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What is Antabuse (Disulfiram)?
What is Antabuse (Disulfiram) used for?
How does Antabuse (Disulfiram) work ?
How should Antabuse (Disulfiram) be used?
What is Antabuse (Disulfiram) Recommended dosage?
How can Antabuse (Disulfiram) affect other medicines?
What are the side effects of Antabuse (Disulfiram)?
What are the Warning for Antabuse (Disulfiram)?
What are the Precautions for Antabuse (Disulfiram)?
From where can one get Antabuse (Disulfiram)?
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What is Antabuse (Disulfiram)?
Antabuse (Disulfiram), proprietary name for Antabuse (Disulfiram), a synthetic chemical used in the treatment of alcoholism.Antabuse (Disulfiram) produces sensitivity to alcohol, which results in a highly unpleasant reaction when the alcoholic under treatment ingests or is exposed to even small amounts of alcohol. When combined with alcohol, Antabuse (Antabuse (Disulfiram)) produces unpleasant side effects such as nausea, headaches, heart palpitations, and collapse. It is prescribed in hopes that patients will associate the ill effects with alcohol and so lose their desire to drink. Some antibiotics coincidentally cause similar symptoms when combined with alcohol, producing an "Antabuse (Disulfiram) effect.
Used alone, without proper motivation and without supportive therapy, Antabuse (Disulfiram) is not a cure for alcoholism, and it will have no more than a brief effect on the drinking pattern of the chronic alcoholic.
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What is Antabuse (Disulfiram) used for?
This medication is used to help treat alcoholism. This drug is not a cure for alcoholism and must be used in combination with supportive therapy and counseling. Disulfiram (Antabuse) helps you overcome your drinking problem by making you very sick if you drink alcohol. While you take this medicine, and for 14 days before you begin taking it, you should not drink even the smallest amount of alcohol. You should not use any foods, products, or medicines that contain alcohol, nor should you come into contact with any chemicals that contain alcohol while using this medicine.
Antabuse (Disulfiram) must never be used without a person's knowledge.
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How does Antabuse (Disulfiram) work?
Antabuse (Disulfiram) is an enzyme inhibitor (aldehyde dehydrogenase inhibitor) which interferes with the metabolism of alcohol and leads to an accumulation of acetaldehyde in the blood. Antabuse (Disulfiram) blocks the oxidation of alcohol at the acetaldehyde stage. During alcohol metabolism after Antabuse (Disulfiram) intake, the concentration of acetaldehyde occurring in the blood may be 5 to 10 times higher than that found during metabolism of the same amount of alcohol alone. Accumulation of acetaldehyde in the blood produces a complex of highly unpleasant symptoms referred to as the Antabuse (Disulfiram)-alcohol reaction. This reaction, which is proportional to the dosage of both Antabuse (Disulfiram) and alcohol, will persist as long as alcohol is being metabolized. Antabuse (Disulfiram) does not appear to influence the rate of alcohol elimination from the body. The duration of the reaction is variable, from 30 to 60 minutes in mild cases, up to several hours in more severe cases or as long as there is alcohol remaining in the blood. In severe reactions, supportive measures to restore blood pressure and treat shock should be instituted. Other measures such as the administration of oxygen or carbogen (95% oxygen, 5% carbon dioxide), massive inter venous doses of vitamin C, ephedrine sulfate, or antihistamine I.V.,might be indicated. Potassium levels should be monitored particularly in alcoholics on digitalis since hypokalemia has been reported. Antabuse (Disulfiram) is slowly absorbed from the gastrointestinal tract and is slowly eliminated from the body. Ingestion of alcohol may produce unpleasant symptoms 1 or even 2 weeks after an alcoholic has taken his last dose of Antabuse (Disulfiram). Prolonged administration of Antabuse (Disulfiram) does not produce tolerance. The longer an alcoholic remains on therapy the more sensitive he becomes to alcohol.
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How should Antabuse (Disulfiram) be used?
