Esperal (Disulfiram) 250mg

Esperal (Disulfiram) 250mg

Introduction

Esperal (Disulfiram) 250mg is a medicinal drug that contains disulfiram. This disulfiram medication is considered to be a supporting treatment for specially selected individuals that are affected with alcohol dependence and are ready to stay abstinent. Disulfiram does not cure withdrawal from alcohol and does not manage alcohol dependence itself. This medicine discourages the alcohol consumption with the help of a potentially dangerous and uncomfortable reaction if any alcohol will be consumed in the process of treatment. According to WHO, disulfiram can be administered as a possibility for decreasing the risks of relapse to heavy alcohol consumption in the right individuals.

Antabuse is a widely recognized disulfiram brand name. Trademarks and the available strengths of the tablets depend on the producer of the medicine and the country.

What is Esperal (Disulfiram) 250mg

Esperal tablet contains disulfiram which is an alcohol-deterrent medicine. The most used esperal tablet includes the process of abstinence in people with the use of alcohol dependence treatment. These are the main esperal tablet uses.

This medicine is not used for the purpose of removing the craving for alcohol right away. The main therapeutic feature of this medicine is connected with the knowledge that alcohol intake while using this medicine will lead to an unpleasant reaction. That is why, disulfiram treatment is characterized with the need for a careful participation, monitoring of the patient's condition and psycho-social treatment.

The disulfiram mechanism of action involves an enzyme called aldehyde dehydrogenase inhibition. This enzyme takes part in the process of alcohol metabolism. The first thing that occurs when a person drinks alcohol is its conversion into acetaldehyde which is metabolized further.

How It Works

But disulfiram does not allow acetaldehyde to be broken down. If alcohol is consumed, acetaldehyde begins to accumulate and the disulfiram reaction takes place. The symptoms of it include flushing, sweating, nausea, vomiting, headache, dizziness, palpitation and changes of blood pressure.

Why It Is Prescribed

Disulfiram may be prescribed for the adults that already stopped drinking and need additional help to maintain their abstinence. The fear of an unpleasant reaction to the alcohol intake can be considered as the main motivator for staying away from the alcohol.

According to WHO, disulfiram can be used as one of the options of treatment for reducing relapse to heavy drinking in especially motivated patients whose drug compliance can be controlled by the treatment staff, carers or relatives.

How to Take This Medication

It is important to use Esperal 250 mg exactly according to the prescription. The alcohol intake is stopped before treatment and NHS information warns to avoid drinking for at least 24 hours before disulfiram intake.

Put a prescribed Disulfiram 250 mg tablet in the mouth and wash it down with water. Read the instructions of the specific drug in regard to the eating times and other important things. Make sure to take each dose approximately at the same time each day.

Do not consume any amount of alcohol intentionally to check whether it works. There can be a potential amount of alcohol in many products like liquid medicines, mouthwashes, perfumes, cosmetics, sauces, tonics and aerosols. Even those products that are called "low alcohol" or "alcohol-free".

How It Works in the Body

As soon as this medicine is taken orally, disulfiram is being absorbed and rapidly metabolized. Metabolites of the drug inhibit the function of aldehyde dehydrogenase enzyme. If ethanol enters the organism, the metabolism process is being disturbed and acetaldehyde concentration increases.

The sensitivity to it does not disappear right away after the last dose. Therefore, the intake of alcohol needs to be avoided during the process of treatment and for up to 14 days after disulfiram is stopped since it is possible to react to the alcohol.

Dosage Explanation

Disulfiram dosage depends on the product, on the treatment phase, on the clinical situation and on the recommendations of the prescriber. The initial dosage up to 500 mg per day was recommended to use for one-two weeks, and then the average maintenance dose of 250 mg per day for further period. But the range of maintenance dose was 125 to 500 mg per day.

It means that 250 mg Disulfiram dosage is considered to be the most popular strength of this tablet. It should be taken only if it is prescribed to you.

There is no special pediatric disulfiram dosage calculation that is based on the treatment of adults. Currently the manufacturer information says that disulfiram is not used in the pediatric population.

What to Expect During the Treatment

Esperal does not usually cause any therapeutic effects if the alcohol intake is avoided. Disulfiram efficiency is very much dependent on the adherence and active participation in the treatment program.

Supervised disulfiram treatment is especially important. WHO says that the results of disulfiram treatment can be good if the process of treatment is supervised and the recommendation emphasizes especially motivated patients whose drug compliance is controlled.

Medical consultation should be regular in order to discuss the reaction to disulfiram treatment, adherence to the medication intake, tolerability and need to continue the treatment.

Side Effects

Mild disulfiram side effects can appear even if alcohol is avoided.

• Drowsiness – it can be experienced, especially in the first days of the treatment.
• Tiredness – the person experiences some fatigue.
• Nausea – slight discomfort or nausea of the person.
• Headache – some people have headaches.
• Skin changes – rash or dermatitis can occur.

The persistent and disturbing symptoms should be discussed with the prescriber. The treatment cannot be stopped or the dosage of disulfiram cannot be changed independently of the reasons.

Drug Interactions

The understanding of disulfiram interactions is important since disulfiram influences on the metabolism of many drugs. Manufacturer information describes the interactions of disulfiram with such medicines as warfarin, phenytoin, theophylline, some benzodiazepines, amitriptyline and chlorpromazine. In some cases the dose adjustment is necessary and monitoring.

It is necessary to provide your prescriber and pharmacist the list of medicines and products that you use before the treatment starts.

