Generic Disulfiram

Introduction

Disulfiram is a medication primarily used to deter adults from drinking alcohol. It works by causing an unpleasant physical reaction when alcohol is consumed, thereby discouraging its use. Available as a pill, typically in 250mg and 500mg dosages, Disulfiram falls into the drug class of alcohol deterrents. Its efficacy is rooted in its ability to interfere with the body's metabolism of alcohol.

Quick Reference Facts

Active Ingredient

Disulfiram

Form

pill 250mg | 500mg

Primary and Off-Label Uses

Alcohol dependence; Chronic alcoholism

What is Disulfiram?

Disulfiram is a medication classified as an alcohol deterrent. It is a synthetic compound belonging to the thiuram derivatives class. Its primary and most recognised use is as an aid in the management of chronic alcoholism. The drug is typically administered orally in tablet form. Disulfiram is the generic version of medications containing the active compound Disulfiram, and it is marketed under well-known brand names such as Antabuse, which was one of the earliest brands to introduce this specific formulation. Generic alternatives containing Disulfiram are often available, offering a more cost-effective option for patients.

How Disulfiram Works

Disulfiram's mechanism of action is unique and directly targets the way the body processes alcohol. When alcohol (ethanol) is consumed, it is metabolised in the liver by the enzyme alcohol dehydrogenase into acetaldehyde. Acetaldehyde is then further broken down by another enzyme, aldehyde dehydrogenase, into acetate, which is then eliminated.

Disulfiram inhibits aldehyde dehydrogenase. By blocking this enzyme, Disulfiram causes acetaldehyde to accumulate in the body to potentially toxic levels. This buildup of acetaldehyde triggers a pronounced and unpleasant physiological response, commonly known as the "disulfiram-alcohol reaction" or "acetaldehyde syndrome."

The disulfiram-alcohol reaction typically begins within minutes of consuming even a small amount of alcohol and can last from 30 minutes to several hours. Symptoms can include flushing of the skin, throbbing headache, nausea, vomiting, chest pain, palpitations, rapid heartbeat, shortness of breath, blurred vision, confusion, and even a drop in blood pressure or collapse. The severity of the reaction is generally dose-dependent, both for Disulfiram and the amount of alcohol consumed. The intention behind this reaction is to create a strong negative association with drinking alcohol, thereby serving as a powerful deterrent for individuals who are motivated to abstain from alcohol. Disulfiram itself does not cure alcoholism, but it acts as a behavioural support tool to help individuals maintain sobriety by making the consequences of drinking severe and immediate.

Conditions Treated with Disulfiram

Disulfiram is approved for the management of chronic alcoholism. Its use is intended as an adjunct to psychosocial interventions and counselling for individuals with alcohol dependence who are committed to achieving and maintaining abstinence.

• Chronic Alcoholism: Disulfiram is prescribed for individuals suffering from chronic alcoholism. It is typically used for patients who have already undergone detoxification and are stable and motivated to achieve abstinence. The drug's action of causing an aversive reaction upon alcohol ingestion serves as a behavioural deterrent. By making the consumption of alcohol extremely unpleasant, it helps patients resist the impulse to drink, thereby supporting their recovery efforts and preventing relapse. Its efficacy is maximised when combined with comprehensive behavioural therapy and robust patient and family support.

Is Disulfiram the Right Medication for You?

Disulfiram may be considered for adults who are diagnosed with alcohol dependence and have a strong desire to remain abstinent. It is particularly indicated for individuals who have a history of relapsing into alcohol use and who would benefit from a strong, immediate deterrent against drinking. The decision to use Disulfiram requires careful consideration and should be made in consultation with a healthcare professional familiar with the patient's medical history, psychological state, and motivation for sobriety.

