FAQ: Which Antibiotic(s) Can Cause A Disulfiram-like Reaction?


Which antibiotics can cause a disulfiram-like reaction?

Examples of drugs that have been reported to produce disulfaram- like reactions include metronidazole (Flagyl and other brands), trimethoprim-sulfamethoxazole (Bactrim, Bactrim DS), tinidazole, chlorpropamide (Diabinese), tolbutamide, and others.

Which drug has disulfiram-like action?

In the present study, chloramphenicol, furazolidone, metronidazole, and quinacrine, which are reported to produce a disulfiram – like reaction, as well as disulfiram, were administered to Wistar rats and the hepatic activities of alcohol and aldehyde dehydrogenases (1A1 and 2) were determined.

Does Bactrim cause disulfiram reaction?

The disulfiram reaction is a very uncomfortable reaction characterized by severe flushing, and may be accompanied by tachycardia and hypotension. Although we always think of metronidazole, there have been well described cases of bactrim causing this reaction.

How does metronidazole cause disulfiram reaction?

Background: Metronidazole, an effective antianaerobic agent, has been reported to have aversive properties when ingested with ethanol. This is thought to be due to the blocking of hepatic aldehyde dehydrogenase (ALDH) enzyme followed by the accumulation of acetaldehyde in the blood.

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What are the symptoms of disulfiram reaction?

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.

How do you treat a disulfiram-like reaction?

Recommended treatment consists of supportive measures such as Trendelenberg posture, administration of oxygen and intravenous infusion of fluid, solute, colloid, and, if needed, a pressor agent such as norepinephrine. Iron salts, ascorbic acid, antihistamines and phenothiazines are of no established benefit.

What is the action of disulfiram?

Mechanism of Action Disulfiram irreversibly inhibits aldehyde dehydrogenase (ALDH1A1) by competing with nicotinamide adenine dinucleotide (NAD) at the cysteine residue in the active site of the enzyme. ALDH1A1 is a hepatic enzyme of the major oxidative pathway of alcohol metabolism converting ethanol to acetaldehyde.

How does disulfiram work in the body?

Disulfiram works by blocking the breakdown of alcohol in the body. This leads to buildup of a toxic alcohol-related compound that can cause people who drink alcohol while taking this medication to become very sick. This reaction helps encourage people to avoid alcohol while taking the medication.

Is disulfiram safe to use?

Disulfiram is known to cause hepatitis, which is sometimes fatal. The best estimate of the frequency of disulfiram -induced fatal hepatitis is 1 case in 30,000 patients treated/year. Its appears to be more common in patients given disulfiram for the treatment of nickel sensitivity.

Can I have a glass of wine on Bactrim?

Combining antibiotics and alcohol can increase these side effects. A few antibiotics — such as metronidazole (Flagyl), tinidazole (Tindamax), and sulfamethoxazole and trimethoprim ( Bactrim ) — should not be mixed with alcohol because this may result in a more severe reaction.

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Is chloramphenicol an antibiotic?

Chloramphenicol is an antibiotic. It’s mainly used to treat eye infections (such as conjunctivitis) and sometimes ear infections. Chloramphenicol comes as eye drops or eye ointment.

What is the disulfiram ethanol reaction?

The disulfiram – ethanol reaction (DER) is due to increased serum acetaldehyde concentrations generated by the metabolism of ethanol by alcohol dehydrogenase in the liver. Normally, this acetaldehyde is cleared rapidly by its metabolism to acetate via aldehyde dehydrogenase.

Can I have one drink on metronidazole?

Side effects. It’s unusual to have side effects when using metronidazole cream or gel. However there can be some common side effects with the tablets, suppositories or vaginal gel. Do not drink alcohol while taking the tablets or liquid or using the vaginal gel or suppositories.

How long does metronidazole stay in your system?

The elimination half life of metronidazole is approximately 8 hours. It takes 5.5 x elimination half life for a medicine to be completely cleared from the body. Therefore it will take about 44 hours (5.5 x 8 hrs) for it to be cleared from your system.

Why metronidazole is not taken with alcohol?

Flagyl blocks the effects of this enzyme. As a result, a person on Flagyl cannot fully digest alcohol, and drinking can cause the toxic acetaldehyde to build up in the bloodstream. Because of this, people who drink alcohol while taking Flagyl may experience a disulfiram-like reaction.

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