I am giving disulfiram to my father but it's not showing result or effect even after drinking alcohol, the dose is one tablet a day. It only showed result one time and he stopped drinking for a month or two but now he started again and we r giving the medicine from 3-4 days, same dose but it's not showing result, why?

Dr. Saranya DevanathanPsychiatrist48yrs exp

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Dear lybrate-user, it is nice of you, at the age of 19, helping your father to come out of alcohol. Disulfiram takes about 5-7 days to get adequate blood level to cause disulfiram and alcohol reaction. This is if you give 500 mg/day for 5-7 days. It stays in blood for a long time of 10-15 days. So after the first week, you can give 125-250 mg/day. Be prepared to manage the reaction, if it is too severe like bp fall and not stop vomiting. You need to admit and give required intravenous drips, disulfiram is a long term tablet. Its reaction will vanish after 10-15 days. Then he can take alcohol like earlier days. So better to maintain him on disulfiram or add an anti craving tablet like naltrexone or baclofen or acamprosate in proper dose. All these information are for those who have normal liver function. Check your father's liver by blood test. If it is disturbed, disulfiram will take longer time to react and also to get out of blood. Caution: disulfiram needs to be given under medical supervision to manage the reaction since it can become fatal.  

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