Disulfiram (disulfiram)

The initial dosage of disulfiram is a maximum of 500 mg every morning for 1-2 weeks, then 250 mg daily. The daily dose can be taken in the evening if drowsiness occurs. Maintenance dosage may range from 125-500 mg daily, but the dosage should not exceed 500 mg daily. Daily uninterrupted administration of disulfiram should be continued until a basis for permanent self-control is established. Treatment may be required for months or years.

The practice of inducing an alcohol-disulfiram reaction to demonstrate the reaction to the patient has been largely abandoned; it is considered by most clinicians to be unnecessary, and may, in fact, be associated with increased drug toxicity. An explicit description of the alcohol-disulfiram reaction is usually sufficient to deter the patient from ingesting alcohol during treatment with disulfiram. If an alcohol trial is deemed necessary, it should be performed only under careful medical supervision and with adequate facilities (including oxygen) available for treatment of a severe reaction. Patients older than 50 years of age should not undergo an alcohol test reaction. The procedure for alcohol trial consists of administering 15 mL of 100 proof whiskey (or its equivalent) to the patient after 1-2 weeks of disulfiram therapy. The dose of alcohol may be repeated once, but should not exceed 30 mL of whiskey. Alcohol should be discontinued as soon as symptoms develop.

Disulfiram is administered orally. If compliance becomes a problem during disulfiram therapy, the patient should take the drug under close supervision, preferably as crushed tablets well mixed with liquid. Disulfiram has also been administered as an implant (not commercially available in the US) subcutaneously into the abdominal wall; however, blood concentrations of disulfiram are lower than those obtained following oral administration and safety and efficacy of this route of administration have not been established.

Disulfiram should not be administered until the patient has abstained from alcohol for at least 12 hours and should never be administered without the patient's knowledge.

No dosing information is available for this tab.

No dosing information is available for this tab.

Disulfiram interferes with the hepatic metabolism of alcohol, barbiturates, coumarin anticoagulants, paraldehyde (no longer commercially available in the US), terfenadine (no longer commercially available in the US), and phenytoin and its congeners, and therefore may increase blood concentrations and toxicity of these drugs.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

Safe use of disulfiram during pregnancy has not been established. The drug should be administered during pregnancy only when the potential benefits justify the possible risks to the fetus.

No enhanced messaging available.

No enhanced messaging available.