A friend took Antabuse this morning. He mixed it with his eggs and consumed probably half to 3/4 of a 500 mg tablet. Tonight he is on his third beer and is having no reaction. Why?
Did he cook these eggs after mixing in the drug? If yes, then it could have been heat. This drug should be kept at room temp. The average maintenance dose is 250 mg daily (range, 125 to 500 mg), it should not exceed 500 mg daily. Note: Occasionally patients, while seemingly on adequate maintenance doses of disulfiram, report that they are able to drink alcoholic beverages with impunity and without any symptomatology. All appearances to the contrary, such patients must be presumed to be disposing of their tablets in some manner without actually taking them. Until such patients have been observed reliably taking their daily disulfiram tablets (preferably crushed and well mixed with liquid), it cannot be concluded that disulfiram is ineffective. I would advise that he not mix this drug with eggs but use a liquid such as water or juice.
(If he is not cooking these eggs, I also want to add that this is a dangerous practice and a good way to get very sick with salmonella.)
Disulfiram plus alcohol, even small amounts, produce flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusion. In severe reactions there may be respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death. The intensity of the reaction varies with each individual, but is generally proportional to the amounts of disulfiram and alcohol ingested. Mild reactions may occur in the sensitive individual when the blood alcohol concentration is increased to as little as 5 to 10 mg per 100 mL. Symptoms are fully developed at 50 mg per 100 mL, and unconsciousness usually results when the blood alcohol level reaches 125 to 150 mg.
The duration of the reaction varies from 30 to 60 minutes, to several hours in the more severe cases, or as long as there is alcohol in the blood.
- Antabuse Information for Consumers
- Antabuse Information for Healthcare Professionals (includes dosage details)
- Side Effects of Antabuse (detailed)
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