Generic Name: disulfiram effervescent tablets
Product Name: Antabuse
Indication: What Antabuse is used for
Antabuse is designed to act as a deterrent to alcohol consumption.
Antabuse inhibits an enzyme, which assists in the breakdown of alcohol in the body. A build-up of a substance called acetaldehyde results. If alcohol is consumed when a patient has received Antabuse the so-called “aldehyde reaction” may occur.
Antabuse tablets have been approved for the uses listed above. However, your doctor may prescribe this medicine for another use. If you want more information, ask your doctor.
Antabuse tablets are not addictive.
Under all circumstances when taking Antabuse you must not take alcohol or alcohol-containing preparations e.g. certain cough syrups, sauces, vinegar, tonics, food prepared with wine. You should even avoid the use of after-shave lotions and alcoholic back rubs.
What will happen if you take alcohol and Antabuse
The “aldehyde reaction”, which may occur if you take Antabuse and alcohol together, starts with a flushing from the head downwards involving the face, arms and chest. This is accompanied by a feeling of heat, sweating, palpitations, fast heartbeat, shortness of breath, hyperventilation, and headache. There is a feeling of constriction and irritation in the throat resulting in spasms and coughing. Chest pains may occur. Restlessness or a sense of uneasiness and fear of dying may develop. These symptoms are accompanied by a steep rise in blood pressure, which may be followed by a drop in blood pressure.
Flushing is then replaced by the patient becoming pale, weak, feeling dizzy and sick, which turns into violent vomiting and stomach cramps. Other symptoms may include thirst, dizziness, blurred vision, numbness of the hands and feet and the inability to sleep. Severe reactions may affect the heart, and there may be fits, loss of consciousness and death. The reaction usually lasts 2-4 hours and up to several hours in more severe cases.
Confusion, drowsiness, and sleep usually follow. The intensity of the reaction varies with each individual but generally depends on the amount of Antabuse and alcohol consumed.
If such a reaction is observed, the patient’s doctor should be contacted. If the patient is not in a hospital or a clinic, an ambulance should be called as the patient requires close monitoring.
Action: How Antabuse works
Antabuse tablets are designed to act as a deterrent to alcohol consumption in patients as an aid in the overall management of chronic alcoholism. Disulfiram is relatively pharmacologically inert when taken in small doses. Disulfiram produces irreversible inhibition of the enzyme responsible for the oxidation of the ethanol metabolite acetaldehyde. The accumulation of acetaldehyde contributes to the reaction occurring after alcohol ingestion in disulfiram-treated patients. Blockage of the enzyme leads to accumulation of acetaldehyde, which is an important factor for the clinical disulfiram-alcohol reaction. Re-establishment of the enzymatic activity is dependent on new synthesis which occurs gradually during the course of 1 week or more. Disulfiram and its chief metabolite, diethyldithiocarbamide (DDC) also inhibit the enzyme, dopamine-beta-hydroxylase. This results in reduced synthesis of noradrenaline, which may contribute to the reaction.
Each tablet contains 200 milligrams of disulfiram as the active ingredient. They also contain maize starch, povidone, tartaric acid, sodium bicarbonate, microcrystalline cellulose, colloidal anhydrous silica, magnesium stearate and talc.
Dose advice: How to use Antabuse
Before you take Antabuse
When you must not take Antabuse
Do not use Antabuse:
- If you know you are allergic to it or any of its ingredients, or certain other chemicals (thiuram derivatives) used in pesticides and rubber processing. Signs of allergy include rash, itching, shortness of breath and/or swollen face;
- If you have heart, liver or kidney disease;
- If you are pregnant or are planning to become pregnant;
- If you have a mental illness with abnormal thoughts;
- If you are taking paraldehyde or metronidazole;
- If the packaging is torn or shows signs of being tampered with;
- To treat any other complaints unless your doctor says it is safe to do so.
Before you start to take it
You should not take Antabuse until you have not taken any alcohol for 24 hours. If you stop taking Antabuse, you should wait at least one week before consuming alcohol. Reactions may still occur for up to three weeks after taking Antabuse.
