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NERVOUS SYSTEM › OTHER NERVOUS SYSTEM DRUGS › DRUGS USED IN ADDICTIVE DISORDERS › Drugs used in alcohol dependence
disulfiram
N07BB01
Forms & Strengths
- Oral tablet: 250 mg
- Oral tablet: 500 mg
Adult Dosing
- Initial dose: Maximum 500 mg daily given as a single dose for 1 to 2 weeks
- Maintenance dose: 250 mg daily (range 125 mg to 500 mg daily)
- Maximum daily dose: 500 mg
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
Indications
- Management of chronic alcoholism in supportive treatment to assist in maintaining sobriety
Mechanism of Action
- Aldehyde dehydrogenase inhibitor that blocks the oxidation of alcohol
- Causes a noxious accumulation of acetaldehyde, resulting in severe physiological reactions when ethanol is ingested
Contraindications
- Severe myocardial disease or coronary occlusion
- Psychosis
- Hypersensitivity to disulfiram or related thiuram derivatives
- Recent or concurrent ingestion of alcohol, paraldehyde, metronidazole, or alcohol-containing products
Adverse Reactions
- Drowsiness, fatigue, headache
- Metallic or garlic-like aftertaste
- Hepatotoxicity (potentially fatal)
- Peripheral neuropathy
- Psychotic reactions
Drug Interactions
- Alcohol: Triggers severe disulfiram-ethanol reaction (flushing, nausea, vomiting, hypotension, tachycardia)
- Metronidazole: Concomitant use can cause acute toxic psychosis or confusion
- Isoniazid: Increases risk of neurotoxicity and ataxia
- Warfarin: Inhibits metabolism, enhancing anticoagulant effect and bleeding risk
- Phenytoin: Inhibits hepatic metabolism, leading to phenytoin toxicity
Curated Content: Needs Vetting Before Put to Clinical Use