Disulfiram (Antabuse)


  • Chronic Ethanol Abuse (see Ethanol, [[Ethanol]])


  • Aldehyde Dehydrogenase Inhibitor

Disulfiram is a thiuram derivative which interferes with aldehyde dehydrogenase.

When taken concomitantly with alcohol, there is an increase in serum acetaldehyde levels. High acetaldehyde causes uncomfortable symptoms including flushing, nausea, thirst, palpitations, chest pain, vertigo, and hypotension.

This reaction is the basis for disulfiram use in postwithdrawal long-term care of alcoholism.


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Dose Adjustment

  • Hepatic:
  • Renal:

Adverse Effects

Dermatologic Adverse Effects

  • Acneiform Eruption
  • Dermatitis
  • Rash

Neurologic Adverse Effects

Gastrointestinal Adverse Effects

  • Cholestatic Hepatitis (see xxxx, [[xxxx]])
  • Fulminant Hepatic Failure (see Fulminant Hepatic Failure, [[Fulminant Hepatic Failure]])
  • Metallic/Garlic-Like Aftertaste

Genitourinary Adverse Effects

Ophthalmologic Adverse Effects

Adverse Effects (Disulfiram Intoxication)

Neurologic Adverse Effects

  • Encephalopathy/Coma (see xxxx, [[xxxx]])

Otolaryngologic Adverse Effects

  • Vocal Fold Immobility (see xxxx, [[xxxx]])

Adverse Effects (Disulfiram-Ethanol Reaction)

General Comments

  • Histamine-Like Reaction: due to accumulation of acetaldehyde

Allergic Manifestations

Cardiovascular Manifestations

Dermatologic Manifestations

Gastrointestinal Manifestations

Treatment of Disulfiram-Ethanol Reaction

  • Fomepizole (see Fomepizole, [[Fomepizole]]): alcohol dehydrogenase inhibitor
    • May Be Effective


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