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Drug Interactions between Antabuse and Librium

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

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Interactions between your drugs

Moderate

chlordiazePOXIDE disulfiram

Applies to: Librium (chlordiazepoxide) and Antabuse (disulfiram)

ADJUST DOSE: The combination of disulfiram and benzodiazepines may increase CNS depression. The mechanism may relate to the inhibition of hepatic oxidation of benzodiazepines by disulfiram. Diazepam and chlordiazepoxide may interact with disulfiram to a greater extent than other benzodiazepines. However, the interaction has also been reported with temazepam, even though it is metabolized by glucuronidation.

MANAGEMENT: The benzodiazepine dosage may require reduction. Patients should be monitored for excessive and prolonged sedation.

References

  1. MacLeod SM, Sellers EM, Giles HG, et al. "Interaction of disulfiram with benzodiazepines." Clin Pharmacol Ther 24 (1978): 583-9
  2. Sellers EM, Giles HG, Greenblatt DJ, Naranjo CA "Differential effects on benzodiazepine disposition by disulfiram and ethanol." Arzneimittelforschung 30 (1980): 882-6
  3. Hardman M, Biniwale A, Clarke CE "Temazepam toxicity precipitated by disulfiram." Lancet 344 (1994): 1231-2

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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

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

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Moderate

chlordiazePOXIDE food

Applies to: Librium (chlordiazepoxide)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
View all 4 references

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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.

See also

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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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