Possible Interaction: Ethanol and Disulfiram

“The most commonly prescribed agents are the aversive drugs (e.g., disulfiram , calcium carbimide), which when ingested prior to alcohol produce an unpleasant physiologic reaction, which is supposed to deter further drinking.”

“The therapeutic rationale for using implanted disulfiram is possible inhibition of the liver enzyme acetaldehyde dehydrogenase, producing an acetaldehyde-mediated aversive reaction after intake of ethanol.”

“Finally, in view of the low (approximately 0.5) probability with which a DER follows ingestion of alcohol by a disulfiram implant patient, it is suggested that the approach to patient management should be changed to maximize the effectiveness of the disulfiram implant procedure.”

“In contrast to anti-craving drugs, disulfiram does not modulate neurobiological mechanisms of addiction, but rather works by producing an aversive reaction when combined with alcohol.”

“In vitro permeability was measured unidirectionally in Caco-2 and MDCKII cell models in the presence of acetaldehyde, ethanol, or disulfiram , an aldehyde dehydrogenase inhibitor, which causes acetaldehyde formation when coadministered with ethanol in vivo.”

“ Disulfiram was first used clinically in an attempt to deter people from ethanol consumption (Hald and Jacobsen, 1948).”

“ Disulfiram , an acetaldehyde dehydrogenase inhibitor, enhanced the inhibitory effect of ethanol in vivo.”

“Following co-administration of ethanol and an inhibitor of acetaldehyde metabolism, such as disulfiram or calcium carbamide, acetaldehyde blood concentrations may increase 5-10 fold over normal level (reviewed in [1]).”

“Pretreatment with disulfiram potentiated the effect of ethanol.”

“The symptoms are similar to those obtained when ethanol is taken with disulphiram (antabuse) which acts by inhibiting acetaldehyde metabolism.”