Patient leaflet - Disulfiram 200 mg tablets
1. What Disulfiram is and what it is used for
Disulfiram (Disulfiram’s active ingredient) is used as a supportive agent in the treatment of alcoholism. When you drink alcohol it is changed in the body into acetaldehyde, disulfiram blocks the enzyme which breaks down acetaldehyde. This leads to an increased level of acetaldehyde in the blood causing unpleasant physical reactions.
Disulfiram is used in the treatment of people with drinking problems. If you are treated with Disulfiram and drink alcohol you will experience unpleasant physical reactions, which may stop you from drinking further alcohol.
2. What you need to know before you take Disulfiram
Do not take Disulfiram if you have:
- an allergy to disulfiram or any of the other ingredients of this medicine (listed in section 6)
- severe heart disease or heart failure
- high blood pressure
- severe psychiatric or personality disorder
- had a stroke
- recently consumed alcohol.
Warnings and precautions
Talk to your doctor or pharmacist before taking Disulfiram if you have:
- kidney, liver or lung disease
- diabetes
- low blood pressure
- brain damage
- epilepsy.
Children and adolescents
Do not give this medicine to children.
Other medicines and Disulfiram
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription. Especially:
- warfarin (reduces blood clotting)
- phenytoin and paraldehyde (to treat epilepsy)
- theophylline (to treat asthma)
- chlordiazepoxide and diazepam (to treat anxiety)
- pethidine and morphine (painkillers)
- amphetamines (stimulants)
- pimozide, and chlorpromazine (to treat mental illnesses)
- isoniazid metronidazole, rifampicin (to treat infections)
- amitriptyline (to treat depression).
Other precautions
Certain foods, liquid medicines, remedies, tonics, toiletries, perfumes and sprays may contain enough alcohol to cause an Disulfiram-alcohol reaction. Caution should also be exercised with low alcohol and “non-alcoholic” or “alcohol-free” beers and wines. If enough is taken they may produce unpleasant reactions.
Disulfiram and alcohol
If you drink alcohol during or within 2 weeks of stopping Disulfiram, or you have been exposed to alcohol from other sources (see ‘Other precautions’) an Disulfiram-alcohol reaction may occur. The reaction is unpredictable and symptoms may be severe or life threatening. Symptoms include; flushing of the face and neck, increased body temperature, sweating, feeling or being sick, itchy skin or rash caused by an allergic reaction (pruritis, urticaria) anxiety, dizziness, headache, blurred vision, difficulty breathing, palpitations, rapid breathing.
In severe cases; rapid heart beat, low blood pressure, abnormally slow breathing, chest pain, abnormal heart rhythm, coma or fits may occur.
Rare complications may include; high blood pressure, breathing problems, blood disorders.
If you get some of the symptoms, contact your doctor.
The Disulfiram-alcohol reaction can occur within 15 minutes after drinking alcohol and may last several hours.
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. The use of Disulfiram during the first 3 months of pregnancy or breast-feeding is not advised and should only be used if directed by your doctor.
Driving and using machines
Disulfiram tablets may cause drowsiness or tiredness (see ‘4. Possible side effects’). If you are affected do not drive or operate machinery.
Disulfiram and lactose
If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
3. How to take Disulfiram
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. A check up is advised before starting treatment to check you are suitable for treatment.
Treatment with Disulfiram is usually started in a hospital or specialised clinic. It is important that you have not drunk alcohol for at least 24 hours before taking the first dose. Swallow the tablets with water.
The recommended dose is:
Adults and the elderly:
Initially 4 tablets (800mg) on day 1, then 3 tablets (600mg) on day 2, then 2 tablets (400mg) on day 3 and then 1 tablet (200mg) on days 4 and 5. Then ½ to 1 tablet (100mg – 200mg) a day for as long as told by your doctor, but for no longer than six months without review.
If you take more Disulfiram than you should
If you (or someone else) swallow a lot of tablets at the same time, or you think a child may have swallowed any, contact your nearest hospital casualty department or tell your doctor immediately. Signs of an overdose include; feeling or being sick, stomach pain, diarrhoea, drowsiness, mental disorders, tiredness, rapid heart beat, rapid breathing, high body temperature, low blood pressure, loss of muscle control, high blood sugar, changes in the blood (as seen in blood tests). Severe cases may result in coma, fits or death.
If you forget to take Disulfiram
If you forget to take a dose, and you do not remember it within 12 hours, you should not take it. Do not take a double dose to make up for a forgotten dose.
If you stop taking Disulfiram
Speak to your doctor or nurse before stopping treatment with Disulfiram.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Stop taking this medicine and immediately contact a doctor if you experience any of the following:
- allergic skin reactions such as itching and redness.
Tell your doctor if you notice any of the following side effects or notice any other effects not listed:
- depression, paranoia, schizophrenia, mania,
- decreased sexual desire
- drowsiness and fatigue (especially at start of treatment)
- damage/inflammation of peripheral nerves (causing pain and loss of sensation in hands and feet)
- inflammation of the optic nerve
- encephalopathy (brain disease)
- feeling or being sick
- bad breath
- inflammation of the liver (hepatitis), damage to liver cells, liver failure
- rash.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store Disulfiram
Keep out of the sight and reach of children.
This medicinal product does not require any special storage conditions.
Package leaflet: Information for the user
Disulfiram 200mg Tablets
Front Side
Do not use Disulfiram after the expiry date stated on the label. The expiry date refers to the last day of that month.
Do not throw throw any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Disulfiram contains
The active substance (the ingredient that makes the tablet work) is 200mg of disulfiram.
The other ingredients are Microcrystalline cellulose, Lactose monohydrate, Maize starch, Potato starch, Sodium hydrogen carbonate, Tartaric acid, Povidone K30, Polysorbate 20, Colloidal anhydrous silica and Magnesium stearate.
What Disulfiram tablets look like and contents of pack
The tablet is white to off-white, round, flat, uncoated scored tablets, debossed with “Hϵ” and “1” on either side of breakline and plain on other side. The tablet can be divided into equal doses.
The tablets are available in polyethylene container with a polypropylene child resistant closure with pack size of 50 tablets.
Marketing Authorisation Holder and Manufacturer
Accord, Barnstaple, EX32 8NS, UK
This leaflet was last revised in April 2023.
If you would like a leaflet with larger text, please contact
01271 385257
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