The connection between disulfiram and alcohol is especially important. The alcohol consumption is strictly forbidden during the process of treatment since the consequences of the reaction are unpredicted and sometimes, they can become medically serious.

Esperal vs Alternative Treatments

The alternative treatments of the alcohol dependence include acamprosate and naltrexone and their mechanisms are different from disulfiram.

Usually acamprosate is used for maintenance of the abstinence while naltrexone interferes with the opioid receptors in order to reduce the reinforcement from alcohol consumption. And disulfiram creates the alcohol deterrent by influencing the process of alcohol metabolism.

WHO says that the selection of acamprosate, disulfiram or naltrexone should take into account the personal preferences and the availability of treatment.

Precautions and Warning

The strict alcohol avoidance is the main warning during the Esperal treatment. The disulfiram-alcohol reaction can include such effects as flushing, sweating, headache, nausea, vomiting, dizziness, palpitation and respiratory distress. The severe reaction can become a danger to life and should be urgently treated.

Inform your prescriber about your liver or kidney problems, cardiovascular diseases, diabetes, epilepsy, thyroids problems, respiratory disease, pregnancy or breastfeeding, all of the medications. Manufacturer recommends to assess the eligibility before the treatment and to monitor the liver function during the treatment.

Cost and Affordability

The price of Esperal is variable depending on the manufacturer, the number of tablets in the prescription, the pharmacy, location and availability. It is important to compare the exact prescribed strength and number of the medicine in order to calculate its cost.

For example, the customers searching for Esperal may check the price and current availability of the product via Grant Pharmacy online shop and buy it there if it is possible by legal regulations and with the right prescription if it is required.

Prescription medicines should be purchased in authorized pharmacies only.

Practical Tips for Better Results

Use Esperal 250mg consistently and according to the prescribed schedule. You should continue the counseling, behavioral therapy, recovery program and other psycho-social treatment recommended by the prescriber.

Carefully look at the labels of food products, medicines, cosmetics, personal-care products to avoid hidden alcohol. Do not skip the doses in anticipation of drinking. Do not forget that the alcohol sensitivity can persist for up to 14 days after the end of the treatment.

Storage Instruction

Follow the storage instructions mentioned on the pack of your specific Esperal medicine since they can be different for various producers. As the example, the current official manufacturer information for a disulfiram tablet recommends storing the drug under 25°C.

Store the tablets in the original or the correctly labeled pharmacy container and protect it from unfavorable environmental factors. Keep all the medicines away from children and do not use expired medicines.

FAQs

What is Esperal 250 mg used for?

Esperal contains disulfiram and is used as a supporting treatment for specially selected individuals who suffer from the alcohol dependence and want to stay abstinent. The treatment should be combined with appropriate counseling and monitoring.

How does disulfiram work against the alcohol consumption?

Disulfiram inhibits aldehyde dehydrogenase which is the enzyme involved in the process of alcohol metabolism. The alcohol consumption leads to accumulation of acetaldehyde and the reaction causes discomfort. Therefore, the knowledge that it can happen helps to avoid drinking.

What is the usual disulfiram dose?

The information provided by the manufacturer for the US market includes an average dose of 250 mg per day after the treatment period. But the dose can be various and it is important to follow the prescription and never change the dose independently.

Can I drink alcohol while taking Esperal?

No. The alcohol consumption can cause a dangerous reaction to the disulfiram treatment. The symptoms can include such as flushing, headache, nausea, vomiting, dizziness, sweating, and palpitation. The person should continue to avoid the alcohol consumption for up to 14 days after the treatment.

Can alcohol-containing products cause a disulfiram reaction?

Yes. Some liquid medicines, food products, sauces, mouthwashes, perfumes, cosmetics, tonics and aerosols can contain alcohol. It is important to read carefully the labels and follow the recommendations of the prescriber in regards of avoiding of the alcohol.

What are common side effects of Esperal?

Some possible side effects are connected with disulfiram include drowsiness, fatigue, nausea, headache or skin reactions. The side effects can be various, but the persistent symptoms need to be discussed with the prescriber instead of the dose reduction.

How long should the alcohol intake be avoided after the end of Esperal?

The alcohol should be avoided for up to 14 days after the last disulfiram dose since it can cause disulfiram reaction.

Final Conclusion

Esperal (Disulfiram) 250mg is a prescription medicine that is used as an alcohol deterrent. The mechanism of action is based on the disulfiram blocking the process of alcohol metabolism and, therefore, the alcohol intake causes a dangerous and uncomfortable reaction to the process of treatment.

 

Medically reviewed by the Grant Pharmacy Pharmacists Medical Team.

 

Medical References

U.S. Food and Drug Administration (FDA) – Disulfiram 250 mg, Drug Approval Documentation
https://www.accessdata.fda.gov/drugsatfda_docs/nda/pre96/88482ap.pdf

National Health Service (NHS), Royal Free London – Disulfiram (Antabuse)
https://www.royalfree.nhs.uk/patients-and-visitors/patient-information-leaflets/disulfiram-antabuse

Official Manufacturer Information – Disulfiram Tablets, Summary of Product Characteristics
https://www.medicines.org.uk/emc/product/11168/smpc

World Health Organization (WHO) – Preventing Relapse in Alcohol-Dependent Patients
https://www.who.int/teams/mental-health-and-substance-use/treatment-care/mental-health-gap-action-programme/evidence-centre/alcohol-use-disorders/preventing-relapse-in-alcohol-dependent-patients

World Health Organization (WHO) – Pharmacological Treatment Guidance
https://iris.who.int/bitstream/10665/44095/1/9789241547697_eng.pdf