Patients who are receiving or have recently received metronidazole, paraldehyde, alcohol, or alcohol-containing preparations, e.g., cough syrups, tonics and the like, should not be given Anticol.
Anticol is contraindicated in the presence of severe myocardial disease or coronary occlusion, psychoses, and hypersensitivity to Anticol or to other thiuram derivatives used in pesticides and rubber vulcanization.
What other drugs will affect Antabuse?
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Antabuse, especially:
seizure medications such as phenytoin (Dilantin)
blood thinning medications (including warfarin, Coumadin, Jantoven); or
This list is not complete and other drugs may interact with Anticol, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
Usage In Pregnancy
The safe use of this drug in pregnancy has not been established. Therefore, Anticol should be used during pregnancy only when, in the judgement of the physician, the probable benefits outweigh the possible risks.
Patients with a history of rubber contact dermatitis should be evaluated for hypersensitivity to thiuram derivatives before receiving Anticol (see CONTRAINDICATIONS).
Alcoholism may accompany or be followed by dependence on narcotics or sedatives. Barbiturates and Anticol have been administered concurrently without untoward effects; the possibility of initiating a new abuse should be considered.
Hepatic toxicity including hepatic failure resulting in transplantation or death have been reported. Severe and sometimes fatal hepatitis associated with Anticol therapy may develop even after many months of therapy. Hepatic toxicity has occurred in patients with or without prior history of abnormal liver function. Patients should be advised to immediately notify their physician of any early symptoms of hepatitis, such as fatigue, weakness, malaise, anorexia, nausea, vomiting, jaundice, or dark urine.
Baseline and follow-up liver function tests (10 to 14 days) are suggested to detect any hepatic dysfunction that may result with Anticol therapy. In addition, a complete blood count and serum chemistries, including liver function tests, should be monitored.
Patients taking Anticol tablets should not be exposed to ethylene dibromide or its vapors. This precaution is based on preliminary results of animal research currently in progress that suggest a toxic interaction between inhaled ethylene dibromide and ingested Anticol resulting in a higher incidence of tumors and mortality in rats. A correlation between this finding and humans, however, has not been demonstrated.
How should this medicine be used?
Anticol comes in tablets to take by mouth. It should be taken once a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Anticol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
If you cannot swallow the tablets, crush them and mix the medication with water, coffee, tea, milk, soft drink, or fruit juice.
Why is this medication prescribed?
Anticol is used to treat chronic alcoholism. It causes unpleasant effects when even small amounts of alcohol are consumed. These effects include flushing of the face, headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety. These effects begin about 10 minutes after alcohol enters the body and last for 1 hour or more. Anticol is not a cure for alcoholism, but discourages drinking.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Trial with Alcohol
During early experience with Anticol tablets, it was thought advisable for each patient to have at least one supervised alcohol-drug reaction. More recently, the test reaction has been largely abandoned. Furthermore, such a test reaction should never be administered to a patient over 50 years of age. A clear, detailed and convincing description of the reaction is felt to be sufficient in most cases.
However, where a test reaction is deemed necessary, the suggested procedure is as follows:
After the first one to two weeks’ therapy with 500 mg daily, a drink of 15 mL (1/2 oz) of 100 proof whiskey, or equivalent, is taken slowly. This test dose of alcoholic beverage may be repeated once only, so that the total dose does not exceed 30 mL (1 oz) of whiskey. Once a reaction develops, no more alcohol should be consumed. Such tests should be carried out only when the patient is hospitalized, or comparable supervision and facilities, including oxygen, are available.
DOSAGE AND ADMINISTRATION
Anticol should never be administered until the patient has abstained from alcohol for at least 12 hours.
Anticol is an aid in the management of selected chronic alcohol patients who want to remain in a state of enforced sobriety so that supportive and psychotherapeutic treatment may be applied to best advantage.
Anticol is not a cure for alcoholism. When used alone, without proper motivation and supportive therapy, it is unlikely that it will have any substantive effect on the drinking pattern of the chronic alcoholic.
Marty Ross MD on Antabuse for Chronic Lyme Disease
This is mainly a video article. You will need to listen to the whole video for my thoughts on Antabuse (Anticol) as a new treatment for chronic Lyme disease. Below this video I provide additional points I did not mention during Conversations with Marty Ross MD on 7/18/19 when I recorded these comments.
The Anticol-Alcohol Reaction
Anticol plus alcohol, even small amounts, produce flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusion. In severe reactions there may be respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death.
The intensity of the reaction varies with each individual, but is generally proportional to the amounts of Anticol and alcohol ingested. Mild reactions may occur in the sensitive individual when the blood alcohol concentration is increased to as little as 5 to 10 mg per 100 mL. Symptoms are fully developed at 50 mg per 100 mL, and unconsciousness usually results when the blood alcohol level reaches 125 to 150 mg.
The duration of the reaction varies from 30 to 60 minutes, to several hours in the more severe cases, or as long as there is alcohol in the blood.