Antabuse (Disulfiram) comes in tablets to take by mouth. It should be taken once a day. Take Antabuse (Disulfiram) by mouth, usually one or two tablets daily as directed by your doctor. If you cannot swallow the tablets, crush them and mix the medication with water, coffee, tea, milk, soft drink, or fruit juice. Do not take Antabuse (Disulfiram) for at least 12 hours after drinking alcohol. While taking Antabuse (Disulfiram), it is extremely important you avoid alcohol in all forms including beer, wine, aftershave lotions, mouthwash, colognes, liquid medications. Read labels carefully, including those of nonprescription products, and ask your pharmacist about the alcohol content if you are uncertain,Take Antabuse (Disulfiram) exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
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What is Antabuse (Disulfiram) Recommended dosage ?
Initially 2 tab daily for 2-3 days. Maintenance: 1/4-1/2 tab daily or 1 tab 2 times wkly. Antabuse (Disulfiram) should never be administered until the patient has abstained from alcohol for at least 12 hours.
Initial Dosage Schedule: In the first phase of treatment , a maximum of 500 mg daily is given in a single dose for one to two weeks. Although usually taken in the morning, Antabuse (Disulfiram) may be taken on retiring by patients who experience a sedative effect .
Alternatively, to minimize, or eliminate, the sedative effect , dosage may be adjusted downward.
Maintenance Regimen: The average maintenance dose is 250 mg daily (range, 125 to 500 mg); it should not exceed 500 mg daily.
Note: Occasionally patients, while seemingly on adequate maintenance doses of Antabuse (Disulfiram), report that they are able to drink alcoholic beverages with impunity and without any symptomatology . All appearances to the contrary, such patients must be presumed to be disposing of their tablets in some manner without actually taking them. Until such patients have been observed reliably taking their daily Antabuse (Disulfiram) Tablets (preferably crushed and well mixed with liquid), it cannot be concluded that Antabuse (Disulfiram) is ineffective.
Duration of Therapy: The daily, uninterrupted administration of Antabuse (Disulfiram) must be continued until the patient is fully recovered socially and a basis for permanent self - control is established. Depending on the individual patient , maintenance therapy may be required for months, or even years.
Trial with Alcohol: During early experience with Antabuse (Disulfiram), it was thought advisable for each patient to have at least one supervised alcohol - drug reaction . More recently, the test reaction has been largely abandoned. Furthermore, such a test reaction should never be administered to a patient over 50 years of age. A clear, detailed, and convincing description of the reaction is felt to be sufficient in most cases.
However, where a test reaction is deemed necessary, the suggested procedure is as follows: After the first one to two weeks' therapy with 500 mg daily, a drink of 15 mL (1/2 oz) of 100 proof whiskey, or equivalent , is taken slowly. This test dose of alcoholic beverage may be repeated once only, so that the total dose does not exceed 30 mL (1 oz) of whiskey. Once a reaction develops, no more alcohol should be consumed. Such tests should be carried out only when the patient is hospitalized, or comparable supervision and facilities, including oxygen , are available.
Management Of Antabuse (Disulfiram)-Alcohol Reaction: In severe reactions, whether caused by an excessive test dose or by the patient ' unsupervised ingestion of alcohol , supportive measures to restore blood pressure and treat shock should be instituted. Other recommendations include: oxygen , carbogen (95% oxygen and 5% carbon dioxide), vitamin C intravenously in massive doses (1 g), and ephedrine sulfate . Antihistamines have also been used intravenously. Potassium levels should be monitored, particularly in patients on digitalis, since hypokalemia has been reported.
When you miss a dose: Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Overdose: If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include unsteadiness, unusual bleeding or bruising, facial flushing, decreased sexual ability, fainting, memory loss, garlic or rotten egg breath, metallic taste, and seizures.
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How can Antabuse (Disulfiram) affect other medicines?
Liquid medicines, remedies, tonics and foods may contain sufficient alcohol to elicit an unpleasant reaction.
Even small amounts of alcohol will cause extremely unpleasant reactions e.g.flushing of the face, throbbing headache, palpitations, increased heart rate, nausea, vomiting.
