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

@inproceedings{Williams2000DoEA,
  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},
  year={2000}
}
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.

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References

SHOWING 1-10 OF 18 REFERENCES

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.

Metronidazole and Human Alcohol Dehydrogenase

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.