Teturam: instructions for use and reviews
Latin name: Teturam
ATX code: N07BB01
Active substance: Disulfiram (Disulfiram)
Producer: Pharmstandard - Leksredstva, STI-MED-SORB, Tatkhimfarmpreparaty, AVVA-RUS (Russia)
Description and photo update: 12.08.2019
Teturam is an anti-alcohol drug.
Release form and composition
Dosage form - tablets: round, flat-cylindrical, with a bevel, white with a yellow-green tint or white (10 pcs in a blister pack, in a carton pack of 3 or 5 packs; 30 or 50 pcs in a dark glass jar , in a carton pack 1 can; in addition, 150 mg each: in a polymer jar or bottle of 30 or 50 pcs., in a carton pack 1 can or bottle; in a blister pack of 10 pcs., in a carton pack of 3 or 5 packs ; in a blister pack: 15 or 20 pcs., in a carton pack 1, 2, 3 or 5 packs, or 10 pcs., in a carton pack 1 or 2 packs).
1 tablet contains:
- active ingredient: disulfiram - 100 mg, 150 mg, 200 mg or 250 mg;
- auxiliary components: potato starch, aerosil (colloidal silicon dioxide), stearic acid.
Pharmacological properties
Pharmacodynamics
Disulfiram - the active substance of Teturam - is an inhibitor of the enzyme acetaldehyde dehydrogenase involved in the metabolism of ethanol, which increases the concentration of acetaldehyde, which is a metabolite of ethyl alcohol, by 5-10 times. Acetaldehyde causes a number of unpleasant symptoms: nausea, vomiting, feelings of general malaise, flushing of the skin of the face, tachycardia, and a sharp decrease in blood pressure. This contributes to the development of a conditioned reflex reaction, which consists in the appearance of a feeling of disgust for the smell and taste of alcohol. The intensity of reactions caused by Teturam is directly proportional to the dose taken.
The maximum therapeutic effect is observed 12 hours after taking the tablets orally and can last for 10-14 days after stopping treatment. The degree of effect of the drug is directly determined by the duration of the course of therapy.
Pharmacokinetics
After oral administration, the absorption of disulfiram is 70-90%. The substance is metabolized in the liver by reduction to diethyldithiocarbamate, which is excreted as glucuronide through the kidneys, or converted to diethylamine and carbon disulfide, the ratio of which varies from 4 to 53%. Carbon disulfide is excreted through the lungs. The minimum concentration of disulfiram in the blood is approximately 20 ng / ml.
Indications for use
The use of Teturam is indicated for the treatment of chronic alcoholism and the prevention of its relapse.
In addition, tablets are prescribed as a detoxification drug for chronic nickel poisoning.
Contraindications
- thyrotoxicosis;
- diseases of the cardiovascular system in the stage of decompensation (including atherosclerosis of the cerebral vessels, pronounced cardiosclerosis, coronary insufficiency, conditions before and after a heart attack, aortic aneurysm, stage II–III arterial hypertension);
- severe emphysema;
- bronchial asthma;
- hemoptysis in pulmonary tuberculosis;
- erosive lesions of the gastrointestinal tract (GIT), bleeding from the GIT, exacerbation of peptic ulcer of the stomach and duodenum;
- renal dysfunction, liver failure;
- diabetes;
- glaucoma;
- neuropsychiatric pathologies, epilepsy;
- diseases of the central nervous system (CNS) of infectious genesis;
- neuritis of the auditory and ophthalmic nerves;
- polyneuropathy;
- malignant neoplasms;
- the period of pregnancy and breastfeeding;
- individual intolerance to the components of the drug.
Teturam should be used with caution in a history of psychosis while taking disulfiram, with endarteritis, cardiovascular pathologies in the compensation stage, residual effects of cerebrovascular accident, over the age of 60, during remission of gastric ulcer and duodenal ulcer.
Instructions for use Teturam: method and dosage
Teturam tablets are taken orally.
The appointment of the drug is made after a complete medical examination, the doctor must warn the patient about the possible consequences and complications.
