Disulfiram(dye sul’ firam)
Antabuse
PREGNANCY CATEGORY C
Drug Classes
Antialcoholic drug
Enzyme inhibitor
Therapeutic Actions
Inhibits the enzyme aldehyde dehydrogenase, blocking oxidation of alcohol and allowing acetaldehyde to accumulate to concentrations in the blood 5–10 times higher than normally achieved during alcohol metabolism; accumulation of acetaldehyde produces the highly unpleasant reaction described below that deters consumption of alcohol.
Indications
Aids in the management of selected chronic alcoholics who want to remain in a state of enforced sobriety
Contraindications and Cautions
Contraindicated with allergy to disulfiram or other thiuram derivatives used in pesticides and rubber vulcanization, severe myocardial disease or coronary occlusion; psychoses, current or recent treatment with metronidazole, paraldehyde, alcohol, alcohol-containing preparations (eg, cough syrups), pregnancy.
Use cautiously with diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, chronic and acute nephritis, hepatic cirrhosis or impairment.
Available Forms
Tablets—250, 500 mg
Dosages
Adults
Initial dosage: Administer maximum of 500 mg/day PO in a single dose for 1–2 wk. If a sedative effect occurs, administer at bedtime or decrease dosage.
Maintenance regimen: 125–500 mg/day PO. Do not exceed 500 mg/day. Continue use until patient fully recovers socially and has basis for permanent self-control.
Pharmacokinetics
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