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ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS › ECTOPARASITICIDES, INCL. SCABICIDES, INSECTICIDES AND REPELLENTS › ECTOPARASITICIDES, INCL. SCABICIDES › Sulfur containing products
disulfiram
P03AA04
Forms & Strengths
- Oral tablets: 250 mg
- Oral tablets: 500 mg
Adult Dosing
- Initial dose: Maximum 500 mg daily given in a single dose for 1 to 2 weeks
- Maintenance dose: 250 mg daily (range 125 to 500 mg daily); do not exceed 500 mg daily
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
Indications
- Management of chronic alcoholism in supportive treatment under medical supervision
Mechanism of Action
- Aldehyde dehydrogenase inhibitor; blocks the oxidation of alcohol at the acetaldehyde stage, causing pooling of acetaldehyde and a highly unpleasant physiological reaction when alcohol is ingested
Contraindications
- Severe myocardial disease or coronary occlusion
- Psychosis
- Hypersensitivity to disulfiram or related thiuram derivatives
- Recent ingestion of alcohol, alcohol-containing products (e.g., cough syrups), or metronidazole
Adverse Reactions
- Drowsiness, fatigue, headache
- Metallic or garlic-like aftertaste
- Hepatotoxicity (potentially fatal)
- Peripheral neuropathy, optic neuritis
- Psychotic reactions
Drug Interactions
- Alcohol and alcohol-containing products: triggers severe disulfiram-ethanol reaction
- Metronidazole: acute toxic psychosis or confusion
- Isoniazid: unsteady gait and marked changes in mental status
- Warfarin: increases anticoagulant effect and hemorrhage risk
- Phenytoin: inhibits metabolism leading to increased toxicity
Curated Content: Needs Vetting Before Put to Clinical Use