When alcohol meets the wrong drug

General
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Taking drug with water is ok, but with alcohol- defenitely not a good idea!
That’s because of a disulfiram-like reaction—a classic adverse drug reaction.

What is a disulfiram-like reaction?
It is an unpleasant and sometimes dangerous reaction that occurs when alcohol is consumed while taking certain drugs.

Mechanism
Normally, alcohol is metabolized as:
Ethanol → Acetaldehyde → Acetate

Acetate gets excreted from the body. Some drugs inhibit aldehyde dehydrogenase, leading to accumulation of acetaldehyde, a toxic metabolite. This buildup is responsible for the unpleasant symptoms.

Symptoms

  • Flushing of face
  • Throbbing headache
  • Nausea & vomiting
  • Sweating
  • Palpitations
  • Hypotension
  • Breathlessness

:pill: Drugs Causing Disulfiram-Like Reaction

  • Disulfiram
  • Metronidazole, Tinidazole- antibiotics used against anaerobic infection
  • Cephalosporins (especially cefotetan, cefoperazone)- antibiotic
  • Chlorpropamide- was used for treating diabetes
  • Griseofulvin- antifingal

:name_badge: Why is it called “disulfiram-like”?
Because disulfiram was the first drug deliberately used to produce this reaction as an aversion therapy in chronic alcoholism. So this drug could be used in those persons who would wish to abstain from alcohol. Other drugs mimic the same effect—hence the name.

MBH/PS

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I am sure considering this as a "cool” move (film style) someone might actually try to intake drugs this way and surely they will meet their consequences. Good message!

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This is such an important reminder. Many patients don’t realise that it’s not just “alcohol + medicine = upset stomach”, the reaction can be genuinely dangerous.

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Well written! Completely explains how important it is to have awareness and do how it is being advised by the doctor.

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There are many, if not all, drugs that should not be consumed with alcohol.
Alcohol itself depresses the nervous system; taking it with sleeping drugs might lead to serious, life-threatening adverse effects. Alcohol may also interfere with the metabolism of the drug.

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Posts like this are important because they bridge the gap between pharmacology theory and real life patient safety.

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