Therapeutic Action: Alcohol-sensitizing.
Pharmacological characteristics:
It inhibits the oxidation of acetaldehyde (a product of alcohol metabolism) and that is why the ingestion of alcohol during treatment with disulfiram causes an uncomfortable and unpleasant response (vomiting, headache, dyspnea, sweating, chest pain).
Directions Posology Contraindications Precautions Warnings Interactions Adverse Reactions Overdose
Its mechanism of action is due to the inhibition of hepatic aldehyde dehydrogenase. Acetaldehyde is responsible for the unpleasant effects that persist until the ingested alcohol is metabolized without interfering with its elimination. Disulfiram is absorbed and eliminated slowly, the effects are kept to one or two weeks after the last dose intake, does not produce tolerance.
Directions:
Alcoholism: For use within a comprehensive treatment program for alcoholism in order to reduce the risk of relapse, maintaining abstinence and reducing craving for alcohol during the early stages of recovery. Since Disulfiram is not as useful for all patients and the expected benefit of treatment with Disulfiram is a moderate improvement of the result produced by conventional therapy, its use in alcoholism must be accompanied by psychotherapeutic measures, carried out in specialized contexts in the treatment of this disease.
Dose and route of administration:
Should not be administered until the patient has suspended the intake of alcohol (at least 12 hours). Initial dose: 500mg/day for one to two weeks. Maintenance dose: 250mg/día. Note: if the patient drinks alcohol while taking disulfiram, develops a reaction that requires treatment: restoration of blood pressure, treatment for shock and, when necessary, oxygen, carbogen (95% oxygen, 5% carbon dioxide), vitamin C intravenously in massive doses (1g) and ephedrine sulfate.
Contraindications:
Hypersensitivity to disulfiram or other thiuram derivatives used in the rubber industry. Patients who have recently received metronidazole, paraldehyde, alcohol or preparations containing them (cough syrups). Avoid exposure to covert forms of alcohol: vinegars, sauces, lotions, etc..
Precautions and Warnings:
Should not be administered in the presence of alcohol intoxication. The patient should be fully aware that receive this drug and its possible effects and precautions to take. The effect antabuse, "which occurs due to the simultaneous administration of alcohol and disulfiram, including flushing, headache, dyspnea, nausea, vomiting, sweating, thirst, chest pain, palpitations, weakness, dizziness, blurred vision and, in the most severe, there may be respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions and death.
Drug Interactions:
Disulfiram interferes with the metabolism of certain drugs, which can increase some toxic effects. The administration to patients receiving phenytoin and related drugs should be accompanied by monitoring plasma of these, due to phenytoin toxicity can develop. The dose of oral anticoagulants should be adjusted. Isoniazid can cause unsteady gait and altered mental status checked when administered with disulfiram. The combination of disulfiram and nitrite, bromide of ethylene in animals is the cause of increased incidence of tumors, but still has revealed a similar effect in humans. During treatment and in patients treated with digitalis potasemia should be controlled.
Adverse Reactions:
May cause optic neuritis, polyneuritis and peripheral neuropathy. Fulminant cholestatic hepatitis. Eruptions can be controlled with antihistamines. In some cases it appears drowsiness, fatigue, impotence, headache, metallic taste or garlic, which usually disappear after two weeks of treatment. Psychotic reactions have occurred in high doses or combined toxicity (metronidazole, isoniazid).
Overdose:
In the event of an overdose attend the nearest hospital or contact the Poison Control Centers.
Please consult with your personal doctor before starting on any medical treatment.