Disulfiram-Alcohol Reaction Management

Mechanism and Contraindications

• Disulfiram inhibits aldehyde dehydrogenase (ALDH), causing toxic acetaldehyde accumulation when alcohol is consumed, producing flushing, dizziness, nausea, vomiting, arrhythmia, dyspnea, headache, tachycardia, and hypotension in patients 1
• Disulfiram is contraindicated in patients with alcoholic liver disease, according to multiple clinical practice guidelines, including the American Association for the Study of Liver Diseases 2, 1

Alternative Treatment Options

• Baclofen is the preferred medication for maintaining alcohol abstinence in patients with liver cirrhosis, as it has demonstrated safety and efficacy in these patients 1