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Drug Interactions between Antabuse and fosphenytoin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

disulfiram fosphenytoin

Applies to: Antabuse (disulfiram) and fosphenytoin

MONITOR: Phenytoin serum levels may increase significantly in the presence of disulfiram. Rapid increases in serum phenytoin levels of 73% to 500% have been reported. Disulfiram may inhibit hepatic microsomal metabolism of phenytoin and decrease its elimination rate. Theoretically, other hydantoins may be similarly affected.

MANAGEMENT: Patients should be closely observed for signs of hydantoin toxicity if these drugs must be given concurrently and serum phenytoin concentrations should be monitored. Patients should be advised to notify their physician if they experience symptoms of toxicity, including drowsiness, visual disturbances, change in mental status, seizures, nausea, or ataxia. The hydantoin dose may need to be decreased. In addition, the dose of the hydantoin may require adjustment when initiating or discontinuing treatment with disulfiram. Recovery may take two to three weeks after treatment with disulfiram is discontinued.

References (6)
  1. Brown CG, Kaminsky MJ, Feroli ER, Gurley HT (1983) "Delirium with phenytoin and disulfiram administration." Ann Emerg Med, 12, p. 310-3
  2. Taylor JW, Alexander B, Lyon LW (1981) "Mathematical analysis of a phenytoin-disulfiram interaction." Am J Hosp Pharm, 38, p. 93-5
  3. Kiorboe E (1966) "Phenytoin intoxication during treatment with antabuse (disulfiram)." Epilepsia, 7, p. 246-9
  4. Olesen OV (1966) "Disulfiram (antabuse) as inhibitor of phenytoin metabolism." Acta Pharmacol Toxicol (Copenh), 24, p. 317-22
  5. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  6. Cerner Multum, Inc. "Australian Product Information."

Drug and food interactions

Major

disulfiram food

Applies to: Antabuse (disulfiram)

CONTRAINDICATED: Consumption of ethanol during treatment with disulfiram may cause flushing, nausea, blurred vision, dyspnea, tachypnea, tachycardia, and hypotension. Death has been reported. The mechanism is probably related to inhibition of aldehyde dehydrogenase, the enzyme responsible for the oxidation of acetaldehyde to acetyl CoA. Accumulation of acetaldehyde probably results.

MANAGEMENT: Ethanol should be avoided in patients receiving disulfiram.

References (3)
  1. Jones RO (1949) "Death following the ingestion of alcohol in an antabuse treated patient." Can Med Assoc J, 60, p. 609-12
  2. Stoll D, King LE (1980) "Disulfiram-alcohol skin reaction to beer-containing shampoo." JAMA, 244, p. 2045
  3. van Ieperen L (1984) "Sudden death during disulfiram-ethanol reaction." S Afr Med J, 66, p. 165

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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 interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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