A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Antabuse Side Effects, and Drug Interactions - Disulfiram
Antabuse Side Effects, and Drug Interactions - Disulfiram
SIDE EFFECTS
(See CONTRAINDICATIONS,
WARNINGS, and PRECAUTIONS.)
O.T.(C) NEURITIS, PERIPHERAL
NEURITIS, POLYNEURITIS, AND PERIPHERAL NEUROPATHY MAY OCCUR FOLLOWING
ADMINISTRATION OF DISULFIRAM.
Multiple cases of hepatitis,
including both cholestatic and fulminant hepatitis, have been reported
to be associated with administration
of disulfiram.
Occasional skin eruptions
are, as a rule, readily controlled by concomitant administration
of an antihistaminic
drug.
In a small number of
patients, a transient
mild drowsiness,
fatigability, impotence, headache,
acneform eruptions, allergic
dermatitis, or a
metallic or garlic-like aftertaste
may be experienced during the first two weeks of therapy. These
complaints usually disappear spontaneously with the continuation
of therapy, or with
reduced dosage.
Psychotic reactions have been noted, attributable in most cases
to high dosage, combined toxicity
(with metronidazole
or isoniazid), or to the unmasking of underlying psychoses in patients
stressed by the withdrawal of alcohol.
DRUG INTERACTIONS
Disulfiram appears to decrease the rate
at which certain drugs are metabolized and therefore may increase
the blood levels and the
possibility of clinical toxicity of drugs given concomitantly.
DISULFIRAM SHOULD BE USED WITH CAUTION IN THOSE PATIENTS REVEIVING
PHENYTOIN AND ITS CONGENERS. SINCE THE CONCOMITANT ADMINISTRATION
OF THESE TWO DRUGS CAN LEAD TO
PHENYTOIN INTOXICATION, PRIOR TO
ADMINISTERING DISULFIRAM TO A PATIENT ON
PHENYTOIN THERAPY, A BASELINE PHENYTOIN SERUM LEVEL SHOULD BE
OBTAINED. SUBSEQUENT TO
INITIATION OF DISULFIRAM THERAPY. SERUM LEVELS OF PHENYTOIN SHOULD
BE DETERMINED ON DIFFERENT
DAYS FOR EVIDENCE OF AN INCREASE OR
FOR A CONTINUING RISE IN LEVELS. INCREASED PHENYTOIN LEVELS SHOULD
BE TREATED WITH APPROPRIATE DOSAGE ADJUSTMENT.
It may be necessary to adjust the dosage
of oral anticoagulants
upon beginning or stopping disulfiram. since disulfiram
may prolong prothrombin time..
Patients taking isoniazid
when disulfiram is
given should be observed for the appearance
of unsteady gait or marked
changes in mental status;
the disulfiram should
be discontinued if such
signs appear.
In rats, simultaneous ingestion
of disulfiram and
nitrite in the diet
for 78 weeks has been reported to cause
tumors, and it has been suggested that disulfiram
may react with nitrites
in the rat stomach
to form a nitrosamine,
which is tumorigenic. Disulfiram alone in the rat’s diet
did not lead to such tumors.
The relevance of this finding to humans is not known at this time.
Concomitant Conditions: Because of the possibility of an
accidental disulfiram-alcohol reaction,
disuffiram should be used with extreme caution in patients with
any of the following conditions: diabetes
mellitus, hypothyroidism, epilepsy, cerebral damage, chronic
and acute nephritis,
hepatic cirrhosis or
insufficiency.
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