Does disulfiram interact with ranitidine or omeprazole?

Fråga: Does disulfiram interact with ranitidine or omeprazole?

Sammanfattning: One case report has been found describing confusion and disorientation in a patient during concomitant treatment with omeprazole and disulfiram. Apart from this preliminary report, no documentation has been found for an interaction between these two drugs. No interaction has been reported between disulfiram and ranitidine.

Svar: Disulfiram inhibits the enzyme aldehyde dehydrogenase. It is also a well-known inhibitor of hepatic microsomal drug-metabolising enzymes, interacting with the metabolism of a number of drugs, eg warfarin and phenytoin (1,2). Both ranitidine and omeprazole are also known inhibitors of the metabolism of many drugs oxidized by the microsomal cytochrome P450 system in the liver (2).

No reports have been found concerning an interaction between disulfiram and ranitidine. One case report was found describing a patient who developed confusion and disorientation on two occasions when omeprazole was added to disulfiram therapy (3). The patient tolerated each drug when given alone. The mechanism of this possible interaction is unclear, and the plasma levels of the drugs were not measured in this published case. 1 Dollery, Therapeutic drugs. 1991; page D188, M101-105 2 FASS 1993; page 993, 1027 3 Hajela R, Cunningham GM, Kapur BM, Peachey JE, Devenyi P: Catatonic reaction to omeprazole and disulfiram in a patient with alcohol dependence. Can Med Assoc J 1990; 143: 1207-1208