Drug/Small Molecule:
disulfiram

PharmGKB contains no dosing guidelines for this drug/small molecule. To report known genotype-based dosing guidelines, or if you are interested in developing guidelines, click here.

PharmGKB has no annotated drug labels with pharmacogenomic information for this drug/small molecule. If you know of a drug label with PGx, send us a message.

Links to Unannotated Labels

These links are to labels associated with disulfiram that have not been annotated by PharmGKB.

  1. DailyMed - DrugLabel PA166105109

PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

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This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

Gene ? Variant?
(138)
Alternate Names / Tag SNPs ? Drugs ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available CA VA
rs1800497 113270828G>A, 16833244G>A, 17316G>A, 2137G>A, 32806C>T, DRD2 Taq1A, DRD2:32806C>T, DRD2:Taq1A, DRD2:Taq1A A1, DRD2:TaqIA allele, Glu713Lys, Taq1A
G > A
Missense
Glu713Lys
No VIP available CA VA
rs1801133 11210333G>A, 11796321G>A, 14783C>T, 419C>T, 665C>T, 677C>T, 788C>T, A222V, Ala140Val, Ala222Val, Ala263Val, C677T, MTHFR: c.677C>T, MTHFR:667C>T, p.A222V
G > A
Not Available
Ala140Val
No VIP available CA VA
rs2283265 113285536C>A, 16847952C>A, 65466G>T, 723+607G>T, 724-353G>T
C > A
Intronic
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 138
2D structure from PubChem
provided by PubChem

Overview

Generic Names
  • Disulfuram
  • Disulphuram
  • Dupon 4472
  • Dupont Fungicide 4472
  • TATD
  • TETD
  • TTD
  • Tetraethylthioperoxydicarbonic Diamide
  • Tetraethylthiram Disulfide
  • Tetraethylthiram Disulphide
  • Tetraethylthiuram
  • Tetraethylthiuram Disulfide
  • Tetraethylthiuram Disulphide
  • Tetraethylthiuram Sulfide
  • Tetraethylthiuran Disulfide
  • Usaf B-33
Trade Names
  • Abstensil
  • Abstinil
  • Abstinyl
  • Accel Tet
  • Accel Tet-R
  • Akrochem Tetd
  • Alcophobin
  • Alk-Aubs
  • Ancazide Et
  • Antabus
  • Antabuse
  • Antadix
  • Antaenyl
  • Antaethan
  • Antaethyl
  • Antaetil
  • Antalcol
  • Antetan
  • Antethyl
  • Antetil
  • Anteyl
  • Anthethyl
  • Anti-Ethyl
  • Antiaethan
  • Anticol
  • Antietanol
  • Antietil
  • Antikol
  • Antivitium
  • Aversan
  • Averzan
  • Bonibal
  • Contralin
  • Contrapot
  • Cronetal
  • Dicupral
  • Disetil
  • Disulfan
  • Disulfram
  • Ekagom Dtet
  • Ekagom Teds
  • Ekagom Tetds
  • Ekaland Tetd
  • Ephorran
  • Espenal
  • Esperal
  • Etabus
  • Ethyl Thiram
  • Ethyl Thiudad
  • Ethyl Thiurad
  • Ethyl Tuads
  • Ethyl Tuads Rodform
  • Ethyl Tuex
  • Ethyldithiourame
  • Ethyldithiurame
  • Etyl Tuex
  • Exhoran
  • Exhorran
  • Gababentin
  • Hoca
  • Krotenal
  • Nocbin
  • Nocceler Tet
  • Nocceler Tet-G
  • Noxal
  • Perkacit Tetd
  • Perkait Tetd
  • Refusal
  • Ro-Sulfiram
  • Sanceler Tet
  • Sanceler Tet-G
  • Soxinol Tet
  • Stopaethyl
  • Stopethyl
  • Stopety
  • Stopetyl
  • Super Rodiatox
  • TTS
  • TTS X
  • Tenurid
  • Tenutex
  • Tetidis
  • Tetradin
  • Tetradine
  • Tetraetil
  • Teturam
  • Teturamin
  • Thiocid
  • Thiophos
  • Thioscabin
  • Thireranide
  • Tillram
  • Tiuram
Brand Mixture Names

PharmGKB Accession Id:
PA449376

Description

A carbamate derivative used as an alcohol deterrent. It is a relatively nontoxic substance when administered alone, but markedly alters the intermediary metabolism of alcohol. When alcohol is ingested after administration of disulfiram, blood acetaldehyde concentrations are increased, followed by flushing, systemic vasodilation, respiratory difficulties, nausea, hypotension, and other symptoms (acetaldehyde syndrome). It acts by inhibiting aldehyde dehydrogenase.

