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pamphlet ways to avoid getting antabuse into system |
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pamphlet ways to avoid getting antabuse into system Manufacturer: Odyssey
The physician should instruct relatives accordingly pamphlet ways to avoid getting antabuse into system.
CHEMICAL NAME: bis(diethylthiocarbamoyl) disulfide pamphlet ways to avoid getting antabuse into system. STRUCTURAL FORMULA:
Each tablet for oral administration contains 250 mg or 500 mg disulfiram, USP pamphlet ways to avoid getting antabuse into system. Tablets also contain colloidal silicon dioxide, anhydrous lactose, magnesiumstearate, microcrystalline cellulose, sodium starch glycolate, and stearic acid pamphlet ways to avoid getting antabuse into system.
Disulfiram blocks the oxidation of alcohol at the acetaldehyde stage pamphlet ways to avoid getting antabuse into system. Duringalcohol metabolism following disulfiram intake, the concentration of acetaldehydeoccurring in the blood may be 5 to 10 times higher than that found during metabolismof the same amount of alcohol alone pamphlet ways to avoid getting antabuse into system. Accumulation of acetaldehyde in the blood produces a complex of highly unpleasantsymptoms referred to hereinafter as the disulfiram-alcohol reaction pamphlet ways to avoid getting antabuse into system. This reaction,which is proportional to the dosage of both disulfiram and alcohol, will persistas long as alcohol is being metabolized pamphlet ways to avoid getting antabuse into system. Disulfiram does not appear to influencethe rate of alcohol elimination from the body pamphlet ways to avoid getting antabuse into system. Disulfiram is absorbed slowly from the gastrointestinal tract and is eliminatedslowly from the body pamphlet ways to avoid getting antabuse into system. One (or even two) weeks after a patient has taken hislast dose of disulfiram, ingestion of alcohol may produce unpleasant symptoms pamphlet ways to avoid getting antabuse into system. Prolonged administration of disulfiram does not produce tolerance; the longera patient remains on therapy, the more exquisitely sensitive he becomes to alcohol pamphlet ways to avoid getting antabuse into system.
Disulfiram is not a cure for alcoholism pamphlet ways to avoid getting antabuse into system. When used alone, without proper motivationand supportive therapy, it is unlikely that it will have any substantive effecton the drinking pattern of the chronic alcoholic pamphlet ways to avoid getting antabuse into system.
Disulfiram is contraindicated in the presence of severe myocardial diseaseor coronary occlusion, psychoses, and hypersensitivity to disulfiram or to otherthiuram derivatives used in pesticides and rubber vulcanization pamphlet ways to avoid getting antabuse into system.
The physician should instruct relatives accordingly pamphlet ways to avoid getting antabuse into system. The patient must be fully informed of the disulfiram-alcohol reaction pamphlet ways to avoid getting antabuse into system. He mustbe strongly cautioned against surreptitious drinking while taking the drug,and he must be fully aware of the possible consequences pamphlet ways to avoid getting antabuse into system. He should be warnedto avoid alcohol in disguised forms, i.e., in sauces, vinegars, cough mixtures,and even in aftershave lotions and back rubs pamphlet ways to avoid getting antabuse into system. He should also be warned thatreactions may occur with alcohol up to 14 days after ingesting disulfiram pamphlet ways to avoid getting antabuse into system. The Disulfiram-Alcohol Reaction: Disulfiram plus alcohol, even small amounts,produce flushing, throbbing in head and neck, throbbing headache, respiratorydifficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation,dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness,weakness, vertigo, blurred vision, and confusion pamphlet ways to avoid getting antabuse into system. In severe reactions theremay be respiratory depression, cardiovascular collapse, arrhythmias, myocardialinfarction, acute congestive heart failure, unconsciousness, convulsions, anddeath pamphlet ways to avoid getting antabuse into system. The intensity of the reaction varies with each individual, but is generallyproportional to the amounts of disulfiram and alcohol ingested pamphlet ways to avoid getting antabuse into system. Mild reactionsmay occur in the sensitive individual when the blood alcohol concentration isincreased to as little as 5 to 10 mg per 100 mL pamphlet ways to avoid getting antabuse into system. Symptoms are fully developedat 50 mg per 100 mL, and unconsciousness usually results when the blood alcohollevel reaches 125 to 150 mg pamphlet ways to avoid getting antabuse into system. The duration of the reaction varies from 30 to 60 minutes, to several hoursin the more severe cases, or as long as there is alcohol in the blood pamphlet ways to avoid getting antabuse into system. Concomitant Conditions: Because of the possibility of an accidental disulfiram-alcoholreaction, disulfiram should be used with extreme caution in patients with anyof the following conditions: diabetes mellitus, hypothyroidism, epilepsy, cerebraldamage, chronic and acute nephritis, hepatic cirrhosis or insufficiency pamphlet ways to avoid getting antabuse into system.
