Drug for alcohol use disorder, aldehyde dehydrogenase inhibitor×Imidazole derivatives (antiprotozoal / antibacterial)
Mechanism
Both inhibit ALDH. Combined use accumulates acetaldehyde and causes psychosis with hallucinations, delirium and fatal neurological complications. FDA boxed warning.
Symptoms
Psychosis, hallucinations, delirium within 1-3 days.
Management
Combination contraindicated. Do not give metronidazole within 14 days after disulfiram withdrawal.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.