Source: Drug Bank

Indication

For the treatment and management of chronic alcoholism

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Disulfiram blocks the oxidation of alcohol at the acetaldehyde stage during alcohol metabolism following disulfiram intake causing an accumulation of acetaldehyde in the blood producing highly unpleasant symptoms. Disulfiram blocks the oxidation of alcohol through its irreversible inactivation of aldehyde dehydrogenase, which acts in the second step of ethanol utilization. In addition, disulfiram competitively binds and inhibits the peripheral benzodiazepine receptor, which may indicate some value in the treatment of the symptoms of alcohol withdrawal, however this activity has not been extensively studied.

Source: Drug Bank

Pharmacology

Disulfiram produces a sensitivity to alcohol which results in a highly unpleasant reaction when the patient under treatment ingests even small amounts of alcohol. Disulfiram blocks the oxidation of alcohol at the acetaldehyde stage during alcohol metabolism following disulfiram intake, the concentration of acetaldehyde occurring in the blood may be 5 to 10 times higher than that found during metabolism of the same amount of alcohol alone. Accumulation of acetaldehyde in the blood produces a complex of highly unpleasant symptoms referred to hereinafter as the disulfiram-alcohol reaction. This reaction, which is proportional to the dosage of both disulfiram and alcohol, will persist as long as alcohol is being metabolized. Disulfiram does not appear to influence the rate of alcohol elimination from the body. Prolonged administration of disulfiram does not produce tolerance; the longer a patient remains on therapy, the more exquisitely sensitive he becomes to alcohol.

Source: Drug Bank

Food Interaction

Avoid alcohol for up to 14 days after treatment has been stopped.|Take without regard to meals.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic.

Source: Drug Bank

Absorption

Disulfiram is absorbed slowly from the gastrointestinal tract (80 to 90% of oral dose).

Source: Drug Bank

Toxicity

LD 50=8.6g/kg (orally in rats). Symptoms of overdose include irritation, slight drowsiness, unpleasant taste, mild GI disturbances, and orthostatic hypotension.

Source: Drug Bank

Chemical Properties

Chemical Formula

C10H20N2S4

Source: Drug Bank

Isomeric SMILES

CCN(CC)C(=S)SSC(=S)N(CC)CC

Source: OpenEye

Canonical SMILES

CCN(CC)C(=S)SSC(=S)N(CC)CC

Source: Drug Bank

Average Molecular Weight

296.539

Source: Drug Bank

Monoisotopic Molecular Weight

296.05093141

Source: Drug Bank

PharmGKB Curated Pathways

Pathways created internally by PharmGKB based primarily on literature evidence.

  1. Sympathetic Nerve Pathway (Neuroeffector Junction)
    Simplified diagram of a sympathetic neuroeffector junction displaying genes which may be involved.

External Pathways

Links to non-PharmGKB pathways.

PharmGKB contains no links to external pathways for this drug. To report a pathway, click here.

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

EvidenceGene
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
ABCB1
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
ANKK1
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available PW
DBH
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
DRD2
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
MTHFR

Drug Targets

Gene Description
ALDH2 (source: Drug Bank)
DBH (source: Drug Bank)
TSPO (source: Drug Bank)

