Drug that causes an adverse reaction to alcohol
A disulfiram-like drug is a drug that causes an adverse reaction to
alcohol leading to
nausea ,
vomiting ,
flushing ,
dizziness , throbbing
headache ,
chest and
abdominal discomfort , and general
hangover -like
symptoms among others.
[1]
[2] These effects are caused by accumulation of
acetaldehyde , a major but toxic
metabolite of alcohol formed by the
enzyme
alcohol dehydrogenase .
[1]
[2] The reaction has been variously termed a
disulfiram-like reaction , alcohol intolerance , and acetaldehyde syndrome .
[3]
The
prototypical drug of this group is
disulfiram (brand name Antabuse), which acts as an
acetaldehyde dehydrogenase
inhibitor , preventing the metabolism of acetaldehyde into
acetic acid , and is used in the treatment of
alcoholism .
[1]
[2] A variety of other drugs cause disulfiram-like reactions upon consumption of alcohol as unintended
drug interactions and
side effects .
[1]
[2] Many disulfiram-like drugs act as inhibitors of acetaldehyde dehydrogenase similarly to disulfiram. However, some do not act via inhibition of this
enzyme , and instead act via other, poorly elucidated
mechanisms .
Unlike acetaldehyde dehydrogenase inhibitors and other disulfiram-like drugs,
alcohol dehydrogenase inhibitors such as
fomepizole (brand name Antizol) inhibit the
metabolism of alcohol into acetaldehyde, thereby increasing and extending the effects of alcohol and reducing its toxicity.
[4] As such, they can be thought of as converses of disulfiram-like drugs.
[4] Fomepizole is used medically as an
antidote against
methanol and
ethylene glycol
poisoning .
[4]
List of agents
Intended
Drugs which cause disulfiram-like reactions upon ingestion of alcohol as an intended effect include:
[5]
Unintended
Drugs which cause disulfiram-like reactions upon ingestion of alcohol as an unintended effect include:
[6]
[1]
[7]
Abacavir
Cephalosporins , but only these with a methylthiotetrazole side chain or a methylthiodioxotriazine ring; thought to be due to common
N -methylthiotetrazole
metabolite , which is similar in structure to disulfiram.
[8] Such drugs include
cefamandole ,
cefmenoxime ,
cefmetazole ,
cefonicid ,
cefoperazone ,
cefotetan ,
ceftriaxone , and
latamoxef (moxalactam) .
[9]
[10]
Chloral hydrate
Chloramphenicol
Ethacrynic acid
Griseofulvin (weak evidence)
[8]
Hydrazines
Ketoconazole (weak evidence)
[8]
Macrolide
immunosuppressants such as
pimecrolimus and
tacrolimus
Mepacrine (quinacrine)
Nilutamide
Nitrovasodilators (nitrates) such as
nitroglycerin
Nitroimidazoles such as
benznidazole ,
metronidazole (disproven),
[8]
ornidazole .
Pargyline
Phenacetin
Phentolamine
Phenylbutazone
Propranolol
Sulfiram
Sulfonamides : sulfamethoxazole likely safe
[8]
Sulfonylureas , specifically the first generation:
[8]
chlorpropamide ,
glibenclamide (glyburide) , and
tolbutamide
Tolazoline
A number of drugs do not cause disulfiram-like reactions, but have other unintended interactions with alcoholic drinks. For example, alcohol interferes with the efficacy of
erythromycin . Patients on
linezolid and
tedizolid may be sensitive to the
tyramine present in tap beers and red wine.
[8]
Antibiotics
Antibiotics such as
metronidazole ,
tinidazole ,
cephamandole ,
latamoxef ,
cefoperazone ,
cefmenoxime , and
furazolidone , cause a
disulfiram -like chemical reaction with alcohol by inhibiting its breakdown by
acetaldehyde dehydrogenase , which may result in vomiting, nausea, and shortness of breath.
[11] In addition, the efficacy of doxycycline and
erythromycin succinate may be reduced by alcohol consumption.
[12] Other effects of alcohol on antibiotic activity include altered activity of the liver enzymes that break down the antibiotic compound.
[13]
Natural
Natural compounds and species which have been found to cause disulfiram-like reactions upon ingestion of alcohol include:
[14]
[15]
List of agents previously thought to cause disulfiram-like reactions
See also
References
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^ Kitson TM (1987). "The effect of cephalosporin antibiotics on alcohol metabolism: a review". Alcohol . 4 (3): 143–8.
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^ Lewis R. Goldfrank (2006).
Goldfrank's Toxicologic Emergencies . McGraw Hill Professional.
ISBN
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^
"Can I drink alcohol while taking antibiotics?" . NHS Direct (UK electronic health service).
Archived from the original on 24 October 2010. Retrieved 17 February 2008 .
^ Stockley IH (2002). Stockley's Drug Interactions (6th ed.). London: Pharmaceutical Press. [
page needed ]
^
"Antibiotics FAQ" . McGill University, Canada. Archived from
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^ Joseph F. Ammirati (1985).
Poisonous Mushrooms of the Northern United States and Canada . U of Minnesota Press. pp. 131–.
ISBN
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^
Barry H. Rumack ; David G. Spoerke (27 September 1994).
Handbook of Mushroom Poisoning: Diagnosis and Treatment . CRC Press. pp. 303–.
ISBN
978-0-8493-0194-0 .
^
"Herbal Approaches to Alcohol Dependence: Evidence and Risks" . Pharmacy Times . 7 December 2016.
^ Workowski, Kimberly A; Bachmann, Laura H; Chan, Philip A; Johnston, Christine M; Muzny, Christina A; Park, Ina; Reno, Hilary; Zenilman, Jonathan M; Bolan, Gail A (2021).
"Sexually Transmitted Infections Treatment Guidelines, 2021" . MMWR. Recommendations and Reports . 70 (4): 1–187.
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^ Fjeld, Hilde; Raknes, Guttorm (16 September 2014).
"Er det virkelig farlig å kombinere metronidazol og alkohol?" . Tidsskrift for den Norske Legeforening . 134 (17): 1661–1663.
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10.4045/tidsskr.14.0081 .
ISSN
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PMID
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External links