Are disulfiram-like reactions associated with abacavir-containing antiretroviral regimens in clinical practice?
Abacavir is metabolized primarily by two enzymes: alcohol dehydrogenase and gluconyl transferase. Under normal conditions, alcohol is hepatically cleared via alcohol dehydrogenase to acetaldehyde, and subsequently by acetaldehyde dehydrogenase (ACD) to acetic acid. Disulfiram acts as an ACD blocker. Abacavir may also act as an inhibitor of alcohol dehydrogenase, which raises the possibility of disulfiram-like reactions (if complete inhibition occurs) or reduced alcohol tolerance (if partial inhibition occurs) occurring with abacavir therapy.
Barber
Tristan J
TJ
Imperial College, London, UK.
Marett
Brett
B
Waldron
Sean
S
Portsmouth
Simon
S
Mackie
Nicola E
NE
Weston
Rosy
R
Winston
Alan
A
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D019380:Anti-HIV Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015224:Dideoxynucleosides / Q000009:adverse effects*; D004221:Disulfiram / Q000009:adverse effects; D000431:Ethanol / Q000633:toxicity*; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D008297:Male; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects*; D000099227:Abacavir
D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D004221:Disulfiram; D000431:Ethanol; D018894:Reverse Transcriptase Inhibitors; D000099227:Abacavir