Interactions between ritonavir and Antabuse (disulfiram)
disulfiram and ritonavir (Major Drug-Drug)
GENERALLY AVOID: Ritonavir capsules, ritonavir oral solution, and lopinavir-ritonavir oral solution contain alcohol, which can produce severe reactions when coadministered with disulfiram. The mechanism is inhibition of aldehyde dehydrogenase (ALDH) by disulfiram. Following ingestion of alcohol, inhibition of ALDH results in increased concentration of acetaldehyde, the accumulation of which produces an unpleasant physiologic response referred to as the 'disulfiram reaction'. Symptoms include flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, weakness, vertigo, blurred vision, and confusion. Severe reactions may result in respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death.
MANAGEMENT: Use of ritonavir capsules, ritonavir oral solution, or lopinavir-ritonavir oral solution with disulfiram should be avoided.
