MajorDrug for alcohol use disorder, aldehyde dehydrogenase inhibitor×Antiepileptic, hydantoin derivative (sodium channel blocker)
Updated · Methodology
Mechanism
Disulfiram inhibits CYP2C9 and CYP2C19. Phenytoin rises 2-3 fold – toxicity (nystagmus, ataxia).
Symptoms
Nystagmus, ataxia, dizziness within 5-7 days.
Management
Check phenytoin level at 5 and 14 days. Reduce dose 30-50%.
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.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Antabuse (disulfiram) prescribing information (2015)– FDA Antabuse label, Section 4