Antabuse (Disulfiram) Dosage. Medication to stop drinking
Initial Dosage Schedule. AA treatment
The treatment of the alcohol addiction (AA) has three stages with Antabuse.
The first stage takes 7 days. A patient is prescribed a pill of Antabuse 500 mg per day, or 1 pill of Antabuse 250 mg per day. The drug is taken in high doses in order to accumulate the active ingredients in the tissues, maintain them in high concentrations during the creation of the provocations with alcohol.
The pills are taken every day; any dose is not skipped. It is better if the patient takes the pills at the same time.
Antabuse subsequent dosage for alcohol abuse treatment
The second stage is the basic treatment, takes from 1 to 4 weeks. A patient should reduce the daily dose up to 250 mg Antabuse during this period. A pill is taken every day, dissolving it in 100-150 ml of water. This solution is taken on an empty stomach. In case of a bad tolerance, the daily dose is taken after meals.
The alcohol provocations are conducted every two days at this stage if the patient is at the hospital, and in every 5 days, if the treatment is at home. If the response to the provocations is weak, the dose of Antabuse is increased up to 500 mg; if the response is normal, the reaction appears, the dosing is not adjusted and a patient has a maintenance therapy.
Duration of Therapy with Antabuse (Disulfiram). Treatment plan for alcoholism
Depending on the severity of the alcohol abuse, clinical pattern of the patient with alcoholism, the maintenance therapy may last for 1 to 3 years. A patient has to take a minimal dose of Antabuse 125 mg a day within this period. The Antabuse pill 250 mg may be divided into two parts, and half of the pill may be taken every day, at the same time.
According to the clinical studies, a person develops a stable rejection of alcohol in 3 years, and then the use of the pills is pointless. It has been proved that a long-term therapy with Antabuse within 3 years does not influence on the functioning of the body. The drug is not toxic, does not cause a psychological addiction, and does not cause a development of the physiological tolerance. The dose of Antabuse is not changed during the prolonged therapy, and is kept within 125 mg per day.
Tests with Alcohol during Disulfiram treatment. Drinking on Antabuse
To detect the level of the efficacy of Antabuse of a patient, a test with alcohol is taken. This test is taken under the doctor’s supervision, and at the hospital. The alcohol test is taken on the second stage of the treatment (in 7-10 days after the use of the pills), when Disulfiram has been accumulated in the tissues.
The principle of the test:
- A patient is given a pill of Antabuse 500 mg.
- The patient is given 20-30 ml of stiff drink (vodka is preferred because it is the purest alcohol product) in 1-2 hours after the use of the pill.
- The body has to produce an acquired reflex to this provocation, so that side effects of Disulfiram-Alcohol Reaction has to appear.
- If a patient did not have any reaction within 20-30 minutes, the dose of alcohol is raised by 10-15 ml.
- An acute intoxication with peculiar symptoms appear during the weak sensitivity to Antabuse (60-80 ml of stiff alcohol).
- The procedure is repeated in 2-5 days depending on conditions.
- The dosing of Antabuse and alcohol is adjusted during the repeated procedure.
These tests may be taken within a month to produce the maximally fast reflex, during the consumption of the minimal dose of alcohol. If the dose of 250 mg Antabuse does not give a response during low doses of alcohol, the dosing of 500 mg per day is kept. The dose is reduced in 2-3 months.
As soon as the doctor has achieved the adequate body reaction to the interaction of Disulfiram with ethanol, the provocations are stopped and a patient receives the maintenance therapy according to the doctor’s recommendations.
It is not recommended to have Disulfiram-alcohol reaction and alcohol tests during the maintenance therapy because a response may be very severe after the accumulation of the drug in the body.
Management of Disulfiram-Alcohol Reaction
Disulfiram-Alcohol Reaction is a common thing during the provocations in the treatment. To make this procedure successful, without complications for a patient, the test should be taken at the hospital, under doctor’s supervision.
A doctor has to be ready to administer a medical aid during Disulfiram-alcohol reaction.
- Adsorbing agents to absorb the toxins in the gastro-intestinal tract;
- A lot of clear water;
- Oxygen reservoir;
- Intravenous infusion of fluid;
- Noradrenaline to increase the blood pressure and the cardiac output.
A doctor has to properly control the dose of alcohol during the test. The reaction usually appears in 20 minutes after the use of the alcohol but if the side effects do not appear, wait for 20-30 minutes. The interaction may be delayed due to the poor absorption of ethanol in the gastro-intestinal tract. The test may be repeated in an hour after the use of a low dose of alcohol.
The dose of alcohol should be increased, gradually. If 30 ml of vodka did not give the effect, do not give a patient 60 ml. This process may be divided into 2 stages: a patient is given 45 ml at first, and if the effect is absent, 60 ml is given. This way, an acute and unexpected reaction may be avoided and a patient’s state is controlled.
As soon as the reaction appears, a patient must be followed within 4-5 hours. It happens that the adverse symptoms grow in 4 hours. If the patient’s state is normal in 4-5 hours, he/she may go home and be controlled by the family.