Recommended dosage: according to an individual scheme from 150 to 500 mg 2 times a day. Teturam-alcohol test is carried out after 7-10 days of therapy, it consists in the patient taking 20-30 ml of vodka (40%) after 500 mg of the drug. In case of a weak reaction, the amount of vodka is increased by 10–20 ml. The dose of alcohol should not exceed 120 mg. Repeated tests with correction of doses of alcohol and / or the drug are carried out after 1-2 days in a hospital and after 3-5 days - on an outpatient basis. Maintenance therapy at a daily dose of 150–200 mg may be continued for 1–3 years.
Side effects
- disorders caused by the properties of the drug: confusion, headache, taste of metal in the mouth, unpleasant odor (due to carbon sulfide) in patients with colostomy, memory loss, optic neuritis, asthenia, polyneuritis of the lower extremities, manifestation of allergic reactions on the skin; rarely - hepatitis (including in the absence of alcohol dependence in patients with nickel eczema);
- disorders caused by the intake of doses of alcohol during therapy that exceed the equivalent of 50–80 ml of vodka: edema, severe disorders of the respiratory and cardiovascular systems, convulsions;
- violations caused by the combination of Teturam with ethyl alcohol: possibly - respiratory failure, cerebral edema, cardiovascular collapse, angina pectoris, rhythm disturbances; sometimes - myocardial infarction, neurological disorders;
- disorders caused by complications during long-term therapy: exacerbation of polyneuritis; rarely - gastritis, hepatitis, psychosis (similar to alcohol); possibly (with cardiovascular diseases) - thrombosis of cerebral vessels.
Overdose
Symptoms of an overdose of Teturam are neurological complications, clouded consciousness, coma, collapse.
There is no specific antidote for disulfiram. With a severe disulfiram-alcohol reaction lasting about 1.5 hours, oxygen therapy is used. Inhalation of carbogen (a mixture of 95% oxygen and 5% carbon dioxide), intravenous administration of high doses of ascorbic acid (up to 1 g), antihistamines and ephedrine sulfate are also recommended. It is necessary to constantly monitor the content of potassium in the blood serum, especially if the patient is taking digitalis preparations.
special instructions
Due to the risk of developing cerebral thrombosis, immediate discontinuation of the drug is required when the patient develops facial numbness and paresthesias in the extremities.
With the development of severe disorders against the background of alcohol consumption in a dose exceeding the permissible threshold, the patient needs urgent detoxification therapy, including analeptics and symptomatic treatment.
When the drug is combined with oral anticoagulants, the patient should be provided with frequent monitoring of the level of prothrombin concentration and appropriate dose adjustment of anticoagulants. This will reduce the risk of bleeding.
Influence on the ability to drive vehicles and complex mechanisms
Taking Teturam tablets has little effect on the ability to drive a car or perform potentially hazardous work.
Use during pregnancy and lactation
Pregnancy must be excluded before taking Teturam. During treatment with disulfiram, reliable contraception should be used.
For impaired renal function
According to the instructions, Teturam is used with caution in patients with any degree of renal insufficiency.
For impaired liver function
The drug is contraindicated in severe liver dysfunction. It is used with caution in liver dysfunctions.
drug interaction
Due to the high risk of developing an intolerance reaction that causes vomiting, flushing, tachycardia, erythema, the simultaneous use of ethanol-containing drugs and alcohol is contraindicated.
Undesirable combinations include the combination of the drug with the following agents:
- isoniazid - because of its ability to cause impaired coordination and behavior;
- ornidazole, tinidazole, metronidazole, secnidazole (nitro-5-imidazoles) - the risk of developing delirious disorders, confusion;
- phenytoin - reduces metabolism, quickly and significantly increasing its level in blood plasma with symptoms of toxicity (in case of clinical necessity, treatment should be accompanied by laboratory monitoring of phenytoin in the blood).
With the simultaneous use of Teturama:
- oral anticoagulants, including warfarin, increase their effect and the risk of bleeding, so it is recommended to conduct more frequent checks of their level and keep the dose of anticoagulants adjusted after drug withdrawal for 8 days;
- theophylline slows down your metabolism;
- benzodiazepines increase their sedative effect;
- tricyclic antidepressants may exacerbate alcohol intolerance reactions.
