Drug Interaction Report

GENERALLY AVOID: The diagnostic radiopharmaceutical florbetaben F-18 intravenous solution contains up to 1.2 g ethanol (alcohol) per dose, equivalent to 30 mL beer (approximately 1 ounce) or 12.5 mL wine (approximately 0.4 ounces) per dose and may cause an interaction with disulfiram. The mechanism is inhibition of aldehyde dehydrogenase (ALDH) by disulfiram. Following ingestion of alcohol, inhibition of ALDH results in increased concentration of acetaldehyde, the accumulation of which produces an unpleasant physiologic response referred to as the 'disulfiram reaction'. Symptoms include flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, weakness, vertigo, blurred vision, and confusion. Severe reactions may result in respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death.

MANAGEMENT: Caution and close monitoring are recommended if florbetaben F-18 is required in patients on disulfiram therapy. It may be advisable to temporarily discontinue disulfiram prior to administering florbetaben F-18.

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.