Larger amounts of alcohol may cause irregular heart beat, low blood pressure, collapse.
Antabuse (Disulfiram) inhibits the metabolism of the following medicines and may increase their effects:
- warfarin
- phenytoin
- benzodiazepines
When given together with the following medicines there may be an increase in confusion and changes in mood:
- metronidazole
- isoniazid
- paraldehyde
Chlorpromazine and amitriptyline may increase the intensity of the Antabuse (Disulfiram)-alcohol reaction.
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What are the side effects of Antabuse (Disulfiram) ?
Side effects of Antabuse (Disulfiram) include headache, drowsiness, restlessness, skin rash, acne, garlic-like aftertaste, changes in vision. Inform your doctor if any of these effects persist or worsen. Unlikely to occur but report immediately: tingling hands or feet, fatigue, weakness, loss of appetite, nausea, vomiting, strong stomach pains, dark urine, yellowing of the eyes or skin. If you notice other effects not listed above, contact your doctor or pharmacist.
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What are the Warning for Antabuse (Disulfiram)?
Antabuse (Disulfiram) should never be administered to an individual without their full knowledge or when they are in a state of alcohol intoxication. The attending physician should instruct those tending to the individual accordingly.
Alcoholics must be fully informed about the Antabuse (Disulfiram)-alcohol reaction. They must be strongly cautioned against surreptitious drinking while taking the drug and must be fully aware of possible consequences.
They should be further informed to avoid contact with alcohol in disguised forms of food or other normal daily used items.
Do not drink alcohol whilst taking this medicine.
Use with caution in:
Alcoholics who continue to drink
Children
Diabetes
Disease affecting the airways or lungs (respiratory disease)
Epilepsy
Kidney disease
Liver disease
Not to be used in:
Coronary heart disease
Heart failure
High blood pressure (hypertension)
History of stroke
Psychiatric disorders
Psychotic illness
Risk of suicide
Stroke
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and Breastfeeding: Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby.Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
This medicine should not be used in pregnancy. Seek medical advice from your doctor.
There is no information available about the safety of this medicine during breastfeeding. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek medical advice from your doctor.
Label Warning: This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.
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What are the Precautions for Antabuse (Disulfiram) ?
Disulfiram (Antabuse) plus even small amounts of alcohol produces flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypertension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusion. In severe reactions, there may be respiratory depression, cardiovascular collapse, arrhythmia, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death.
The intensity of the reaction may vary with each individual but is generally proportional to the amount of Antabuse (Disulfiram) and alcohol ingested.
Alcoholics having a history of industrial contact dermatitis, such as worked in the rubber industry, should be evaluated for hypersensitivity to thiuram derivatives before receiving Antabuse (Disulfiram).
Alcoholics exposed to organic solvents that may contain alcohol, acetaldehyde, paraldehyde, or structural analogues are at risk of experiencing Antabuse (Disulfiram)-alcohol reactions. Such exposure should be eliminated before treatment.
It is suggested that every alcoholic under treatment carry an identification card stating that he is receiving Antabuse (Disulfiram) and describing the symptoms most likely to occur as a result of the Antabuse (Disulfiram)-alcohol reaction. In addition, this card should identify the attending physician or institution to be contacted in emergency.
Alcoholism may be associated or followed by dependence on narcotics or sedatives. Barbiturates have been administered concurrently with Antabuse (Disulfiram) without untoward effects, but the possibility of initiating a new dependence should be considered. Alcoholics taking Antabuse (Disulfiram) should not be exposed to ethylene dibromide or its vapors.
Since Antabuse (Disulfiram)-alcohol reactions could aggravate some medical conditions such as diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, chronic and acute nephritis, hepatic cirrhosis, or hepatic insufficiency, Antabuse (Disulfiram) should be used with extreme care in alcoholics having such a medical history. Baseline and follow-up transaminase tests (10 to 14 days) are suggested to detect any hepatic dysfunction that may be associated with Antabuse (Disulfiram) therapy.
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