Disulfiram drug interactions

The following drug interactions were reported for metronidazole, a chemically related nitroimidazole. Therefore, these drug interactions may occur with tinidazole. Drugs that may affect tinidazole include cholestyramine, CYP3A4 inducers and inhibitors and oxytetracycline. Drugs that may be affected by tinidazole include alcohols, anticoagulants, cyclosporine, tacrolimus, disulfiram, fluorouracil, hydantoins, and lithium. 

Plasma phenytoin concentrations are increased in the presence of chloramphenicol, disulfiram, and isoniazid, since the latter drugs inhibit the hepatic metabolism of phenytoin. A reduction in phenytoin dose can alleviate the consequences of these drug-drug interactions. 

Until the role of echinacea in immune modulation is better defined, this agent should be avoided in patients with immune deficiency disorders (eg, AIDS, cancer), autoimmune disorders (eg, multiple sclerosis, rheumatoid arthritis), and patients with tuberculosis. While there are no reported drug interactions for echinacea, some preparations have a high alcohol content and should not be used with medications known to cause a disulfiram-like reaction. In theory, echinacea should also be avoided in persons taking immunosuppressant medications (eg, organ transplant recipients). 

The Academy of Pediatrics made their recommendations concerning ethanol exposure from medications based on potential acute and chronic ethanol-related problems. Acutely, the coadministration of ethanol may alter drug adsorption or metabolism, and may result in drug interactions (e.g., increased sedation when taken with sedatives). Disulfiram-like reactions have occurred after the ingestion of an alcohol-containing medication or... 

Administered as a single, daily dose on an empty stomach Monoamine oxidase inhibitors drug-food interactions with tyramine-rich foods such as red wines, dark beers, aged cheeses, yogurt may precipitate hypertensive crisis drug interactions tricyclic antidepressants and SSRIs, sympathomimetics disulfiram-like reaction with alcohol... 

Toxicity Adverse effects of metronidazole include gastrointestinal irritation, headache, and dark coloration of urine. More serious toxicity includes leukopenia, dizziness, and ataxia. Drug interactions with metronidazole include a disulfiram-like reaction with ethanol and potentiation of coumarin anticoagulant effects. Safety of metronidazole in pregnancy and in nursing mothers has not been established. 

Interactions with the following drugs may increase the risk of hypoglycemia other hypoglycemics, sulfonamides, propranolol, salicylates, clofibrate, probenecid, pentamidine, valproic acid, dicumarol, cimetidine, MAO inhibitors, and alcohol. In addition, co-ingestion of alcohol may occasionally produce a disulfiram-like interaction (see p 186). 

Drug-drag interactions Ethanol A 50-year-old man developed intractable hypotension, which led to ischemic electrocardiographic changes and myocardial damage as a result of a disulfiram-ethanol interaction [30 ]. 

Drug-drug interactions Disulfiram A pharmacokinetics study (n=40) examined the effect of disulfiram (DIS) on EFV, ritonavir and ATV, concluding that ATV co-administration reduced the effect of DIS on aldehyde dehydrogenase (which mediates the DIS-alcohol reaction) [286 j. This happens possibly as a result of ATV s inihibition of CYP 3A4, what may render DIS ineffective in the treatment of alcoholism. 

In deciding whether disulfiram should be used in alcoholism rehabilitation, patients should be made aware of the hazards of the medication, including the need to avoid over-the-counter preparations that include alcohol, the need to avoid drugs that can interact with disulfiram, and the potential for a DER to be precipitated by alcohol used in food preparation. The administration of disulfiram to anyone who does not agree to use it, who does not seek to be abstinent from alcohol, or who has any psychological or medical contraindications is not recommended. 

Drugs that may interact with disulfiram include alcohol, benzodiazepines, caffeine, chlorzoxazone, cocaine, hydantoins, isoniazid, metronidazole, theophylline, tricyclic antidepressants, and warfarin. 

Drugs that may interact with isoniazid include acetaminophen, carbamazepine, chlorzoxazone, disulfiram, enflurane, hydantoins, ketoconazole, rifampin, and theophylline. 

Drugs that may interact with zalcitabine include antacids, chloramphenicol, cisplatin, dapsone, didanosine, disulfiram, ethionamide, glutethimide, gold, hydralazine, iodoquinol, isoniazid, metronidazole, nitrofurantoin, phenytoin, ribavirin, vincristine, cimetidine, metoclopramide, amphotericin, aminoglycosides, foscarnet, antiretroviral nucleoside analogs, pentamidine, and probenecid. 

---