disulfiram1
disulfiram
CLINICAL USE
Adjunct in the treatment of chronic alcohol dependence
DOSE IN NORMAL RENAL FUNCTION
800 mg on day 1 reducing over 5 days to 100–200 mg daily
PHARMACOKINETICS
Molecular weight                           :296.5 %Protein binding                           :96 %Excreted unchanged in urine     : 70–76 (as metabolites) Volume of distribution (L/kg)       :No datahalf-life – normal/ESRD (hrs)      :12/– DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50     : Dose as in normal renal function 10 to 20     : Use with caution <10           : Avoid DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Unlikely to be dialysed. Avoid HD                     :Unlikely to be dialysed. AvoidHDF/high flux   :Unlikely to be dialysed. AvoidCAV/VVHD      :Unlikely to be dialysed. Dose as in GFR 10 to 20 mL/min IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsAlcohol: risk of severe disulfiram reaction Anticoagulants: enhanced anticoagulant effect with coumarinsAnti-epileptics: inhibition of metabolism of phenytoin (increased risk of toxicity)Paraldehyde: increased risk of toxicity with paraldehyde ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
–Comments
– OTHER INFORMATION
Review after 6 months Patients should be warned about severe nature of alcohol and disulfiram reactionContraindicated in cardiovascular disease, psychoses or severe personality disordersDisulfiram blocks the metabolism of alcohol and leads to an accumulation of acetaldehyde in the bloodstream. Use with caution in diabeticsDisulfiram is rapidly metabolised to diethyldithiocarbamic acid (DDC); is conjugated with glucuronic acid, oxidised to sulphate, methylated, and decomposed to diethylamine and carbon disulphide. Excretion is primarily through the kidneys
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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