Drug Interactions

Drug Description
disulfiram Disulfiram increases the effect and toxicity of theophylline (source: Drug Bank)
disulfiram Increased irsk of side effects (oral solution) (source: Drug Bank)
disulfiram Increased irsk of side effects (oral solution) (source: Drug Bank)
disulfiram Disulfiram increases chlorzoxazone levels (source: Drug Bank)
disulfiram Disulfiram increases chlorzoxazone levels (source: Drug Bank)
acenocoumarol Disulfiram increases the anticoagulant effect (source: Drug Bank)
acenocoumarol Disulfiram may increase the anticoagulant effect of acenocoumarol. (source: Drug Bank)
aminophylline Increases the effect and toxicity of theophylline (source: Drug Bank)
amprenavir Increased risk of side effects (oral solution) (source: Drug Bank)
amprenavir Increased risk of side effects (oral solution) (source: Drug Bank)
anisindione Disulfiram may increase the anticoagulant effect of anisindione. (source: Drug Bank)
chlorzoxazone Increases chlorzoxazone levels (source: Drug Bank)
chlorzoxazone Increases chlorzoxazone levels (source: Drug Bank)
cocaine Increases the cardiac toxicity of cocaine (source: Drug Bank)
cocaine Increases the cardiac toxicity of cocaine (source: Drug Bank)
dicumarol Increases the anticoagulant effect (source: Drug Bank)
dicumarol Disulfiram may increase the anticoagulant effect of dicumarol. (source: Drug Bank)
dyphylline Increases the effect and toxicity of theophylline (source: Drug Bank)
ethotoin Increases the effect of phenytoin (source: Drug Bank)
fosphenytoin Increases the effect of phenytoin (source: Drug Bank)
isoniazid Increased risk of CNS adverse efects (source: Drug Bank)
isoniazid Increased risk of CNS adverse efects (source: Drug Bank)
mephenytoin Increases the effect of phenytoin (source: Drug Bank)
mephenytoin Increases the effect of phenytoin (source: Drug Bank)
metronidazole Possible acute psychosis and confusion (source: Drug Bank)
metronidazole Possible acute psychosis and confusion (source: Drug Bank)
oxtriphylline Increases the effect and toxicity of theophylline (source: Drug Bank)
phenytoin Increases the effect of phenytoin (source: Drug Bank)
phenytoin Increases the effect of phenytoin (source: Drug Bank)
theophylline Increases the effect and toxicity of theophylline (source: Drug Bank)
theophylline Increases the effect and toxicity of theophylline (source: Drug Bank)
warfarin Increases the anticoagulant effect (source: Drug Bank)
warfarin Disulfiram may increase the anticoagulant effect of warfarin. (source: Drug Bank)
disulfiram Disulfiram increases the effect of phenytoin (source: Drug Bank)
disulfiram Increased risk of CNS adverse effects (source: Drug Bank)
disulfiram Increased risk of CNS adverse effects (source: Drug Bank)
disulfiram Possible acute psychosis and confusion (source: Drug Bank)
disulfiram Possible acute psychosis and confusion (source: Drug Bank)
disulfiram Disulfiram increases the effect and toxicity of theophylline (source: Drug Bank)
disulfiram Disulfiram increases the effect of phenytoin (source: Drug Bank)
disulfiram Disulfiram increases the effect of phenytoin (source: Drug Bank)
disulfiram Disulfiram increases the effect and toxicity of theophylline (source: Drug Bank)
disulfiram Disulfiram increases the effect and toxicity of theophylline (source: Drug Bank)
disulfiram Disulfiram may cause Tipranavir (Aptivus brand) toxicity by inhibiting alcohol metabolism. Aptivus capsules contain alcohol. (source: Drug Bank)
disulfiram Disulfiram, a strong CYP2E1 inhibitor, may decrease the metabolism and clearance of Trimethadione, a CYP2E1 substrate. Consider alternate therapy or monitor for changes in Trimethadione therapeutic and adverse effects if Disulfiram is initiated, discontinued or dose changed. (source: Drug Bank)

Curated Information ?

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
May Prevent
Induces
Contraindicated With