It is crucial that patients understand the severe and potentially dangerous reactions that can occur if alcohol is consumed while taking Disulfiram. This medication is not suitable for everyone. It is contraindicated in individuals with known hypersensitivity to Disulfiram or related compounds, and in those who have recently consumed alcohol within the past 12-48 hours, or who are currently intoxicated. Patients with severe cardiac disease, psychosis, or those who have demonstrated an inability to refrain from alcohol use or use of other substances that could cause a similar reaction, may also not be suitable candidates. Furthermore, individuals consuming certain medications or products that contain alcohol (e.g., some cough syrups, mouthwashes) must be counselled about potential risks.

Buying Disulfiram from Our Online Pharmacy

Acquiring Disulfiram can present challenges related to accessibility and affordability. Our online pharmacy service is designed to bridge these gaps, offering a reliable and convenient solution for obtaining this essential medication.

Why Choose Our Service?

We understand that accessing consistent and affordable medication is paramount to maintaining recovery. Our service provides a straightforward pathway for individuals seeking Disulfiram, ensuring that the continuity of their treatment is not compromised by logistical or financial hurdles. We aim to be a trusted resource, simplifying the process of obtaining medications that support vital health management programmes.

Quality & Safety Assurance

We partner with licensed international pharmacies to ensure quality and authenticity. All medications, including Disulfiram, are sourced from reputable manufacturers and undergo rigorous quality checks. Our commitment to patient well-being means we only facilitate access to genuine, high-quality pharmaceutical products, adhering to international standards for drug safety and efficacy.

Pricing & Access

Disulfiram is the generic alternative containing the active compound Disulfiram, often providing significant cost savings compared to its branded counterparts. Our pharmacy service strives to offer competitive pricing, often near the manufacturer's cost, making treatment more accessible and sustainable for individuals managing chronic conditions. By working with international partners, we can also provide access to medications that may have limited availability in certain regions.

Discreet Delivery

We prioritise your privacy and discretion. All orders for Disulfiram are packaged in plain, discreet outer wrapping, with no indication of the contents on the outside of the parcel. This ensures that your privacy is maintained from the moment of purchase through to delivery. We offer reliable shipping options, with express delivery typically arriving within 7 days and standard airmail within approximately 3 weeks, ensuring you receive your medication promptly and confidentially.

Use: Dosing, Missed Dose, Overdose

Specific dosing for Disulfiram is determined by a healthcare professional and depends on the individual's response and tolerance.

• Dosing: A common starting dose for adults is 250mg once daily, taken orally. The dose may be increased by the prescribing physician to 500mg daily for the first one to two weeks of treatment. After this initial period, the dose is usually reduced back to 250mg daily for maintenance therapy. Treatment duration is variable and depends on the patient's overall treatment plan and progress.
• Missed Dose: If a dose of Disulfiram is missed, it should be taken as soon as remembered, unless it is close to the time for the next scheduled dose. If it is nearly time for the next dose, the missed dose should be skipped, and the regular dosing schedule resumed. It is important not to "double up" on the dose to compensate for a missed one. If unsure, consult your healthcare provider or pharmacist.
• Overdose: An overdose of Disulfiram can be serious. Symptoms of Disulfiram overdose may include drowsiness, confusion, hallucinations, dizziness, nausea, vomiting, and unsteady gait. If an overdose is suspected, seek immediate medical attention. In the event of a significant alcohol intake while on Disulfiram, leading to a severe disulfiram-alcohol reaction, emergency medical services should be contacted immediately.

Precautions: patients should be advised to avoid all forms of alcohol, including alcohol found in foods, beverages, and topical or oral medications (e.g., cough syrups, mouthwash) while undergoing Disulfiram therapy and for at least two weeks after stopping the medication. Operating machinery or driving may be impaired due to potential side effects like drowsiness or confusion.

Safety Information

⚠️ Who Should Not Take Disulfiram

Disulfiram is contraindicated in several circumstances. It must not be used by patients who:

• Have absolutely taken alcohol in the past 12 to 48 hours.
• Are currently intoxicated with alcohol.
• Have known hypersensitivity to Disulfiram.
• Have severe myocardial disease (heart muscle disease).
• Have a history of cerebrovascular psychosis (mental disorders affecting the brain).
• Are concurrently taking certain medications such as oral anticoagulants, paraldehyde, or isoniazid.
• Have significant liver or kidney dysfunction.