Analogues
Teturam's analogues are: Antabuse, Esperal.
Terms and conditions of storage
Keep away from children.
Store in a place protected from moisture and light at temperatures up to 25 ° C.
Shelf life - 4 years.
Instruction:
Clinical and pharmacological group
02.063 (drug for the treatment of alcohol dependence)Release form, composition and packaging
Tablets white with a creamy tint, round, slightly biconvex, with the inscription "ESPERAL" on one side and a cross-shaped notch on the other; without smell.
Excipients: povidone K30, carmellose sodium, magnesium stearate, microcrystalline cellulose, purified water.
20 pcs. - polypropylene bottles (1) - cardboard packs.
pharmachologic effect
A drug for the treatment of alcoholism. The action of disulfiram is based on the blockade of acetaldehyde, which is involved in the metabolism of ethanol. This leads to an increase in the concentration of the ethanol metabolite - acetaldehyde, which causes negative sensations (including flushing to the face, nausea, vomiting, tachycardia, lowering blood pressure), which make it extremely unpleasant to drink alcohol after taking the drug. This leads to a conditioned reflex aversion to the taste and smell of alcoholic beverages.
The maximum therapeutic effect is achieved 12 hours after taking the drug orally and can last for 10-14 days after stopping treatment.
Pharmacokinetics
After oral administration, the absorption of disulfiram from the gastrointestinal tract ranges from 70 to 90%. It is rapidly metabolized to dithiocarbamate, which is itself excreted as a glucuron conjugate or converted to diethylamine and carbon sulfide, part of which (4-53%) is excreted through the lungs.
Dosage
Before starting treatment, the patient should be carefully examined and warned about the consequences and complications.
The drug is administered orally at 500 mg 1 time / day in the morning with meals according to an individual scheme, gradually reducing the dose to 250 mg (1/2 tablet) or 125 mg (1/4 tablet) per day. Depending on the patient's response to treatment, the dose can be increased or decreased.
After 7-10 days, a teturam-alcohol test is carried out: 20-30 ml of 40% ethanol (vodka) after taking the drug at a dose of 500 mg; with a weak reaction, the dose of alcohol is increased by 10-20 ml (the maximum dose of vodka is 100-120 ml). The test is repeated after 1-2 days in a hospital and after 3-5 days on an outpatient basis, with dose adjustment of alcohol and / or drug, if necessary. In the future, the drug can be used at a maintenance dose of 150-200 mg / day for 1-3 years.
Overdose
Symptoms: the combination of disulfiram-ethanol causes depression of consciousness up to coma, cardiovascular collapse, neurological complications.
Treatment: symptomatic therapy.
drug interaction
Combinations are contraindicated
With the simultaneous use of the drug Esperal® and ethanol, an intolerance reaction develops (hot flushes, erythema, vomiting, tachycardia).
With simultaneous use with isoniazid - violations of behavior and coordination.
With simultaneous use with 5-nitroimidazole derivatives (metronidazole, ornidazole, secnidazole, tinidazole), delirious disorders and confusion develop.
With simultaneous use with phenytoin, there is a significant and rapid increase in the concentration of phenytoin in the blood plasma with the development of toxic symptoms (due to inhibition of phenytoin metabolism). If the combination cannot be avoided, then clinical monitoring and monitoring of plasma concentrations of phenytoin during and after treatment with disulfiram should be carried out.
Combinations requiring caution
With simultaneous use with warfarin (and other oral anticoagulants), its effect is enhanced and the risk of bleeding increases (due to inhibition of warfarin metabolism in the liver). With this combination, more frequent monitoring of the level of prothrombin in the blood and dose adjustment of anticoagulants are recommended within 8 days after the discontinuation of disulfiram.
Disulfiram inhibits the metabolism of theophylline. Therefore, a dose reduction of theophylline is required, depending on the clinical symptoms and its plasma concentration.
Disulfiram is able to enhance the sedative effect of benzodiazepines due to inhibition of their oxidative metabolism (especially chlordiazepoxide and diazepam). Doses of benzodiazepines should be adjusted according to clinical manifestations.