Publications related to disulfiram: 32

No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
ANKK1 and DRD2 pharmacogenetics of disulfiram treatment for cocaine abuse. Pharmacogenetics and genomics. 2013. Spellicy Catherine J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacogenetics of alcoholism: a clinical neuroscience perspective. Pharmacogenomics. 2012. Ray Lara A, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Arylamine N-acetyltransferase 1: a novel drug target in cancer development. Pharmacological reviews. 2012. Butcher Neville J, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
The MTHFR C677T Variant is Associated with Responsiveness to Disulfiram Treatment for Cocaine Dependency. Frontiers in psychiatry / Frontiers Research Foundation. 2012. Spellicy Catherine J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Very important pharmacogene summary: ABCB1 (MDR1, P-glycoprotein). Pharmacogenetics and genomics. 2011. Hodges Laura M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Breaking Barriers in the Genomics and Pharmacogenetics of Drug Addiction. Clinical pharmacology and therapeutics. 2010. Ho M K, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Warfarin interactions with substances listed in drug information compendia and in the FDA-approved label for warfarin sodium. Clinical pharmacology and therapeutics. 2009. Anthony M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Mechanisms and kinetics of human arylamine N-acetyltransferase 1 inhibition by disulfiram. The FEBS journal. 2009. Malka Florence, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Histone deacetylase inhibitors induce a very broad, pleiotropic anticancer drug resistance phenotype in acute myeloid leukemia cells by modulation of multiple ABC transporter genes. Clinical cancer research : an official journal of the American Association for Cancer Research. 2009. Hauswald Stefanie, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Genetic determinants of response to clopidogrel and cardiovascular events. The New England journal of medicine. 2009. Simon Tabassome, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Redox regulation of multidrug resistance in cancer chemotherapy: molecular mechanisms and therapeutic opportunities. Antioxidants & redox signaling. 2009. Kuo Macus Tien. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Several major antiepileptic drugs are substrates for human P-glycoprotein. Neuropharmacology. 2008. Luna-Tortós Carlos, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Structure, function and regulation of P-glycoprotein and its clinical relevance in drug disposition. Xenobiotica; the fate of foreign compounds in biological systems. 2008. Zhou S-F. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Polymorphisms in the drug transporter gene ABCB1 predict antidepressant treatment response in depression. Neuron. 2008. Uhr Manfred, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Citalopram enantiomers in plasma and cerebrospinal fluid of ABCB1 genotyped depressive patients and clinical response: a pilot study. Pharmacological research : the official journal of the Italian Pharmacological Society. 2008. Nikisch Georg, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Cobalamin potentiates vinblastine cytotoxicity through downregulation of mdr-1 gene expression in HepG2 cells. Cellular physiology and biochemistry : international journal of experimental cellular physiology, biochemistry, and pharmacology. 2007. Marguerite Véronique, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Mechanism of inhibition of P-glycoprotein mediated efflux by vitamin E TPGS: influence on ATPase activity and membrane fluidity. Molecular pharmaceutics. 2007. Collnot Eva-Maria, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Gefitinib modulates the function of multiple ATP-binding cassette transporters in vivo. Cancer research. 2006. Leggas Markos, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Impact of P-glycoprotein on clopidogrel absorption. Clinical pharmacology and therapeutics. 2006. Taubert Dirk, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Single nucleotide polymorphisms in human P-glycoprotein: its impact on drug delivery and disposition. Expert opinion on drug delivery. 2006. Dey Surajit. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Influence of lipid lowering fibrates on P-glycoprotein activity in vitro. Biochemical pharmacology. 2004. Ehrhardt Manuela, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Interactions of human P-glycoprotein with simvastatin, simvastatin acid, and atorvastatin. Pharmaceutical research. 2004. Hochman Jerome H, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Polymorphisms in human MDR1 (P-glycoprotein): recent advances and clinical relevance. Clinical pharmacology and therapeutics. 2004. Marzolini Catia, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Disulfiram facilitates the development and expression of locomotor sensitization to cocaine in rats. Biological psychiatry. 2003. Haile Colin N, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Genetic polymorphisms of the human MDR1 drug transporter. Annual review of pharmacology and toxicology. 2003. Schwab Matthias, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Interaction of omeprazole, lansoprazole and pantoprazole with P-glycoprotein. Naunyn-Schmiedeberg's archives of pharmacology. 2001. Pauli-Magnus C, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
The role of intestinal P-glycoprotein in the interaction of digoxin and rifampin. The Journal of clinical investigation. 1999. Greiner B, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Biochemical, cellular, and pharmacological aspects of the multidrug transporter. Annual review of pharmacology and toxicology. 1999. Ambudkar S V, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Competitive, non-competitive and cooperative interactions between substrates of P-glycoprotein as measured by its ATPase activity. Biochimica et biophysica acta. 1997. Litman T, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
P-glycoprotein structure and evolutionary homologies. Cytotechnology. 1993. Croop J M. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
3,4-dihydroxyphenylethylamine beta-hydroxylase. Physical properties, copper content, and role of copper in the catalytic acttivity. The Journal of biological chemistry. 1965. Friedman S, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
The adrenal medulla and the biosynthesis of pressor amines. Recent progress in hormone research. 1956. HAGEN P, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
49884-153-01
DrugBank:
DB00822
ChEBI:
4659
KEGG Compound:
C01692
KEGG Drug:
D00131
PubChem Compound:
3117
PubChem Substance:
46506008
4833
Drugs Product Database (DPD):
2534
ChemSpider:
3005
Therapeutic Targets Database:
DAP000012
FDA Drug Label at DailyMed:
5fa6a93d-e41a-4942-b725-5f868ed96d53

Clinical Trials

These are trials that mention disulfiram and are related to either pharmacogenetics or pharmacogenomics.

Common Searches

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.