Common Side Effects

The most frequent side effects associated with Disulfiram occur when alcohol is consumed, but some can also occur during therapy even without alcohol intake. Common side effects include:

• Drowsiness
• Headache
• Fatigue or weakness
• Nausea
• Vomiting
• Metallic or garlic-like taste in the mouth
• Dermatitis
• Potentially elevated liver enzymes, requiring monitoring.

Serious Side Effects (Seek Immediate Medical Help)

While less common, serious side effects can occur, often associated with the Disulfiram-alcohol reaction or individual sensitivities. Seek immediate medical attention if you experience:

• Severe nausea and vomiting
• Severe chest pain or palpitations
• Difficulty breathing or shortness of breath
• Sudden drop in blood pressure
• Severe headache
• Confusion or hallucinations
• Signs of liver damage, such as yellowing of the skin or eyes (jaundice), dark urine, or persistent abdominal pain.

Drug & Food Interactions

Disulfiram can interact with a number of substances, necessitating careful medical review. Significant interactions include:

• Alcohol: The primary interaction that leads to the severe disulfiram-alcohol reaction. This includes all sources containing ethanol.
• Oral Anticoagulants (e.g., Warfarin): Disulfiram can potentiate the effect of these drugs, increasing the risk of bleeding. Close monitoring of prothrombin time (PT) is essential.
• Isoniazid: Concomitant use may lead to central nervous system effects (e.g., rapid mood changes, confusion, dizziness).
• Phenytoin: Disulfiram can reduce the metabolism of phenytoin, leading to increased phenytoin levels and potential toxicity.
• Theophylline: Disulfiram can inhibit the metabolism of theophylline, increasing its blood levels.
• Certain Antidepressants (e.g., Monoamine Oxidase Inhibitors - MAOIs, Tricyclic Antidepressants - TCAs): Use with caution due to potential for severe reactions.
• Barbiturates: May prolong the effect of barbiturates by inhibiting their metabolism if taken together.
• Diazepam and Chlordiazepoxide: Disulfiram can inhibit the metabolism of these benzodiazepines, leading to increased plasma concentrations and sedation.
• Nutritional Supplements: Some supplements or herbal products may contain alcohol, necessitating caution and disclosure to a healthcare provider.

Off-Label and Investigational Uses of Disulfiram

While Disulfiram's primary approved indication is for alcohol dependence, clinical studies and case reports have explored its potential use in other conditions, although these are not its official registered uses and should only be considered under strict medical supervision.

• Cocaine Dependence: Some research has investigated Disulfiram as a potential adjunct treatment for cocaine dependence. The rationale is that Disulfiram might alter dopamine metabolism or induce metabolic changes that could reduce the craving or reinforcing effects of cocaine. However, evidence for its efficacy in this area is still developing and is not definitively established.
• Other Substance Use Disorders: Similarly, explorations into its use for other substance use disorders exist, but robust clinical evidence supporting these uses is often limited.

It is imperative to understand that any use of Disulfiram outside of its approved indication for alcoholism is considered off-label. Efficacy and safety for these investigational uses have not been formally approved by regulatory bodies such as the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK. Patients considering Disulfiram for off-label purposes must engage in thorough discussions with their healthcare provider regarding the potential risks and benefits, as well as the lack of formal regulatory endorsement.

Storage & Handling

Proper storage of Disulfiram is essential to maintain its potency and ensure safety.

• Store Disulfiram tablets at room temperature, typically between 15°C and 30°C (59°F and 86°F).
• Keep the medication protected from light and moisture. Do not store in the bathroom, as the humidity can degrade the pills.
• Ensure the container is tightly closed when not in use.
• Keep Disulfiram out of reach of children and pets.
• Unused or expired medication should be disposed of safely. Do not flush Disulfiram down the toilet. Check with your local pharmacy or waste disposal service for advice on how to properly dispose of unused medications.

