UMEM Educational Pearls

Category: Pharmacology & Therapeutics

Title: Disulfiram-like Reaction with Metronidazole

Keywords: Metronidazole, Disulfiram-like Reaction (PubMed Search)

Posted: 6/6/2020 by Wesley Oliver
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While taking metronidazole it is advised that patients avoid ethanol use for at least 3 days after therapy due to the possibility of a disulfiram-like reaction.  The disulfiram-like reaction presents as abdominal cramps, nausea, vomiting, headaches, and/or flushing and can cause extreme discomfort for patients.  A recent case report describes a case of a disulfiram-like reaction in a patient receiving metronidazole and an oral prednisone solution that contained 30% alcohol.  This case highlights an important point.  Not only should we counsel patients about avoiding alcoholic beverages for at least 3 days after metronidazole therapy, but they should also avoid all alcohol-containing products, such as oral solutions and mouthwash.

 

References

Alonzo MM, Lewis TV, Miller JL. Disulfiram-like Reaction With Metronidazole: An Unsuspected Culprit. J Pediatr Pharmacol Ther. 2019;24:445?449. doi:10.5863/1551-6776-24.5.445
 
UpToDate [Internet]. Waltham, MA: UpToDate. 2020. Metronidazole; [2020 Jun 6]. Available from: http://www.uptodate.com/