A disulfiram-like reaction refers to the body's response that mimics the symptoms experienced when alcohol is consumed after taking disulfiram (Antabuse), an oral medication used for treatment. Disulfiram works by causing adverse effects when alcohol is ingested. Normally, alcohol is metabolized in the body into acetaldehyde by the enzyme alcohol dehydrogenase. Subsequently, acetaldehyde is converted into acetic acid by another enzyme called acetaldehyde dehydrogenase. Disulfiram blocks the action of acetaldehyde dehydrogenase, resulting in the accumulation of acetaldehyde in the bloodstream. This buildup of acetaldehyde leads to uncomfortable symptoms such as headaches, low blood pressure, intense flushing, nausea, thirst, chest pain, and more when alcohol is consumed. A disulfiram-like reaction can also occur when certain other drugs, aside from disulfiram, cause similar effects upon alcohol consumption. Some medications known to trigger these reactions include metronidazole (Flagyl and others), trimethoprim-sulfamethoxazole (Bactrim, Bactrim DS), tinidazole, chlorpropamide (Diabinese), tolbutamide, among others.