Tricyclic antidepressants increase alcohol intolerance reactions if patients treated with disulfiram take alcoholic beverages.
Use during pregnancy and lactation
The drug is contraindicated for use during pregnancy and lactation (breastfeeding).
Side effects
Caused by the properties of disulfiram: metallic taste in the mouth, an unpleasant odor in patients with colostomy (associated with carbon sulfide); rarely - hepatitis, sometimes found in patients with nickel eczema who do not suffer from alcoholism, polyneuritis of the lower extremities, optic neuritis, memory loss, confusion, asthenia, headaches, skin allergic reactions.
Associated with the combination of disulfiram-ethanol: cases of respiratory failure, collapse, cardiac arrhythmias or acute angina pectoris, sometimes myocardial infarction, as well as neurological disorders, cerebral edema, have been described.
Complications with long-term use: psychosis, reminiscent of alcohol, hepatitis, gastritis; in patients with cardiovascular diseases, cerebral vascular thrombosis is possible, therefore, if there are complaints of paresthesia in the limbs and face, the drug should be immediately discontinued; exacerbation of polyneuritis.
When taking doses of alcohol over 50-80 ml (in terms of 40% ethanol), while taking the drug, severe disorders of the cardiovascular and respiratory systems, edema, and convulsions develop. In this case, detoxification therapy is urgently carried out, analeptics are administered, and symptomatic treatment is carried out.
Terms and conditions of storage
List B. The drug should be stored in a dry place, out of the reach of children, at a temperature below 25°C. Shelf life - 3 years.
Indications
— treatment and prevention of recurrence of chronic alcoholism.
Additionally, the drug is used as a detoxification agent for chronic nickel poisoning.
Contraindications
Absolute:
- severe liver failure;
- diabetes;
- epilepsy and convulsive syndrome of any origin;
- mental illness;
- pregnancy;
- lactation period;
- Hypersensitivity to the components of the drug.
Relative:
- renal failure;
- hypothyroidism.
special instructions
During the period of treatment, you should avoid taking alcoholic beverages and medicines containing ethanol.
Use for impaired renal function
Use in violation of liver function
The drug is contraindicated in severe liver failure.
In this article, you can read the instructions for using the drug Teturam. Reviews of site visitors - consumers of this medicine, as well as opinions of specialist doctors on the use of Teturam in their practice are presented. We kindly ask you to actively add your reviews about the drug: the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Teturam in the presence of existing structural analogues. Use for the treatment of chronic alcoholism and elimination of cravings for alcohol in adults, children, as well as during pregnancy and lactation.
Teturam- an agent for the treatment of alcohol dependence. It has an inhibitory effect on the enzyme aldehyde dehydrogenase, which is involved in the metabolism of ethyl alcohol. This leads to an increase in the concentration of the ethyl alcohol metabolite acetaldehyde, which causes flushing to the face, nausea, vomiting, general malaise, tachycardia, and a decrease in blood pressure, which make it extremely unpleasant to drink alcohol after taking Teturam.
Compound
Disulfiram + excipients.
Pharmacokinetics
After oral administration, there is a rapid, but incomplete (70-90%) absorption of the active substance from the gastrointestinal tract. Due to its high lipid solubility, disulfiram is widely distributed in the body and accumulates in various fat depots. Disulfiram is rapidly metabolized to diethyldithiocarbamate (DDC), which is partially excreted as carbon disulfide in exhaled air and partially metabolized in the liver to methyl-DDC. The latter is converted into an active metabolite, diethylthiocarbamic acid methyl ester (methyl-DTC). With mild or moderate deterioration in liver function, metabolism does not change. On the contrary, with cirrhosis of the liver, an increase in the concentration of metabolites in the blood is observed. Metabolites are excreted mainly in the urine. Part is excreted with exhaled air in the form of carbon disulfide. 20% in the form of unchanged disulfiram is excreted through the intestines. Up to 20% of a dose may remain in the body for 1 week or more. Despite very low levels, disulfiram-ethanol reactions can occur up to 5-9 months after implantation.
Indications
For oral administration:
- prevention of relapse during the treatment of chronic alcoholism.
