Disulfiram has 24 known drug interactions based on U.S. FDA drug labeling data. Of these, 6 are contraindicated combinations that should be avoided entirely. 6 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Benznidazole, Bismuth Subcitrate Potassium, Metronidazole And Tetracycline Hydrochloride, Dronabinol. Patients taking Disulfiram should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 24
- Contraindicated
- 6
- Major
- 6
- Moderate
- 10
- Minor
- 2
Contraindicated (6)
- Disulfiram + Benznidazole— Psychotic reactions reported with concurrent use of disulfiram and nitroimidazole agents. Benznidazole should not be giv…
- Disulfiram + Bismuth Subcitrate Potassium, Metronidazole And Tetracycline Hydrochloride— Psychotic reactions can occur; do not take concurrently or within the last 2 weeks of disulfiram.
- Disulfiram + Dronabinol— Dronabinol oral solution contains alcohol and propylene glycol which produce disulfiram-like reactions. Discontinue disu…
- Disulfiram + Metronidazole— Psychotic reactions reported in alcoholic patients using metronidazole and disulfiram concurrently. Metronidazole should…
- Disulfiram + Metronidazole Vaginal Gel, 1.3 %— Psychotic reactions reported in alcoholic patients using disulfiram concurrently with oral metronidazole. Should not be …
- Disulfiram + Tinidazole— Tinidazole should not be given to patients who have taken disulfiram within the last two weeks due to risk of psychotic …
Major (6)
- Disulfiram + Amitriptyline Hydrochloride— Serious interaction requiring monitoring; see WARNINGS section for detailed guidance.
- Disulfiram + Cocaine Hydrochloride— Increases plasma cocaine exposure (AUC and Cmax) by several fold after intranasal or intravenous administration. Avoid u…
- Disulfiram + Cocaine Hydrochloride Nasal— Disulfiram treatment increases plasma cocaine exposure (AUC and Cmax) by several folds. Avoid using NUMBRINO in patients…
- Disulfiram + Phenytoin— Concomitant administration can lead to phenytoin intoxication due to decreased metabolism. Baseline and ongoing serum le…
- Disulfiram + Warfarin— CYP1A2 inhibitor that increases warfarin effect and INR; requires close INR monitoring
- Disulfiram + Warfarin Sodium— CYP1A2 inhibitor that increases warfarin effect and INR; requires closer INR monitoring.
Moderate (10)
- Disulfiram + Acetaminophen, Caffeine, Dihydrocodeine Bitartrate— Co-administration with caffeine may lead to substantial decrease in caffeine clearance, causing accumulation.
- Disulfiram + Fosphenytoin Sodium— May increase phenytoin serum levels; monitoring of phenytoin levels recommended.
- Disulfiram + Isoniazid— Patients should be observed for unsteady gait or marked changes in mental status. Disulfiram should be discontinued if s…
- Disulfiram + Nabilone— A reversible hypomanic reaction was reported; confirmed by dechallenge and rechallenge.
- Disulfiram + Naltrexone Hydrochloride— Safety and efficacy of concomitant use is unknown. Concomitant use of two potentially hepatotoxic medications is not ord…
- Disulfiram + Omeprazole— Omeprazole can prolong elimination of disulfiram. Monitor and determine need for dose adjustments.
- Disulfiram + Omeprazole And Sodium Bicarbonate— Omeprazole and sodium bicarbonate can prolong disulfiram elimination. Monitor for possible dose adjustments.
- Disulfiram + Oral Anticoagulants— Disulfiram may prolong prothrombin time. Dosage adjustment may be necessary when beginning or stopping disulfiram.
- Disulfiram + Phenytoin Sodium— May increase phenytoin serum levels; monitoring of phenytoin levels recommended.
- Disulfiram + Thalidomide— Disulfiram causes peripheral neuropathy and concomitant use with thalidomide can cause additive effect; should be used w…
Minor (2)
- Disulfiram + Acamprosate Calcium— Disulfiram does not affect the pharmacokinetics of acamprosate; no clinically important interaction.
- Disulfiram + Acamprosate Calcium Enteric-Coated— The pharmacokinetics of acamprosate are not affected by disulfiram.