UMEM Educational Pearls

Category: Toxicology

Title: Can I drink Alcohol with this Med?

Keywords: disulfiram reaction (PubMed Search)

Posted: 12/16/2010 by Fermin Barrueto, MD (Updated: 7/17/2024)
Click here to contact Fermin Barrueto, MD

There are medications, if taken with ethanol, will cause a disulfiram reaction. This reaction results from inhibition of aldehyde dehydrogenase, the enzyme in ethanol metabolism that breaks acetaldehyde to acetic acid. The increase in acetaldehyde results in nausea, vomiting, diarrhea, flushing, palpitations and orthostatic hypotension. So if you prescribe a patient with any of these medications you must make certain to tell them NOT to drink any ethanol - that includes cough/cold preparations that have ethanol:

Antibiotics: Metronidazole(Flagyl), Trimethoprim-sulfamethoxazole (Bactrim)

Sulfonylureas: Chlorpropamide and tolbutamide

These have possible reactions: griseofulvin, quinacrine, procarbazine, phentolamine, nitrofurantoin


Bonus Question: $10 Starbuck's Gift Card for  first person that emails me with the answer to this question

What treatment could you give to someone suffering from a life threatening disulfiram reaction that biochemically should cure him?