- treatment of chronic alcoholism
- as a detoxification agent for chronic nickel poisoning.
Release forms
Tablets 100 mg, 150 mg, 200 mg and 250 mg.
There are no other dosage forms, whether drops or capsules.
Instructions for use and regimen
When taken orally, the dose is 125-500 mg per day, the treatment regimen is determined individually.
Side effect
- metallic taste in the mouth;
- polyneuritis of the lower extremities;
- neuropsychiatric disorders;
- memory loss;
- disorientation;
- headache;
- skin rash;
Contraindications
- severe cardiovascular disease;
- severe liver failure;
- diabetes;
- epilepsy;
- neuropsychiatric diseases;
- concomitant use of phenytoin, isoniazid, metronidazole;
- simultaneous use of drinks containing alcohol or taking medications containing ethanol, as well as their use within 24 hours after taking disulfiram;
- pregnancy;
- lactation;
- hypersensitivity to disulfiram.
Use during pregnancy and lactation
Use in children
The drug is contraindicated in children and adolescents under the age of 18 years.
special instructions
Use with caution in patients with renal insufficiency, diseases of the liver, respiratory system.
drug interaction
A case of the development of mania in a patient taking Teturam and buspirone is described.
With simultaneous use, Teturam inhibits the metabolism and excretion of rifampicin.
With simultaneous use with phenazone, T1 / 2 of phenazone increases; with phenytoin - the effects of phenytoin are enhanced due to an increase in its concentration in the blood plasma, toxic reactions develop.
Analogues of the drug Teturam
Structural analogues for the active substance:
Disulfiram Disulfiram Disulfiram Buy a medicine (tablets 150mg #30) Buy with delivery (tablets 150mg #50) Buy with delivery tablets 150mg n30 Buy with delivery 150mg 30 tabs Buy with delivery 150mg 50 tabs Buy with delivery Buy medicine (tablets 150mg #30) Buy with delivery (tablets 150mg #50) Buy with delivery tablets 150mg n30 Buy with delivery 150mg 30 tabs Buy with delivery 150mg 50 tabs Buy with delivery (tablets 500mg #20) Buy with delivery 500mg tablets n20 Buy with delivery with delivery 500 mg 20 tabs Buy with deliveryExpand table in full »
- Preparations
- Teturam
Instruction
- Registration certificate holder: Avva Rus, OJSC (Russia) Tatkhimfarmpreparaty, OJSC (Russia) Pharmstandard-Leksredstva, OJSC (Russia)
Drug for the treatment of alcohol addiction. It has an inhibitory effect on the enzyme aldehyde dehydrogenase, which is involved in the metabolism of ethanol. This leads to an increase in the concentration of the metabolite of ethatol - acetaldehyde, which causes flushing of the face, nausea, vomiting, general malaise, tachycardia, lowering blood pressure, which make it extremely unpleasant to drink alcohol after taking disulfiram.
After oral administration, there is a rapid, but incomplete (70-90%) absorption of the active substance from the gastrointestinal tract.
Due to its high lipid solubility, disulfiram is widely distributed in the body and accumulates in various fat depots.
Disulfiram is rapidly metabolized to diethyldithiocarbamate (DDC), which is partially excreted as carbon disulfide in exhaled air and partially metabolized in the liver to methyl-DDC. The latter is converted into an active metabolite, diethylthiocarbamic acid methyl ester (methyl-DTC). Cmax in blood plasma of methyl-DTK is achieved 4 hours after taking disulfiram, but the maximum inhibitory activity against aldehyde dehydrogenase is first observed after 3 days of taking it.
T 1/2 methyl-DTC is about 10 h, while the inhibitory activity against aldehyde dehydrogenase lasts much longer. The effect, therefore, can persist for 7-14 days after withdrawal.
With mild or moderate deterioration in liver function, metabolism does not change. On the contrary, with cirrhosis of the liver, an increase in the concentration of metabolites in the blood is observed.
Metabolites are excreted mainly in the urine. Part is excreted with exhaled air in the form of carbon disulfide. 20% in the form of unchanged disulfiram is excreted through the intestines.
Up to 20% of a dose may remain in the body for 1 week or more.
