Disulfiram

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Disulfiram

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Treatment is prescribed after a thorough examination of the patient and warning about the consequences and complications.
The drug is taken orally on 150-500 mg 2 times a day for an individual scheme.
After 7-10 days, a teturamalcohol sample is taken (20-30 ml of 40% vodka after taking 500 mg of the drug), with a weak reaction, the dose of alcohol is increased by 10-20 ml (the maximum dose of vodka is 100-120 ml).
The sample is repeated after 1-2 days in the hospital and after 3-5 days on an outpatient basis, with the correction of doses of alcohol and / or the drug as needed.
In the future, you can use a maintenance dose of 150-200 mg per day for 1-3 years.

Adverse reactions

"Metallic" taste in the mouth, unpleasant smell (caused by carbon disulphide) in patients with colostomy, hepatitis, lower extremity polyneuropathy, neuropsychiatric disorders, memory loss, disorientation in time and space, asthenia, headache, skin allergic reactions.

Contraindications

Hypersensitivity, thyrotoxicosis, cardiovascular diseases in the stage of decompensation (including pronounced cardiosclerosis, cerebral arteriosclerosis, cerebral vessels pre-and post-infarction, aortic aneurysm, coronary insufficiency, arterial hypertension II-III stage, CHF), heart disease , bronchial asthma, COPD, severe pulmonary emphysema, erosive lesions of the gastrointestinal mucosa, peptic ulcer and 12 duodenal ulcers (in acute stage), bleeding from the gastrointestinal tract, kidney disease, liver failure, sugar di bet, epilepsy, neuro-psychiatric diseases, infectious CNS diseases, polyneuropathy, neuritis of the auditory and optic nerve, glaucoma, cancer, pregnancy, lactation. Age over 60 years, peptic ulcer and 12 duodenal ulcers (in remission), endarteritis, residual cerebrovascular events, psychosis in patients with disulfiram in history.

Drug interactions

Contraindications
Alcohol: intolerance reaction (flushing, erythema, vomiting, tachycardia). Avoid alcohol and drugs containing alcohol.
Unwanted combinations
Isoniazid: impaired behavior and coordination.
Nitro-5-imidazoles (metronidazole, ordinazole, secnidazole, tinidazole): delirious disorders, confusion.
Phenytoin: a significant and rapid rise in the level of phenytoin in plasma with toxic symptoms (suppression of its metabolism).
If combinations cannot be avoided, clinical observation and control of drug concentrations in the plasma of the entry and after treatment with teturam should be carried out.
Combinations that require caution
Warfarin (and other oral anticoagulants): an increased effect of oral anticoagulants and the risk of bleeding (reduction of warfarin in the liver). More frequent monitoring of the concentration of warfarin and adjustment of the dose of anticoagulants within 8 days after discontinuation of teturam is recommended.
Theophylline: teturam inhibits theophylline metabolism. As a result of this, the dose of theophylline should be adjusted (reduced dosage), depending on the clinical symptoms and the plasma concentration of the drug.
Benzodiazepines: teturam can potentiate the sedative effect of benzodiazepines by inhibiting their oxidative metabolism (especially chlordiazepoxide and diazepam). Benzodiazepine dosage should be adjusted according to clinical manifestations.
Tricyclic antidepressants: it is possible to increase the reaction of intolerance to alcohol (especially if patients take teturam on the background, take alcoholic beverages).

Pregnancy and Lactation

Special instructions

Overdosage