Disulfiram (Disulfiram 200mg tablets)

 

Overview

Information specific to: Disulfiram 200mg tablets when used in Alcohol withdrawal.

Disulfiram (Dye-sul-feer-ram) is a medicine which is used in alcohol dependence.

The information in this Medicine Guide for disulfiram varies according to the condition being treated and the particular preparation used.

Your medicine

Disulfiram is used as part of a programme for people who have previously had an alcohol addiction. It can help people who have successfully stopped drinking alcohol to remain free from drinking alcohol. Disulfiram works by stopping the body breaking down alcohol.

Treatment with Disulfiram can only start once at least 24 hours have passed since you had your last drink of alcohol. After Disulfiram has been stopped you must not drink alcohol for one week. If you take this medicine and you drink alcohol at the same time there can be a dangerous build up of a chemical from the alcohol in the body. This may lead to a severe and sometimes fatal reaction known as a disulfiram–alcohol reaction.

Low alcohol drinks or non-alcohol and alcohol-free beers and wines may cause a reaction when consumed in sufficient quantities. Certain foods, liquid medicines, remedies, tonics, toiletries, perfumes and aerosol sprays may contain sufficient alcohol to cause a Disulfiram-alcohol reaction. For more information about what to avoid while taking Disulfiram talk to a member of your medical team.

Other information about Disulfiram:

  • when starting treatment with this form of this medicine it is normal to start with a high dose and then the dose may be reduced. For more information you should speak to a member of your medical team
  • if you have been taking Disulfiram for six months your prescriber will review the need for you to continue treatment

Do not share your medicine with other people. It may not be suitable for them and may harm them.

The pharmacy label on your medicine tells you how much medicine you should take. It also tells you how often you should take your medicine. This is the dose that you and your prescriber have agreed you should take. You should not change the dose of your medicine unless you are told to do so by your prescriber.

If you feel that the medicine is making you unwell or you do not think it is working, then talk to your prescriber.

Whether this medicine is suitable for you

Disulfiram is not suitable for everyone and some people should never use it. Other people should only use it with special care. It is important that the person prescribing this medicine knows your full medical history.

Your prescriber may only prescribe this medicine with special care or may not prescribe it at all if you:

  • are allergic or sensitive to or have had a reaction to any of the ingredients in the medicine
  • have a personality disorder
  • have brain damage
  • have diabetes
  • have epilepsy
  • have had a stroke
  • have high blood pressure
  • have hypothyroidism
  • have kidney problems
  • have liver problems
  • have lung problems
  • have or have had heart problems
  • have or have had thoughts of committing suicide
  • have psychosis

Furthermore the prescriber may only prescribe this medicine with special care or may not prescribe it at all for a child.

As part of the process of assessing suitability to take this medicine a prescriber may also arrange tests:

  • to determine whether or not the medicine is suitable and whether it must be prescribed with extra care

Over time it is possible that Disulfiram can become unsuitable for some people, or they may become unsuitable for it. If at any time it appears that Disulfiram has become unsuitable, it is important that the prescriber is contacted immediately.

Alcohol

Alcohol can interact with certain medicines.

In the case of Disulfiram:

  • you will have a bad reaction if you drink alcohol while you are being treated with Disulfiram. The symptoms of this reaction include: flushing, increased body temperature, sweating, nausea, vomiting, itching, urticaria, feeling anxious, feeling dizzy, headache, blurred vision, breathing difficulties, palpitations, faster breathing rate, chest pain, convulsions or coma. This reaction may be fatal.

You must not drink any alcohol if you are taking this medicine and for up to 14 days after stopping treatment with Disulfiram.

Diet

Medicines can interact with certain foods. In some cases, this may be harmful and your prescriber may advise you to avoid certain foods.

In the case of Disulfiram:

  • there are no specific foods that you must exclude from your diet when taking Disulfiram

Driving and operating machinery

When taking any medicine you should be aware that it might interfere with your ability to drive or operate machinery safely.

In the case of Disulfiram:

  • this medicine could affect your ability to drive or operate machinery

You should see how this medicine affects you before you judge whether you are safe to drive or operate machinery. If you are in any doubt about whether you should drive or operate machinery, talk to your prescriber.

Family planning and pregnancy

Most medicines, in some way, can affect the development of a baby in the womb. The effect on the baby differs between medicines and also depends on the stage of pregnancy that you have reached when you take the medicine.

In the case of Disulfiram:

  • you should only take this medicine during pregnancy if your doctor thinks that you need it

You need to discuss your specific circumstances with your doctor to weigh up the overall risks and benefits of taking this medicine. You and your doctor can make a decision about whether you are going to take this medicine during pregnancy.

If the decision is that you should not have Disulfiram, then you should discuss whether there is an alternative medicine that you could take during pregnancy.

Breast-feeding

Certain medicines can pass into breast milk and may reach your baby through breast-feeding.

In the case of Disulfiram:

  • women who are breast-feeding must not take this medicine

Before you have your baby you should discuss breast-feeding with your doctor or midwife. If you wish to breast-feed you should discuss with your prescriber whether there are any other medicines you could take which would also allow you to breast-feed. You should not stop this medicine without taking advice from your doctor.

Taking other medicines

If you are taking more than one medicine they may interact with each other. At times your prescriber may decide to use medicines that interact, in other cases this may not be appropriate.

The decision to use medicines that interact depends on your specific circumstances. Your prescriber may decide to use medicines that interact, if it is believed that the benefits of taking the medicines together outweigh the risks. In such cases, it may be necessary to alter your dose or monitor you more closely.

Tell your prescriber the names of all the medicines that you are taking so that they can consider all possible interactions. This includes all the medicines which have been prescribed by your GP, hospital doctor, dentist, nurse, health visitor, midwife or pharmacist. You must also tell your prescriber about medicines which you have bought over the counter without prescriptions.

The following medicines may interact with Disulfiram:

  • alcohol
  • amitriptyline
  • chlordiazepoxide
  • chlorpromazine
  • diazepam
  • isoniazid
  • metronidazole
  • morphine
  • paraldehyde
  • pethidine
  • phenytoin
  • pimozide
  • rifampicin
  • theophylline
  • warfarin

The following types of medicine may interact with Disulfiram:

  • amphetamines
  • benzodiazepines
  • medicines that are metabolised by the liver

If you are taking Disulfiram and one of the above medicines or types of medicines, make sure your prescriber knows about it.

Complementary preparations and vitamins

Medicines can interact with complementary preparations and vitamins. In general, there is not much information available about interactions between medicines and complementary preparations or vitamins.

If you are planning to take or are already taking any complementary preparations and vitamins you should ask your prescriber whether there are any known interactions with Disulfiram.

Your prescriber can advise whether it is appropriate for you to take combinations that are known to interact. They can also discuss with you the possible effect that the complementary preparations and vitamins may have on your condition.

If you experience any unusual effects while taking this medicine in combination with complementary preparations and vitamins, you should tell your prescriber.

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