The testimony of the drug antabusee
Treatment and prevention of relapse of chronic alcoholism.
- severe diseases of the cardiovascular system, hearing (neuritis of auditory nerve) and eyes (glaucoma, optic neuritis);
- bronchial asthma, pulmonary emphysema;
- pulmonary tuberculosis;
- severe liver failure;
- diseases blood-forming organs;
- diabetes mellitus;
- epilepsy and convulsions of any origin;
- mental illness;
- exacerbation of peptic ulcer disease;
- kidney disease;
- malignant tumors;
- polyneuritis of any etiology;
- the period of breastfeeding;
- increased individual sensitivity to the drug.
- cardiovascular diseases in the compensation stage;
- older age (over 60 years);
- ulcers disease stomach and duodenal ulcer in remission;
- residual effects after violations of cerebral circulation;
- previously migrated disulfirame (precipitates) psychosis.
Due to the properties of disulfiram:
- metallic taste in the mouth;
- unpleasant smell in patients with colostomy (associated with sulphide of carbon);
- rare cases of hepatitis (similar to that sometimes encountered in patients with Nickel eczema, not suffering from alcoholism);
- polyneuritis of the lower extremities, optic neuritis;
- memory loss, confusion, asthenia;
- allergic skin manifestations.
Related to the combination of disulfiram-ethanol: we describe the cases of respiratory failure, cardiovascular collapse, arrhythmias; angina, sometimes — myocardial infarction, and neurological disorders; cerebral edema.
Complications with prolonged use: rarely — psychosis, which resembles alcoholic; hepatitis, gastritis; in patients suffering from cardiovascular diseases, and possible thrombosis of the vessels of the brain, so when complaints of paresthesias in the extremities and face, you should immediately stop the drug; exacerbation of polyneuritis.
When receiving doses of alcohol in excess of 50-80 ml of vodka while taking of disulfiram may develop severe disorders of the cardiovascular and respiratory systems, edema, convulsions. Urgently conduct detoxication therapy, enter analeptics, symptomatic treatment.
The combination of disulfiram-ethanol can cause depression of consciousness up to coma, cardiovascular collapse, neurological complications.
Response to ethanol reduces ascorbic acid.
Contraindicated in combination
Alcohol. Intolerance reactions (flushing, erythema, vomiting, tachycardia). Should avoid taking alcoholic beverages and drugs containing alcohol.
Isoniazid. Disturbances of behavior and coordination.
Nitro-5-imidazoles (metronidazole, ordinator, seknidazol, tinidazole). Delirious disorder, confusion.
Phenytoin. The significant and rapid rise in the level of phenytoin in plasma with toxic symptoms (inhibition of its metabolism).
If combination cannot be avoided, should be carried out clinical monitoring and control of concentrations of drug in plasma during and after treatment with disulfiram.
Combinations requiring caution
Warfarin (and other oral anticoagulants). Increased effect of oral anticoagulants and risk of bleeding (decreasing the breakdown of warfarin in the liver). We recommend more frequent monitoring of warfarin concentration and dose adjustment of anticoagulants within 8 days after discontinuation of antabusee.
Theophylline. Disulfiram inhibits metabolism of theophylline. As a result, the dose of theophylline should be adjusted (reduced dose), depending on the clinical symptoms and the drug concentration in the plasma.
Benzodiazepines. Disulfiram may potentiate the sedative effect of benzodiazepines by inhibiting their oxidative metabolism (especially chlordiazepoxide and diazepam). Benzodiazepine dosage should be adjusted according to the clinical manifestations.
Tricyclic antidepressants. Perhaps the amplification reaction of intolerance to alcohol, if patients on a background of reception of disulfiram take alcoholic drinks.
Method of application and doses
Inside. Effervescent tablet dissolved in water in amounts sufficient for complete dissolution of the drug (half a Cup). Treatment is prescribed after careful examination of the patient and the prevention of consequences and complications. Take 200-500 mg 1-2 times per day on an individual scheme. After 7-10 days, spend a disulfiram-alcohol sample (20-30 ml of vodka after taking 500 mg of the drug), with a weak response, the dose of alcohol increased by 10-20 ml (maximum dose vodka 100-120 ml). The sample was repeated every 1-2 days in the hospital and after 3-5 days of outpatient with correction doses of alcohol and/or drug as needed. In the future, you can use a maintenance dose of 150-200 mg/day for 1-3 years.
Patients should be warned about the danger of a reaction of intolerance to alcoholic beverages. In the case of co-administration with oral anticoagulants should be subject to more frequent control of prothrombin and correction doses of anticoagulants, which is associated with increased risk of bleeding.
antabuse should be taken with caution in patients with renal insufficiency, or hypothyroidism, especially when the risk of possible combinations with alcohol.