Disulfiram, Oral

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KEY POINTS

• This medicine is taken by mouth to treat alcoholism. Do not start taking this medicine unless you have not had any alcohol or products that contain alcohol for at least 12 hours. Take it exactly as directed.
• Do not drink any alcohol or take any medicines that contain alcohol while you are taking this medicine and for 2 weeks after you stop taking this medicine. Before you buy any medicines, mouthwash, or cosmetics, ask your pharmacist if they contain alcohol. Any amount of alcohol, including alcohol in products used on the skin, could make you sick. Check food products and avoid any that contain alcohol.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: alcohol antagonist

Generic and brand names: disulfiram, oral; Antabuse

What is this medicine used for?

This medicine is taken by mouth to treat alcoholism. It is not a cure. It makes you very sick if you drink alcohol, to discourage you from doing so.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine or to rubber or latex
• Brain damage or a brain injury
• Diabetes
• Heart disease
• Kidney or liver disease
• Mental health problems
• Seizures
• Thyroid problems

Tell your healthcare provider if you have taken metronidazole by mouth or used metronidazole on your skin in the past 2 weeks. Using these medicines within 2 weeks of each other can cause severe side effects.

Females of childbearing age: Tell your healthcare provider if you are pregnant or you plan to become pregnant while taking this medicine. It is not known whether this medicine will harm an unborn baby. Do not breast-feed without your healthcare provider's approval.

How do I take it?

Do not start taking this medicine unless you have not had any alcohol or products that contain alcohol for at least 12 hours. Take it every day as directed by your healthcare provider. Check the label on the medicine for directions about your specific dose.

Check with your healthcare provider before using this medicine in children under age 18 years.

Swallow the tablets whole with water. If you have trouble swallowing the tablets, you may crush the tablets and mix them with food or liquid to make them easier to swallow.

This medicine is usually taken once a day in the morning. If you have problems with drowsiness, talk with your healthcare provider about taking the medicine at bedtime.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, trouble walking, fainting, numbness or tingling in your hands or feet, seizures

What should I watch out for?

Do not drink any alcohol or take any medicines that contain alcohol while you are taking this medicine and for 2 weeks after you stop taking this medicine. Before you buy any medicines, mouthwash, or cosmetics, ask your pharmacist if they contain alcohol. Any amount of alcohol, including alcohol in products used on the skin, could make you sick. Check food products and avoid any that contain alcohol.

If you use any alcohol, you will have flushing, head and neck pain, trouble breathing, nausea, severe vomiting, sweating, thirst, chest pain, pounding or fast heartbeat, fainting, marked uneasiness, weakness, dizziness, blurred vision, and confusion. This reaction can last for 30 minutes to several hours. The more alcohol you use, the worse the reaction will be. A severe reaction can result in death.

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may make you drowsy. Do not drive or operate machinery unless you are fully alert.

The effects of caffeine on your nervous system and your heart may be increased. Ask your healthcare provider or pharmacist which foods, beverages, or medicines you should avoid.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine. You may want to carry an ID card or wear a med alert bracelet to let people know that you take this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Yellowing of your skin or eyes; dark urine; unexplained loss of appetite; severe stomach pain, nausea, or vomiting; unusual tiredness or weakness; mood or behavior changes; numbness or tingling in your hands or feet; vision problems; severe skin rash.

Other: Drowsiness, change in sense of taste, mild rash, acne, headache, change in sexual ability or desire.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antianxiety medicines such as chlordiazepoxide and diazepam (Valium)
• Antiseizure medicines such as ethotoin (Peganone), fosphenytoin (Cerebyx), and phenytoin (Dilantin, Phenytek)
• Caffeine in food, drinks, or medicines
• Dacarbazine
• Doxepin (Silenor)
• HIV medicines such as lopinavir/ritonavir (Kaletra), ritonavir (Norvir), and tipranavir (Aptivus)
• Isoniazid, rifampin/isoniazid (IsonaRif, Rifamate), and rifampin/isoniazid/pyrazinamide (Rifater)
• Linezolid (Zyvox)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Metronidazole
• Omeprazole (Prilosec)
• Procarbazine (Matulane)
• Products that contain methylene blue (Hyophen, Prosed DS, Urophen, Uta)
• Rasagiline (Azilect)
• Sertraline (Zoloft) (the liquid concentrate of this medicine contains alcohol)
• Tedizolid (Sivextro)
• Temazepam (Restoril)
• Theophylline
• Tinidazole (Tindamax)
• Tricyclic antidepressants such as amitriptyline, desipramine (Norpramin), imipramine (Tofranil), and nortriptyline (Pamelor)
• Warfarin (Coumadin)

Do not drink alcohol while you are taking this medicine.

This medicine will make you sick if you take any form of alcohol, including alcohol in drinks, cough syrups, mouthwashes, or foods and any alcohol that may be absorbed through your skin from after-shave lotions, liniments, and other skin products. Read the labels on beverages, foods, and medicines, and avoid those that contain alcohol, even in small amounts. If you need help, ask your healthcare provider or pharmacist.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.