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Drug Interactions between disulfiram and Remular-S

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

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Interactions between your drugs

Moderate

chlorzoxazone disulfiram

Applies to: Remular-S (chlorzoxazone) and disulfiram

MONITOR: Disulfiram may increase the depressant effects that chlorzoxazone has on the central nervous system. The mechanism is inhibition of the CYP450 2E1 hepatic metabolism of chlorzoxazone, resulting in increased serum levels and half-life.

MANAGEMENT: Patients should be monitored for excessive CNS depressant effects. If these effects increase during concomitant administration, the clinician should consider decreasing chlorzoxazone dosage. Patients should be advised to report excessive sedation, headache or nausea to their physician.

References

  1. Kharasch ED, Thummel KE, Mhyre J, Lillibridge JH "Single-dose disulfiram inhibition of chlorzoxazone metabolism: a clinical probe for P450 2E1." Clin Pharmacol Ther 53 (1993): 643-50

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Drug and food interactions

Major

disulfiram food

Applies to: 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

chlorzoxazone food

Applies to: Remular-S (chlorzoxazone)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents such as chlorzoxazone. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills. In addition, in one small study, watercress was reported to increase chlorzoxazone peak concentrations, AUC, and half-life. The proposed mechanism is inhibition of CYP450 2E1 metabolism. The clinical significance is unknown.

MANAGEMENT: Patients receiving chlorzoxazone should be 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 chlorzoxazone affects them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities. Watercress should be avoided if an interaction is suspected; e.g., excess sedation, nausea, or headache occurs.

References

  1. Leclercq I, Desager JP, Horsmans Y "Inhibition of chlorzoxazone metabolism, a clinical probe for CYP2E1, by a single ingestion of watercress." Clin Pharmacol Ther 64 (1998): 144-9

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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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