It is suggested that every patient under treatment carry an IdentificationCard stating that he is receiving disulfiram and describing the symptoms mostlikely to occur as a result of the disulfiram-alcohol reaction pamphlet ways to avoid getting antabuse into system. In addition,this card should indicate the physician or institution to be contacted in anemergency pamphlet ways to avoid getting antabuse into system. (Cards may be obtained from ODYSSEY PHARMACEUTICALS upon request.) Alcoholism may accompany or be followed by dependence on narcotics or sedatives pamphlet ways to avoid getting antabuse into system. Barbiturates and disulfiram have been administered concurrently without untowardeffects; the possibility of initiating a new abuse should be considered pamphlet ways to avoid getting antabuse into system. Hepatic toxicity including hepatic failure resulting in transplantation ordeath have been reported pamphlet ways to avoid getting antabuse into system. Severe and sometimes fatal hepatitis associated withdisulfiram therapy may develop even after many months of therapy pamphlet ways to avoid getting antabuse into system. Hepatic toxicityhas occurred in patients with or without prior history of abnormal liver function pamphlet ways to avoid getting antabuse into system. Patients should be advised to immediately notify their physician of any earlysymptoms of hepatitis, such as fatigue, weakness, malaise, anorexia, nausea,vomiting, jaundice, or dark urine pamphlet ways to avoid getting antabuse into system. Baseline and follow-up liver function tests (10-14 days) are suggested to detectany hepatic dysfunction that may result with disulfiram therapy pamphlet ways to avoid getting antabuse into system. In addition,a complete blood count and serum chemistries, including liver function tests,should be monitored pamphlet ways to avoid getting antabuse into system. Patients taking disulfiram tablets should not be exposed to ethylene dibromideor its vapors pamphlet ways to avoid getting antabuse into system. This precaution is based on preliminary results of animal researchcurrently in progress that suggest a toxic interaction between inhaled ethylenedibromide and ingested disulfiram resulting in a higher incidence of tumorsand mortality in rats pamphlet ways to avoid getting antabuse into system. A correlation between this finding and humans, however,has not been demonstrated pamphlet ways to avoid getting antabuse into system.
DISULFIRAM SHOULD BE USED WITH CAUTION IN THOSE PATIENTS RECEIVING PHENYTOINAND ITS CONGENERS, SINCE THE CONCOMITANT ADMINISTRATION OF THESE TWO DRUGS CANLEAD TO PHENYTOIN INTOXICATION pamphlet ways to avoid getting antabuse into system. PRIOR TO ADMINISTERING DISULFIRAM TO A PATIENTON PHENYTOIN THERAPY, A BASELINE PHENYTOIN SERUM LEVEL SHOULD BE OBTAINED pamphlet ways to avoid getting antabuse into system. SUBSEQUENTTO INITIATION OF DISULFIRAM THERAPY, SERUM LEVELS OF PHENYTOIN SHOULD BE DETERMINEDON DIFFERENT DAYS FOR EVIDENCE OF AN INCREASE OR FOR A CONTINUING RISE IN LEVELS pamphlet ways to avoid getting antabuse into system. INCREASED PHENYTOIN LEVELS SHOULD BE TREATED WITH APPROPRIATE DOSAGE ADJUSTMENT pamphlet ways to avoid getting antabuse into system. It may be necessary to adjust the dosage of oral anticoagulants upon beginningor stopping disulfiram, since disulfiram may prolong prothrombin time pamphlet ways to avoid getting antabuse into system. Patients taking isoniazid when disulfiram is given should be observed for theappearance of unsteady gait or marked changes in mental status, the disulfiramshould be discontinued if such signs appear pamphlet ways to avoid getting antabuse into system. In rats, simultaneous ingestion of disulfiram and nitrite in the diet for 78weeks has been reported to cause tumors, and it has been suggested that disulfirammay react with nitrites in the rat stomach to form a nitrosamine, which is tumorigenic pamphlet ways to avoid getting antabuse into system. Disulfiram alone in the rat's diet did not lead to such tumors pamphlet ways to avoid getting antabuse into system. The relevanceof this finding to humans is not known at this time pamphlet ways to avoid getting antabuse into system. Usage in Pregnancy: The safe use of this drug in pregnancy has not been established pamphlet ways to avoid getting antabuse into system. Therefore, disulfiram should be used during pregnancy only when, in the judgementof the physician, the probable benefits outweigh the possible risks pamphlet ways to avoid getting antabuse into system. Pediatric Use: Safety and effectiveness in pediatric patients have not beenestablished pamphlet ways to avoid getting antabuse into system. Nursing Mothers: It is not known whether this drug is excreted in human milk pamphlet ways to avoid getting antabuse into system. Since many drugs are so excreted, disulfiram should not be given to nursingmothers pamphlet ways to avoid getting antabuse into system. Geriatric Use: A determination has not been made whether controlled clinicalstudies of disulfiram included sufficient numbers of subjects aged 65 and overto define a difference in response from younger subjects pamphlet ways to avoid getting antabuse into system. Other reported clinicalexperience has not identified differences in responses between the elderly andyounger patients pamphlet ways to avoid getting antabuse into system. In general, dose selection for an elderly patient should becautious, usually starting at the low end of the dosing range, reflecting thegreater frequency of decreased hepatic, renal or cardiac function, and of concomitantdisease or other drug therapy pamphlet ways to avoid getting antabuse into system. |
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Copyright 2005 D-S LTD. |
