Disulfiram Alprazolam

An isolated report describes temazepam toxicity due to disulfiram. The serum levels of chlordiazepoxide and diazepam are increased by the use of disulfiram and some patients may possibly experience increased drowsiness. Alprazolam, oxazepam and lorazepam are either not affected, or only minimally affected, by disulfiram. 

Other studies show that the pharmacokinetics of lorazepam and alprazolam are unaffected by disulfiram. ... 

There seems to be only one report (with temazepam) of a olinieally signif-ieant interaction between disiifiram and the benzodiazepines, and this report is unconfirmed, as the patient did not take temazepam alone. The other reports only describe potential interactions that have been identified by single-dose studies. These do not necessarily reliably predict what will happen in practice. However, it seems possible that some patients will experience increased drowsiness, possibly because of this interaction, and because drowsiness is a very common adverse effect of disulfiram. Reduce the dosage of the benzodiazepine if necessary. Benzodiazepines that are metabolised by similar pathways to diazepam and chlordiazepoxide, may possibly interact in the same way (e.g. bromazepam, clonazepam, clorazepate, prazepam, ketazolam, clobazam, flurazepam, nitrazepam, medazepam) but this needs confirmation. Alprazolam, oxazepam and lo-razepam appear to be non-interacting alternatives. 

Diquet B, Gujadhur L, Lamiable D, Warot D, Hayoun H, Choisy H. Lack of interaction between disulfiram and alprazolam in alcoholic patients. EurJ Clin Pharmacol ( 990)3Z 157-60. 

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