Medicine Information

Alcot

Name: Alcot
Brand: Alcot
Rating: 4.5 (117 reviews)

Tablet400 mgDrugs Used in Alcohol DependenceATC: N07BB01

Generic Name

Disulfiram

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

Loading images...

Price Details

Current market pricing information

Variant	Unit Price	Strip Price
alcot 400 mg tablet	৳ 1.00	৳ 10.00

Description

Overview of the medicine

Disulfiram is an alcohol deterrent drug used to support the treatment of chronic alcoholism by producing an acute sensitivity to alcohol. It works by causing an unpleasant reaction when alcohol is consumed.

Uses & Indications

Support in the management of chronic alcoholism

To deter alcohol consumption in patients motivated to maintain sobriety

As an adjunct to other supportive and psychotherapeutic measures in the treatment of alcoholism

Dosage

Adults

Initial dose: 500 mg once daily for 1-2 weeks. Maintenance dose: 250 mg once daily. Max dose: 500 mg daily. Should not exceed 500 mg daily.

Elderly

Use with caution, starting with lower doses (e.g., 125-250 mg once daily), due to increased sensitivity and potential for adverse effects. Dose adjustment based on individual tolerance.

Renal_impairment

No specific dose adjustment guidelines are available. Use with caution due to potential accumulation of metabolites. Monitor patient closely for adverse effects.

How to Take

Administer orally, usually once daily in the morning. If drowsiness occurs, it may be taken at bedtime. The tablet can be crushed and mixed with liquid (water, coffee, milk, or fruit juice) to facilitate administration.

Mechanism of Action

Disulfiram inhibits the enzyme acetaldehyde dehydrogenase, which is involved in the metabolism of alcohol. This leads to the accumulation of acetaldehyde in the body after alcohol consumption, causing highly unpleasant symptoms known as the disulfiram-ethanol reaction.

Pharmacokinetics

Onset

Effects typically begin within 10-30 minutes of alcohol ingestion, and drug action persists for 1-2 weeks after the last dose due to irreversible enzyme inhibition.

Excretion

Mainly excreted via urine as metabolites. A small portion is excreted as carbon disulfide through the lungs.

Half life

Elimination half-life is variable (60-120 minutes for unchanged drug) but the clinical effect persists much longer.

Absorption

Readily absorbed from the gastrointestinal (GI) tract (80-90%).

Metabolism

Metabolized extensively in the liver to diethyldithiocarbamate and its metabolites, which are potent inhibitors of aldehyde dehydrogenase.

Side Effects

Contraindications

Severe myocardial disease or coronary occlusion
Psychosis
Alcohol intoxication or recent alcohol consumption (within 12 hours)
Hypersensitivity to disulfiram or thiuram derivatives
Concomitant use with alcohol, metronidazole, paraldehyde, or alcohol-containing preparations

Drug Interactions

Alcohol

Severe disulfiram-ethanol reaction (flushing, nausea, vomiting, hypotension, potentially fatal).

Warfarin

Increases anticoagulant effect, leading to increased risk of bleeding.

Isoniazid

May lead to an increased risk of CNS side effects like ataxia or changes in mental status.

Phenytoin

Inhibits phenytoin metabolism, increasing phenytoin levels and risk of toxicity.

Metronidazole

May cause psychotic reactions and confusion.

Storage

Store below 30°C (86°F) in a dry place, protected from light and moisture. Keep out of reach of children. Do not freeze.

Overdose

Symptoms of overdose include nausea, vomiting, abdominal pain, diarrhea, and drowsiness. Management is supportive, including gastric lavage, activated charcoal, and symptomatic treatment. Seek immediate medical attention.

Pregnancy & Lactation

Pregnancy Category C. Use only if potential benefit justifies the potential risk to the fetus. Not recommended during breastfeeding due to potential excretion into breast milk and unknown effects on the infant.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 Tablets (Blister Pack)30 Tablets (Blister Pack)

Shelf Life

2-3 years from manufacturing date. Check the expiration date on the packaging.

Availability

Pharmacies, Hospitals

Approval Status

Approved by DGDA

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Disulfiram has been extensively studied in numerous clinical trials since its introduction for its efficacy and safety in treating alcohol dependence. Research continues into its potential use in other conditions.

Lab Monitoring

Liver function tests (LFTs) before initiation and periodically (e.g., every 10-14 days for first few months, then monthly) during treatment due to risk of hepatotoxicity.
Complete blood count (CBC) and serum electrolytes occasionally.

Doctor Notes

Ensure patient is fully aware of the disulfiram-ethanol reaction and is highly motivated for complete abstinence from alcohol.
Monitor liver function tests (LFTs) closely, especially during the initial months of treatment, and discontinue if liver enzyme elevations are significant.
Carefully assess patients with a history of cardiac disease, diabetes, or renal/hepatic impairment before initiating therapy.
Educate patients about hidden sources of alcohol in food and non-prescription products.

Patient Guidelines

Strictly avoid all forms of alcohol, including hidden alcohol in foods, mouthwashes, and OTC medications.
Carry a medical identification card stating you are taking disulfiram to alert medical professionals in case of an emergency.
Report any symptoms of liver problems (e.g., unusual fatigue, dark urine, yellowing skin/eyes, abdominal pain) immediately to your doctor.
Do not start or stop any other medication without consulting your doctor.

Missed Dose Advice

If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.

Driving Precautions

Alcot may cause drowsiness, fatigue, or dizziness. Patients should avoid driving or operating heavy machinery until they know how disulfiram affects them and are certain they can perform such activities safely.

Lifestyle Advice

Engage in supportive therapy and counseling for alcohol dependence, as disulfiram is an adjunct to treatment, not a cure.
Maintain a healthy diet and regular exercise routine to support overall well-being during recovery.