Disulfiram is a drug for the treatment of alcohol dependence.
Release form and composition
- Disulfiram tablets for oral use, 20 pieces per pack, containing 250 or 500 mg of disulfiram each, as well as auxiliary components: polyoxyl 40 stearate, stearic acid, microcrystalline cellulose, hydroxypropylcellulose, sodium starch stearate, calcium diphosphate;
- Disulfiram tablets for implantation, 10 pieces in glass vials containing 100 mg of disulfiram each. The excipients of the medication are sodium chloride, mannitol, PEG-6000.
Disulfiram is also available as an oily solution for intravenous administration.
Indications for use
According to the instructions, Disulfiram oral tablets are indicated for the prevention of relapse in the treatment of alcoholism.
Implantation tablets are used in the treatment of chronic alcoholism for detoxification treatment for chronic nickel poisoning.
According to the instructions, Disulfiram is contraindicated in the following cases:
- Bronchial asthma;
- Neuropsychiatric diseases;
- Severe renal failure;
- During pregnancy and breastfeeding;
- Diseases of the hematopoietic system;
- Severe cardiovascular diseases;
- Combined treatment with phenytoin, metronidazole, isoniazid, agents that contain alcohol;
- Gastrointestinal bleeding;
- Malignant tumors;
- Ulceration of the gastrointestinal tract;
- Neuritis of the auditory nerve;
- Optic neuritis;
- Hypersensitivity to disulfiram or its pharmacological and structural analogues.
Disulfiram is prescribed with caution when:
- Renal failure;
- Liver disease;
- Psychoses in the history of funds containing disulfiram;
- Ulcerative lesions of the gastrointestinal tract during remission;
- Ages over 60;
- Pathologies of the bronchopulmonary system, accompanied by impaired respiratory function.
Dosing and Administration
Oral tablets Disulfiram take 250-500 mg per day. Intravenous drug is administered at a dose of 250-500 mg per day.
Implants are sutured subcutaneously in parts of the body where fatty tissue is present: shoulder blades, buttocks, thighs, abdomen. At the same time, 5-8 Disulfiram tablets are sewn in, a more precise dosage is set by the attending physician, depending on the severity of the disease and the effectiveness of the therapy.
An important component in the successful application of Disulfiram is the desire of the patient himself to get rid of alcohol dependence.
The use of Disulfiram may cause the following side effects:
- Metallic taste in the mouth;
- Itchy skin;
- Neuropsychiatric disorders;
- Memory loss;
- Skin rash;
- Polyneuritis of the lower extremities;
- Optic neuritis;
- Unpleasant smell of skin and discharge from colostomy.
The combination of medication with alcohol can cause:
- Severe heart rhythm disturbances, even death;
- Bouts of angina pectoris;
- Respiratory failure;
- The development of coma;
- Myocardial infarction;
- Cerebral edema.
In the case of alcohol use during Disulfiram therapy, the patient should immediately undergo detoxification therapy and provide him with medical supervision. With the development of pronounced side effects, it is necessary to introduce analeptics and symptomatic treatment.
Prolonged use of Disulfiram may be accompanied by:
- Psychosis by type of alcoholic;
- Cerebral vascular thrombosis (in patients with cardiovascular diseases);
- Hepatitis C;
- Acute polyneuritis.
Disulfiram is not recommended in combination with:
- Isoniazid (impaired coordination and behavior);
- Nitro-5-imidazoles (confusion, delirious disorders);
- Phenytoin (toxic symptoms due to the rapid increase in the level of phenytoin in the blood). If the combined use of medications is necessary, it is recommended to monitor the plasma level of phenytoin during therapy;
- Warfarin and other oral anticoagulants (risk of bleeding due to decreased warfarin in the liver).
Disulfiram use in combination with:
- Theophylline - inhibits theophylline metabolism, so the dose of the latter must be adjusted;
- Benzodiazepines - potentiation of the sedative effect of benzodiazepines is possible, therefore, correction of their dose requires;
- Tricyclic antidepressants - may increase the reaction of alcohol intolerance.
During pregnancy, Disulfiram is contraindicated for use, as it is dangerous for the fetus. For the entire period of therapy should use reliable methods of contraception.
Before starting Disulfiram therapy, the patient must be warned about the categorical prohibition of alcohol use. Severe disulfiram-like reaction may develop even after taking the minimum dose (50 ml) of alcohol.
In case of paresthesia in patients with cardiac abnormalities, urgent hospitalization is required to rule out brain thrombosis.
Implantation Disulfiram is carried out after a course of therapy, designed to reduce the patient's craving for alcohol.
Structural analogues of Disulfiram and drugs that have similar pharmacological effects are:
Terms and conditions of storage
According to the instructions, Disulfiram should be stored at temperatures up to 25 degrees Celsius, away from direct sunlight and moisture. The shelf life of oral tablets Disulfiram is 5 years, the oil solution and implantation tablets - 2 years.