Do Ethanol and Metronidazole Interact to Produce a Disulfiram-Like Reaction?

  title={Do Ethanol and Metronidazole Interact to Produce a Disulfiram-Like Reaction?},
  author={C. S. Williams and K R Woodcock},
  booktitle={The Annals of Pharmacotherapy},
OBJECTIVE: To obtain and evaluate evidence about the supposed disulfiram-like interaction between metronidazole and ethanol. DATA SOURCES: MEDLINE search from January 1964 to June 1999, using the terms metronidazole, ethanol, and drug reaction. DATA SYNTHESIS: The manufacturer's warnings include a disulfiram-like reaction between metronidazole and ethanol. However, review of reports published between 1969 and 1982 produced no convincing evidence that this reaction exists. Six case reports… 

[Is combining metronidazole and alcohol really hazardous?].

  • H. FjeldG. Raknes
  • Medicine
    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke
  • 2014
The warning against simultaneous use of alcohol and metronidazole appear to be based on laboratory experiments and individual case histories in which the reported reactions are equally likely to have been caused by ethanol alone or by adverse effects of metronidsazole.

Lack of Disulfiram-Like Reaction with Metronidazole and Ethanol

This study shows that metronidazole does not have an effect on blood acetaldehyde concentrations when ingested with ethanol and does not has any objective or subjective disulfiram-like properties, and it is possible that disulfIRam- like reaction can occur in some subgroups and by other mechanisms than the inhibition of hepatic ALDH.

Disulfiram-like Reaction With Metronidazole: An Unsuspected Culprit.

If this interaction between metronidazole and alcohol containing medications occurs, it may be initially unrecognized, potentially resulting in patient discomfort or harm, and it is important for healthcare professionals to identify these potential drug-drug interactions.

Alcohol-Medication Interactions: The Acetaldehyde Syndrome

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Hypersensitivity reactions to metronidazole.

Taking into account the low sensitivity of the cutaneous tests (prick tests and epicutaneous tests), oral provocation must be considered the "gold standard" for establishing the diagnosis in many cases of hypersensitivity reactions to metronidazole.

Drug interactions involving ethanol and alcoholic beverages

Ethanol is likely among the most widely and extensively used drugs in the world. It has also been demonstrated to alter the expression or activity of some drug-metabolizing enzymes. Thus, marked

Disulfiram: Side Effects and Toxicity

  • A. Sousa
  • Medicine, Psychology
  • 2019
This chapter is a clinical review of the various common and uncommon side effects of disulfiram when used in patients with alcohol and/or cocaine dependence. Among the side effects noted liver

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A comprehensive overview on potential drug interactions with antibiotics, which are mediated by the cytochrome-P450-enzymes is presented.



Sudden death due to metronidazole/ethanol interaction.

The cause of death was reported to be cardiac dysrhythmia due to acetaldehyde toxicity due to an ethanol/ metronidazole interaction, and Autonomic stress associated with the assault is likely to have contributed to this woman's death.

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Evidence is presented to shed light on whether metronidazole (‘Flagyl’) might inhibit alcohol dehydrogenase, and if so, how this might affect the treatment of alcoholism.

Metabolic interactions of aldehyde dehydrogenase with therapeutic and toxic agents.

The perturbation of ALDH by specific therapeutic agents suggests a potential role of this enzyme in a number of different drug-induced toxicities.

Metronidazole and Alcohol: Potential Problems

A case of metabolic acidosis and cardiovascular instability that highlights the potentially dangerous interaction between alcohol and metronidazole.