diszulfiram

Disulfiram, sometimes spelled diszulfiram in some texts, is a medication used as an adjunct in the treatment of alcohol dependence. It acts by inhibiting aldehyde dehydrogenase, an enzyme involved in metabolizing ethanol. When alcohol is consumed by someone taking disulfiram, acetaldehyde accumulates, producing a constellation of unpleasant effects such as facial flushing, headache, nausea, vomiting, sweating, palpitations, and sometimes fainting or hypotension. This disulfiram-ethanol reaction is intended to deter drinking and encourage abstinence.

Indications for disulfiram include use as part of a comprehensive treatment program for adults with chronic alcohol dependence who are committed to abstinence and can adhere to supervision and monitoring. It is not a cure for alcoholism. The medication is taken orally, usually once daily, with typical doses ranging from 125 mg to 500 mg depending on individual response and tolerability. The reaction can occur within minutes to hours after alcohol ingestion and may last several hours. Patients should avoid all sources of alcohol, including alcoholic beverages and certain medicines, as well as alcohol-containing products such as some mouthwashes, cough syrups, and flavorings, and should inform clinicians of all concurrent medications.

Contraindications include active alcohol use, hypersensitivity to disulfiram, significant liver disease, pancreatitis, and pregnancy. Caution is advised in individuals with liver impairment or cardiovascular disease, and disulfiram should be discontinued if signs of liver injury occur. Interactions with other drugs can occur; concomitant use with alcohol-containing products must be avoided. Some antibiotics, such as metronidazole, can increase the risk of adverse reactions. Regular medical supervision and liver function monitoring are recommended during therapy.