Cefoperazone Alcohol

Cephalosporins that contain a methylthiotetrazole group (eg, cefamandole, cefmetazole, cefotetan, cefoperazone) frequently cause hypoprothrombinemia and bleeding disorders. Administration of vitamin Ki, 10 mg twice weekly, can prevent this. Drugs with the methylthiotetrazole ring can also cause severe disulfiram-like reactions consequently, alcohol and alcohol-containing medications must be avoided. 

The great biliary excretion of cefoperazone causes changes in bowel flora and diarrhea may often occur. Containing a 7V-methylthiotetrazole side chain, cefoperazone may also cause hypoprothrombinemia and a disulfiram-like reaction with alcohol (alcohol intolerance). This antibiotic should be avoided by patients receiving anticoagulants. 

A disulfiram-like effect When cefamandole [se FAM an dol] or cefoperazone is ingested with alcohol or alcohol-containing medications. a disulfiram-like effect is seen (see p. 96), because these cephalosporins block the second step in alcohol oxidation, which results in the accumulation of acetaldehyde1. 

Cephalosporins that contain a methyltetrazole-thiol side chain (as in cefamandole, cefmenoxime, cefmeta-zole, cefonizid, cefoperazone, ceforanide, cefotetan, cefotiam, latamoxef, and moxalactam) and chemically similar structures (cefepime, ceftriaxone) co-adminis-tered with alcohol can produce a disulfiram-like syndrome by inhibiting aldehyde dehydrogenase (195,202,203). 

The MTT group has also been implicated in the intolerance to alcohol a.ssociatcd with certain injectable cephalosporins ccfamandole, cefotcian. ccfmetazolc, and cefoperazone. Thus, disulfiram-like reactions, attributed to the accumulation of acetaldehyde and resulting from the inhibition of aldehyde dehydrogenase-catalyzed oxidation of ethanol by M lT-contuining cephalo.sporins. " may occur in patients who have consumed alcohol before, during, or shortly after the course of therapy. 

Alcohol should be avoided when taking certain cephalosporins (cefamandole, cefoperazone, or moxalactam) because patients might experience adverse side effects that include ... 

Disulfiram-like reactions can occur in those who take cefaman-dole, cefmenoxime, cefoperazone, cefotetan, latamoxef (moxa-lactam) and possibly cefonicid, and drink alcohoL This is not a general reaction of the cephalosporins, but is confined to those with particular chemical structures. 

Similar reactions have been described in patients or subjects receiving cefamandole, cefoperazone, " ce nenoxime, cefonicid and cefotetan, after drinking wine, beer, or other aleoholic drinks, or after the ingestion of an 8.5% alcoholic elixir. ... 

Kemmerich B, Lode H. Cefoperazone - another cephalo rin associated with a disulfiram type alcohol incompatibility. Infection (1981) 9,110. 

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