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Drug interactions between Antabuse and Flagyl

Results for the following 2 drugs:
Antabuse (disulfiram)
Flagyl (metronidazole)

Interactions between your drugs

Major

metronidazole ↔ disulfiram

Applies to:Flagyl (metronidazole) and Antabuse (disulfiram)

Consumer information for this interaction is not currently available.

CONTRAINDICATED: Use of a nitroimidazole in patients treated with disulfiram may result in psychotic reactions. The exact mechanism of interaction is unknown, but may involve additive effects on aldehyde dehydrogenase (ALDH) inhibition. The interaction has been reported with metronidazole. In one study, 6 of 29 hospitalized alcoholic patients who were treated with disulfiram (500 mg daily for one month, then 250 mg daily) and metronidazole (750 mg daily for one month, then 250 mg daily) developed acute psychoses or a confusional state, compared to none of the 29 patients receiving disulfiram alone. Five had paranoid delusions and three had visual and auditory hallucinations. Symptoms initially increased following withdrawal of the medications, but resolved slowly over two weeks and did not recur when disulfiram alone was restarted. No data are available for other nitroimidazoles or vaginally administered metronidazole.

MANAGEMENT: Nitroimidazole therapy should not be administered with disulfiram. Metronidazole and benznidazole are specifically contraindicated in patients who have taken disulfiram within the last two weeks according to their product labeling.

References

  1. "Product Information. Metrogel-Vaginal (metronidazole)." Curatek Pharmaceuticals Ltd, Elk Grove Village, IL.
  2. Knee ST, Razani J "Acute organic brain syndrome: a complication of disulfiram therapy." Am J Psychiatry 131 (1974): 1281-2
  3. Scher JM "Psychotic reaction to disulfiram." JAMA 201 (1967): 175
View all 6 references

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2017 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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