.
- A feeling of lightheadedness, as if you could pass out.
When disulfiram is combined with large amounts of alcohol, more severe symptoms can occur, including severe chest pain that spreads to your jaw and shoulder, a slow heartbeat, a weak pulse, seizures, fainting, shallow or weak breathing, or even slow breathing. Alcohol and disulfiram can have fatal reactions.
The side effects of disulfiram can be serious. If you experience:
- Eye pain or sudden vision loss;
- Confuse yourself with unusual thoughts or behaviors.
- Liver problems: nausea; upper stomach discomfort; itching and fatigue; loss of appetite; dark urine; clay-colored stools. Jaundice.
Some of the common side effects associated with disulfiram include:
- Skin rash, acne
- Mild headache and tiredness
- Impotence; loss of interest in sexual activity
- A metallic or garlic taste in the mouth.
There may be other side effects. For medical advice on side effects, call your doctor. The FDA can be contacted at 1-800-FDA-1088 to report side effects.
Details on dosage
Adult dose for alcohol dependence:
Initial dose: 500mg orally, once daily (generally continued for 1 to 2 weeks).
Maintenance dosage: 250 mg orally, once daily (range: from 125mg to 500mg once a day).
Maximum dose: 500 mg once a day.
Duration: Therapy can last for months or years, depending on the individual.
Comment:
Patients who feel sedative effects may take this medication in the evening, even though it is usually taken in the morning. The dosage can also be adjusted.
Use: As an alcohol deterrent to treat patients who are cooperative and have drinking problems. It should be used in conjunction with supportive treatment.
Interaction with other drug
Disulfiram may interact with other drugs, such as prescription and over-the-counter medicines, vitamins, and herbal products. Inform your healthcare providers of all the medicines you are taking and those you plan to take.