Frequently Asked Questions

About Using Disulfiram

• When should I take my Disulfiram dose? Disulfiram is typically taken once daily. It is often recommended to take it in the morning, but consistency is key. Discuss the best timing for dosing with your prescribing healthcare professional to integrate it smoothly into your daily routine.

• What are the actual risks if I drink alcohol while taking Disulfiram? Drinking alcohol while taking Disulfiram can result in a severe and potentially dangerous reaction. Symptoms can include intense flushing, throbbing headache, nausea, vomiting, chest pain, palpitations, and shortness of breath, which can lead to dangerously low blood pressure and collapse.

• Can I use alcohol-containing mouthwash or cough syrup while on Disulfiram? No, you must avoid all products containing alcohol, including many mouthwashes, colognes, perfumes, lotions, and over-the-counter cough and cold remedies. These products can trigger the disulfiram-alcohol reaction, even if consumed in small quantities.

• How long does Disulfiram stay in my system after I stop taking it? Disulfiram can remain in your system and exert its effects for at least 14 days after your last dose. Therefore, you must avoid alcohol for at least two weeks after discontinuing the medication to prevent a reaction.

Product Information

• Are there visual differences between brand-name Disulfiram and generic versions? While the active ingredient Disulfiram is the same, generic Disulfiram pill formulations may differ slightly in colour, size, or shape compared to brand-name products due to variations in inactive ingredients (excipients) used by different manufacturers.

• What are the inactive ingredients in Disulfiram? Inactive ingredients can vary between manufacturers but may include substances such as microcrystalline cellulose, povidone, maize starch, colloidal anhydrous silica, and magnesium stearate. Specific ingredient lists are usually available on the product packaging or patient information leaflet.

Safety & Regulations

• Will taking Disulfiram affect my ability to drive or operate machinery? Yes, Disulfiram can cause side effects such as drowsiness, confusion, and blurred vision. It is advisable to avoid driving or operating heavy machinery until you know how Disulfiram affects you and whether these side effects impair your ability.

• Can Disulfiram be used by people with liver problems? Disulfiram should be used with extreme caution or avoided in individuals with liver dysfunction. The medication is metabolised in the liver, and there is a risk of hepatotoxicity (liver damage), especially with prolonged use or high doses. Regular liver function monitoring by a healthcare provider is often recommended.

• Is there a pregnancy category for Disulfiram? Disulfiram is generally not recommended for use during pregnancy. Its use should be carefully considered based on the potential benefits versus the risks to the foetus. Consult a healthcare professional for guidance on managing alcohol dependence during pregnancy.

Glossary

Aldehyde Dehydrogenase

An enzyme in the liver responsible for breaking down acetaldehyde, a toxic byproduct of alcohol metabolism. Disulfiram's action on this enzyme causes acetaldehyde to build up.

Acetaldehyde

A chemical compound produced during the metabolism of alcohol (ethanol) in the body. High levels of acetaldehyde are toxic and cause the unpleasant symptoms of the disulfiram-alcohol reaction.

Deterrent Therapy

A form of treatment that aims to discourage a particular behaviour, in this case, alcohol consumption, by creating an aversive or unpleasant consequence for engaging in that behaviour.

Hepatotoxicity

Drug-induced liver damage. Certain medications, including Disulfiram, can potentially cause harm to the liver.

Contradiction

A specific situation, condition, or factor that makes a recommended medical treatment or procedure inadvisable.

Disclaimer

The information provided about Disulfiram is for general knowledge purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. All medical decisions, including decisions about starting, continuing, or changing any treatment regimen involving Disulfiram, particularly for any off-label uses, must be made under the direct supervision of a qualified healthcare provider. We operate under the premise that all users of our platform are responsible adults capable of making informed decisions regarding their personal health. Our online pharmacy service aims to improve access to medications like Disulfiram for individuals who may face challenges with availability through traditional channels, have specific insurance needs, or are seeking cost-effective generic options. Always consult with your doctor or other qualified health professional before starting, altering, or discontinuing any medication.