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Antabuse (Disulfiram)

Indications

Antabuse is prescribed for the management of chronic alcoholism. It helps patients who are motivated to quit drinking by causing unpleasant effects when alcohol is consumed, thereby discouraging alcohol intake.

Dosage and Administration

• Take Antabuse exactly as prescribed by your doctor, usually once daily.
• Ensure you have not consumed alcohol for at least 12 hours before starting Antabuse.
• Inform your healthcare provider of all medications and supplements you are taking to avoid interactions.
• Regularly attend follow-up appointments with your healthcare provider to monitor progress and side effects.
• Do not consume any form of alcohol while taking Antabuse, including alcohol in foods, medicines, or hygiene products like mouthwash.
• Avoid stopping Antabuse suddenly without consulting your doctor, even if you feel better.
• Do not take Antabuse if you are intoxicated or without your doctor’s supervision.

Mechanism of Action

Antabuse (disulfiram) works by inhibiting the enzyme acetaldehyde dehydrogenase. This results in the accumulation of acetaldehyde, a toxic metabolite of alcohol, when alcohol is consumed. The buildup of acetaldehyde leads to unpleasant reactions, including nausea, vomiting, headache, and flushing, which deter patients from drinking alcohol.

Contraindications

• Severe Heart Disease: Do not use if you have severe heart disease or coronary artery disease.
• Psychosis: Avoid if you have a history of psychosis.
• Recent Alcohol Consumption: Do not take if you have consumed alcohol in the past 12 hours.
• Known Allergy to Disulfiram: Avoid if you have had an allergic reaction to disulfiram or similar compounds.

Side Effects

Common Side Effects

• Drowsiness
• Fatigue
• Headache
• Metallic or garlic-like taste in the mouth
• Skin rash or acne

Serious Side Effects

• Severe liver problems (jaundice, dark urine, severe stomach pain)
• Severe allergic reactions (swelling of the face, tongue, or throat, severe rash)
• Neurological issues (confusion, memory loss, mood changes)
• Eye pain or vision changes

Precautions

• Liver Function: Regular liver function tests are recommended, as Antabuse can cause liver toxicity.
• Pregnancy and Breastfeeding: Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
• Heart Disease: Use with caution if you have a history of heart disease; consult your doctor about risks.
• Mental Health: Monitor for signs of depression or suicidal thoughts and report them to your doctor immediately.
• Diabetes: Inform your doctor if you have diabetes, as Antabuse can affect blood sugar levels.
• Avoid Alcohol-Containing Products: Be cautious of hidden alcohol in foods, medicines, and products like mouthwash and aftershave.

Storage Instructions

• Store Antabuse at room temperature, between 68°F and 77°F (20°C and 25°C).
• Keep the tablets in their original container, tightly closed, and away from moisture and light.
• Keep out of reach of children and pets.
• Do not use expired medication; dispose of it properly as per local regulations.

References

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=12850de3-c97c-42c1-b8d3-55dc6fd05750