Disulfiram

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A drug used to treat alcohol dependence (also called Antabuse).

Information about Disulfiram

Disulfiram is an alcohol deterrent used as an adjunct to treatment of chronic alcoholism, based upon its ability to cause an aversive reaction when taken with alcohol.

Liver safety of Disulfiram

Disulfiram has been associated a low rate of with serum aminotransferase elevations during chronic therapy and has been linked to clinical apparent acute liver injury which can be severe and result in fatality.

Mechanism of action of Disulfiram

Disulfiram (dye sul' fi ram) is tetraethylthiuram disulfide and is a potent inhibitor of aldehyde dehydrogenase activity, which interferes with the oxidative metabolism of alcohol resulting in accumulation of acetaldehyde.

The elevations in serum acetaldehyde levels cause the aversive symptoms of disulfiram which include flushing, headache, nausea, vomiting and sweating and can result in dizziness, blurred vision, dyspnea, palpitations, hypotension, chest pain and syncope. Disulfiram was developed as an antihelminthic, but was then pursued as a possible alcohol deterrent when its aversive effects upon alcohol intake were found.

FDA approval information for Disulfiram

Disulfiram was approved for use in the United States in 1948 and has been widely used in management of alcoholism, but in recent years has fallen out of favor because of its difficult side effects.

Dosage and administration for Disulfiram

Disulfiram is available in tablets of 250 and 500 mg in generic forms and under the brand name Antabuse. The recommended starting dose is 500 mg once daily for 1 to 2 weeks, followed by a maintenance dose of 125 to 500 mg daily. Treatment can continue for months or years.

Side effects of Disulfiram

By itself (without alcohol use), disulfiram has few side effects, but can cause skin rash, gastrointestinal upset, drowsiness, headache, tremor and metallic taste.

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