Your doctor may need to monitor closely if you suffer from certain conditions. Tell your doctor if you have any of the following:
- Thyroid problems;
- Heart, kidney or liver disease;
- An allergic skin reaction if you come into contact with certain irritants;
- Mental illness with abnormal thoughts.
Tell your doctor or pharmacist if you are breastfeeding. They will advise you on whether you should take Antabuse.
Always tell your doctor if you are taking other medicines, including ones you buy from the pharmacy or supermarket. Medicines which have interacted with Antabuse include:
- Phenytoin and isoniazid;
- Sleeping tablets such as Valium;
- Medicines which stop blood clotting (warfarin);
- Metronidazole and paraldehyde;
- Painkillers such as morphine, pethidine, amphetamines, and barbiturates.
How to take it
The following are the usual doses, but your doctor may adjust them to suit your needs:
Take between half a tablet (100 mg) and one and a half tablets (300 mg) dissolved in water as a single dose daily for one to two weeks. Your doctor will tell you the exact dosage. Then go back and see your doctor.
Take one tablet daily.
Take the tablets in the morning when you wake up. However, if you find the tablets make you sleepy you can take them before bedtime. If you are taking Antabuse for a long time, then your doctor will need to do a regular checkup. This may include a blood test.
If you forget to take it
If you forget to take Antabuse, do so as soon as you remember, and then go back to taking it as you would normally.
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Do not take a double dose to make up for the one you missed.
If you have problems remembering when to take your medicine, ask your pharmacist for some hints.
If you think you or anybody else has taken too much Antabuse, contact your doctor, pharmacist or the Poisons Information Centre in your state who will advise you what to do. (You can contact the Poisons Information Centre by dialing 000 and ask for your local Poisons Centre). If you have taken too much Antabuse you may get drowsy, experience some pain or numbness in the hands and feet which may get worse if not treated.
While you are taking Antabuse
Things you must do
Always follow your doctor’s instructions carefully, and seek your doctor’s advice before changing or stopping treatment. Your doctor will be happy to discuss any concerns you may have about your treatment.
Always read labels of food and medicines bought to check they contain no alcohol.
Things you must not do
Do not, under any circumstances, take any alcohol or alcohol-containing products. You will suffer from the “aldehyde reaction” which needs immediate medical attention and, in some circumstances, may be fatal.
Do not take Antabuse if you have taken any alcohol in the last 24 hours. Also, do not take any alcohol for at least a week after stopping Antabuse. You may still get a reaction for up to 3 weeks after stopping Antabuse.
Do not give this medicine to anybody else.
Things to be careful of
Ask your doctor before taking any other medicines. Antabuse can interact with other medicines. Especially check bought medicines from your chemist or supermarket to make sure they contain no alcohol.
After using Antabuse
Keep your Antabuse in a cool, dry place where the temperature stays below 25oC.
Do not store it or any medicines in the bathroom or near a sink. Heat and dampness can destroy some medicines.
Keep it where young children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Do not use Antabuse beyond the date (month and year) printed on the pack after the letters “EXP”, even if it has been stored properly. Medicines cannot be stored indefinitely.
Once you have finished using Antabuse, ask your pharmacist what to do with any that is left.
Schedule of Antabuse
Antabuse is a Schedule 4 – prescription only medicine.
Side effects of Antabuse
Tell your doctor as soon as possible if you do not feel well while you are taking Antabuse. All medicines have side effects. Often they are not serious but sometimes they can be. You may need medical treatment if you get some of the side effects.
Tell your doctor immediately if you notice any of the following:
- Numbness, tingling, pain or weakness in hands or feet;
- Change in vision or eye tenderness or pain;
- Mood changes or abnormal thoughts;
- Malaise (generally feeling unwell);
- Loss of appetite;
- Nausea (feeling sick);
- Dark urine or yellowing of the skin or eyes (jaundice) or abdominal pain.
You may have some of the following effects for the first two weeks of treatment. If any of them worry you or continue please tell your doctor as soon as possible:
- Acne or skin rash;
- Stomach upset;
- Impotence in men;
- Metallic or garlic-like aftertaste.
Do not hesitate to report any other side effects to your doctor or pharmacist.
For further information talk to your doctor.