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Disulfiram-cotrimoxazole reaction
1Department of Pharmacy, Baystate Medical Center, Springfield, Massachusetts, USA.
Pharmacotherapy
|August 6, 1998
Summary
The disulfiram-ethanol reaction causes acetaldehyde buildup. Trimethoprim-sulfamethoxazole (cotrimoxazole) can also trigger this reaction when combined with alcohol, leading to similar symptoms.
Area of Science:
- Pharmacology
- Toxicology
Background:
- The disulfiram-ethanol reaction is a known adverse effect of disulfiram treatment for alcohol dependence.
- It results from the accumulation of acetaldehyde, a toxic metabolite of ethanol.
Observation:
- Patients taking disulfiram experience a predictable set of symptoms within minutes of ethanol ingestion.
- These symptoms include flushing, sweating, palpitations, dyspnea, and gastrointestinal distress, among others.
Findings:
- Trimethoprim-sulfamethoxazole (cotrimoxazole), an antibiotic, can induce a similar reaction when co-administered with ethanol.
- This interaction also leads to the accumulation of acetaldehyde in the bloodstream.
Implications:
- Healthcare providers should be aware of the potential for a disulfiram-like reaction with cotrimoxazole and ethanol use.
- Patients should be counseled regarding this drug-chemical interaction to prevent adverse events.