Drug reference
Adjunct in the treatment of alcohol dependence (under expert supervision) ▶BY MOUTH ▶Adult: 200 mg daily, increased if necessary up to 500 mg daily l UNLICENSED USE Disulfiram doses in BNF may differ from those in product literature.
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Cardiac failure. coronary artery disease. history of cerebrovascular accident. hypertension . psychosis. severe personality disorder. suicide risk
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Alcohol challenge not recommended on routine basis (if considered essential—specialist units only with resuscitation facilities). avoid in Acute porphyrias p. 1120. diabetes mellitus. epilepsy. respiratory disease
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Before initiating disulfiram, prescribers should evaluate the patient’s suitability for treatment, because some patient factors, for example memory impairment or social circumstances, make compliance to treatment or abstinence from alcohol difficult.
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→Appendix 1: disulfiram
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Allergic dermatitis. breath odour. depression. drowsiness. encephalopathy. fatigue. hepatocellular injury. libido decreased. mania. nausea. nerve disorders. paranoia. psychotic disorder. vomiting
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High concentrations of acetaldehyde which occur in presence of alcohol may be teratogenic; avoid in first trimester.
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Avoid—no information available.
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Manufacturer advises caution.
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Use with caution.
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During treatment with disulfiram, patients should be monitored at least every 2 weeks for the first 2 months, then each month for the following 4 months, and at least every 6 months thereafter.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 2 ▶Disulfiram (Non-proprietary) Disulfiram 200 mg Disulfiram 200mg tablets | 50 tablet P £127.22 DT = £111.54 ▶Antabuse (Imported (United States)) Disulfiram 250 mg Antabuse 250mg tablets | 100 tablet P s ▶Esperal (Imported (France)) Disulfiram 500 mg Esperal 500mg tablets | 20 tablet P s GAMMA-AMINOBUTYRIC ACID ANALOGUES AND DERIVATIVES
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Manufacturer advises patients and their carers should be counselled on the disulfiram-alcohol reaction—reactions may occur following exposure to small amounts of alcohol found in perfume, aerosol sprays, or low alcohol and "non-alcohol" beers and wines; symptoms may be severe and life- threatening and can include nausea, flushing, palpitations, arrhythmias, hypotension, respiratory depression, and coma. g Patients and their carers should be counselled on the signs of hepatotoxicity—patients should discontinue treatment and seek immediate medical attention if they feel unwell or symptoms such as fever or jaundice develop. h
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200 mg daily, increased if necessary up to
First-line fragment. Read the complete Indications and Dose section above.
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