Brand names: Disulfiram
Aldehyde Dehydrogenase Inhibitor · Acetyl Aldehyde Dehydrogenase Inhibitors
Route: Oral
FDA Black Box Warning
WARNING: Disulfiram should never be administered to a patient when he is in a state of alcohol intoxication, or without his full knowledge. The physician should instruct relatives accordingly. Disulfiram should never be administered to a patient when he is in a state of alcohol intoxication, or without his full knowledge. The physician should instruct relatives accordingly.
Contraindications
CONTRAINDICATIONS: Patients who are receiving or have recently received metronidazole, paraldehyde, alcohol, or alcohol-containing preparations, e.g., cough syrups, tonics and the like, should not be given disulfiram. Disulfiram is contraindicated in the presence of severe myocardial disease or coronary occlusion, psychoses, and hypersensitivity to disulfiram or to other thiuram derivatives used in pesticides and rubber vulcanization.
Pregnancy & Breastfeeding
Usage in Pregnancy: The safe use of this drug in pregnancy has not been established. Therefore, disulfiram should be used during pregnancy only when, in the judgment of the physician, the probable benefits outweigh the possible risks.
19 interactions on record
Psychotic reactions can occur; do not take concurrently or within the last 2 weeks of disulfiram.
Source: NLP:bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride
Dronabinol oral solution contains alcohol and propylene glycol which produce disulfiram-like reactions. Discontinue disulfiram at least 14 days before starting dronabinol and do not administer within 7 days of completing treatment.
Source: NLP:dronabinol
Psychotic reactions reported in alcoholic patients using metronidazole and disulfiram concurrently. Metronidazole should not be given to patients who have taken disulfiram within the last two weeks.
Source: NLP:metronidazole
Psychotic reactions reported in alcoholic patients using disulfiram concurrently with oral metronidazole. Should not be used within two weeks of disulfiram.
Source: NLP:metronidazole vaginal gel, 1.3 %
Tinidazole should not be given to patients who have taken disulfiram within the last two weeks due to risk of psychotic reactions.
Source: NLP:tinidazole
Increases plasma cocaine exposure (AUC and Cmax) by several fold after intranasal or intravenous administration. Avoid use of cocaine hydrochloride nasal solution in patients taking disulfiram.
Source: NLP:cocaine hydrochloride
Disulfiram treatment increases plasma cocaine exposure (AUC and Cmax) by several folds. Avoid using NUMBRINO in patients taking disulfiram; consider alternative local anesthesia.
Source: NLP:cocaine hydrochloride nasal
Concomitant administration can lead to phenytoin intoxication due to decreased metabolism. Baseline and ongoing serum level monitoring required with possible dosage adjustment.
Source: NLP:disulfiram
CYP1A2 inhibitor that increases warfarin effect and INR; requires close INR monitoring
Source: NLP:warfarin
CYP1A2 inhibitor that increases warfarin effect and INR; requires closer INR monitoring.
Source: NLP:warfarin sodium
Amitriptyline may interact with disulfiram; see WARNINGS section for details.
Source: NLP:amitriptyline hydrochloride
May increase phenytoin serum levels; monitoring of phenytoin levels recommended.
Source: NLP:fosphenytoin sodium
Patients should be observed for unsteady gait or marked changes in mental status. Disulfiram should be discontinued if such signs appear.
Source: NLP:disulfiram
A reversible hypomanic reaction was reported; confirmed by dechallenge and rechallenge.
Source: NLP:nabilone
Safety and efficacy of concomitant use is unknown. Concomitant use of two potentially hepatotoxic medications is not ordinarily recommended unless probable benefits outweigh known risks.
Source: NLP:naltrexone hydrochloride
Omeprazole can prolong elimination of disulfiram. Monitor and determine need for dose adjustments.
Source: NLP:omeprazole
Disulfiram may prolong prothrombin time. Dosage adjustment may be necessary when beginning or stopping disulfiram.
Source: NLP:disulfiram
May increase phenytoin serum levels; monitoring of phenytoin levels recommended.
Source: NLP:extended phenytoin sodium
Disulfiram does not affect the pharmacokinetics of acamprosate; no clinically important interaction.
Source: NLP:acamprosate calcium