Drug therapy reviews: management of the disulfiram-alcohol reaction.

A review of the proposed mechanisms of the disulfiram-alcohol interaction and recommended management of the interaction is presented. The efficacy of disulfiram in the management of alcoholism, the signs and symptoms of the disulfiram-alcohol interaction, and other agents with disulfiram-like activity are discussed. Recommended treatment consists of supportive measures such as Trendelenberg posture, administration of oxygen and intravenous infusion of fluid, solute, colloid, and, if needed, a pressor agent such as norepinephrine. Iron salts, ascorbic acid, antihistamines and phenothiazines are of no established benefit.