Disulfiram (Teturam) 150 mg – [50 tablets]

Description Teturam Pharmacodynamics During metabolism, ethanol is metabolized in the liver by the enzyme acetaldehyde dehydrogenase. Disulfiram irreversibly inhibits acetaldehyde dehydrogenase, which leads to increased concentration of ethanol metabolite – acetaldehyde. After taking ethanol during disulfiram treatment, the concentration of acetaldehyde increases and certain unpleasant feelings develop (“rushes” of blood to the skin, nausea, vomiting, tachycardia, lowering of blood pressure). As a result, a conditioned reflex reaction to the taste and smell of ethanol occurs. Maximum therapeutic effect is achieved 12 hours after oral administration and may last for 10-14 days after discontinuation of treatment.   Indications Treatment and prevention of relapse in chronic alcoholism.   Contraindications . – Hypersensitivity to disulfiram or excipients of the drug. – Severe hepatic insufficiency. – Respiratory insufficiency of a heavy degree. – Renal insufficiency of a severe degree. – Diabetes mellitus. – Stroke in the history or severe organic lesions of the brain. – Neuropsychiatric disorders. – Epilepsy and seizure syndrome of any genesis. – Diseases of the cardiovascular system, including coronary heart disease. – Consumption of alcoholic beverages or medications containing ethanol within the preceding 24 hours. – Pregnancy and childbearing age (in the absence of contraception). – Breast-feeding period. – Childhood under 18 years of age (due to lack of efficacy and safety data). – Concomitant use of isoniazid, metronidazole, ornidazole, secnidazole, tinidazole, phenytoin (see section “Interaction with other medicinal products”). Caution – Renal insufficiency (risk of more severe disulfiram-ethanol reaction). – Hypothyroidism (risk of more severe disulfiram-ethanol reaction). – Nickel dermatitis (increased risk of developing hepatitis). – Gastric and duodenal ulcer (see section “Side effects”). – Optic neuritis (see section “Side effects”). – In patients taking cocaine (risk of QT interval prolongation, see section “Interaction with other medicinal products”). – Patients over 60 years of age.   Dosage and administration   Treatment is administered after careful examination of the patient and warning about the consequences and complications. The patient should not take alcohol (ethanol) 5-7 days before the start of treatment, the test for ethanol in the blood should be negative. The dose may be varied up or down depending on the patient’s response. Disulfiram-ethanol test Disulfiram-ethanol test shall be carried out 7-10 days later (after taking 500 mg of the drug, the patient shall take 20-30 ml of 40% ethanol). In case of weak disulfiram-ethanol reaction (blood rush to the face, skin hyperemia, nausea, vomiting, weakness, tachycardia, reduced arterial pressure), the ethanol dose shall be increased by 10-20 ml (maximum dose is 120 ml in recalculation on 40% ethanol). The test is repeated in 1-2 days in the hospital and 3-5 days later as an outpatient, with correction of doses of ethanol and/or the drug as necessary. Thereafter, the drug may be used in a maintenance dose of 150 mg per day for 1-3 years. Disulfiram-ethanol testing is not recommended in patients over 50 years of age.