Drug interactions
Disulfiram + Metronidazole
Severity: Major
Disulfiram and Metronidazole: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Concurrent use has been associated with acute psychosis and confusional states. Disulfiram is also a classic agent causing intolerance of alcohol-related reactions, which metronidazole is thought to mimic.
What this interaction means in plain words
Disulfiram and Metronidazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive neurotoxic effects; the exact mechanism is not well established.
What to do
Avoid combining; if metronidazole is needed, stop disulfiram first (labeling suggests waiting about two weeks) and monitor mental status.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Metronidazole
- Ethanol + Metronidazole Contraindicated
- Metronidazole + Pimozide Contraindicated
- Amiodarone + Metronidazole Major
- Ergotamine + Metronidazole Major
- Lomitapide + Metronidazole Major
- Lonafarnib + Metronidazole Major
Frequently asked questions
Can I take Disulfiram with Metronidazole?
MediHelp rates the interaction as major. Disulfiram and Metronidazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Concurrent use has been associated with acute psychosis and confusional states. Disulfiram is also a classic agent causing intolerance of alcohol-related reactions, which metronidazole is thought to mimic.
How serious is the interaction between Disulfiram and Metronidazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining; if metronidazole is needed, stop disulfiram first (labeling suggests waiting about two weeks) and monitor mental status.
What other medicines interact with Metronidazole?
MediHelp also lists interactions of Metronidazole with, for example, Ethanol, Pimozide, Amiodarone. The full list is on the Metronidazole page.
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