After implantation, disulfiram penetrates into the blood. The minimum content of disulfiram in the blood is about 20 ng / ml. The content of DDC and carbon disulfide in the blood reaches 0.14 µg/ml after implantation of 1-1.6 g of disulfiram. However, despite these very low levels, disulfiram-ethanol reactions can occur up to 5-9 months after implantation.
For oral administration: prevention of relapse during the treatment of chronic alcoholism.
For implantation: treatment of chronic alcoholism, as a detoxification agent for chronic nickel poisoning.
When taken orally, the dose is 125-500 mg / day, the treatment regimen is determined individually.
When implanted in the subcutaneous fat using a special technique, 800 mg is administered.
From the digestive system: metallic taste in the mouth; rarely - hepatitis.
From the side of the central nervous system: polyneuritis of the lower extremities, neuropsychiatric disorders, memory loss, disorientation, headache.
Allergic reactions: skin rash, itching.
Reactions due to the association of disulfiram-ethanol: collapse, cardiac arrhythmias, angina attacks, myocardial infarction, cerebral edema.
Contraindicated for use during pregnancy and lactation.
Before implantation, pregnancy should be excluded. Against the background of the action of disulfiram, it is necessary to use reliable contraceptives.
With simultaneous use of coumarin derivatives with anticoagulants (including warfarin), the anticoagulant effect increases, and the risk of bleeding increases.
Disulfiram inhibits liver enzymes, therefore, with the simultaneous use of drugs metabolized in the liver, their metabolism may be impaired.
With the simultaneous use of disulfiram with tricyclic antidepressants, phenothiazine derivatives, MAO inhibitors, there is a risk of developing serious adverse reactions associated with drug interactions.
A case of the development of mania in a patient taking disulfiram and buspirone is described.
With simultaneous use, the clearance of desipramine and imipramine from the body decreases.
With simultaneous use with amitriptyline, it is possible to increase the therapeutic effect of disulfiram, but it is also possible to increase the toxic effect of amitriptyline on the central nervous system.
With simultaneous use, the concentration in the blood plasma of diazepam and chlordiazepoxide increases, in some cases accompanied by dizziness. Under the influence of diazepam, a decrease in the intensity of the disulfiram-alcohol reaction is possible. A case of increased toxicity of temazepam has been described.
With simultaneous use with isoniazid, cases of the development of dizziness, depression are described; with caffeine - the excretion of caffeine from the body decreases; with metronidazole - develops acute psychosis, confusion; with omeprazole - a case of development of impaired consciousness and catatonia is described.
With simultaneous use with perphenazine, the development of psychotic symptoms cannot be excluded.
With the simultaneous use of disulfiram, it inhibits the metabolism and excretion of rifampicin.
With simultaneous use with phenazone, T 1/2 of phenazone increases; with phenytoin - the effects of phenytoin are enhanced due to an increase in its concentration in the blood plasma, toxic reactions develop.
With simultaneous use with chlorzoxazone, the concentration of chlorzoxazone in the blood plasma increases; with chlorpromazine - possibly increased arterial hypotension.
Contraindicated in severe liver failure. Use with caution in patients with liver disease.
Wives and mothers of alcoholics do not feed pharmacies, use this cheap analogue from the times of the USSR
Active substance
Analogues
To defeat alcoholism, pour it into a glass of water.
Why did greedy pharmacies hide a remedy 39 times more powerful than Exoderil? They turned out to be Soviet thick.
Even the deadest liver is cleansed with this remedy!
International name
Group affiliation
Dosage form
pharmachologic effect
Inhibits acetaldehyde dehydrogenase involved in ethanol metabolism; increases the concentration of acetaldehyde, which is a metabolite of ethanol and causes a number of unpleasant sensations after its use ("flushing" of blood to the skin of the face, nausea, vomiting, feeling unwell, tachycardia, lowering blood pressure). As a result, a conditioned reflex reaction of aversion to the taste and smell of ethanol is developed.
The duration of action of oral tablets is 48 hours.
Application in the form of implants creates a constant concentration of the drug in the body. Disulfiram-ethanol reactions may occur within 5-9 months after implantation. In the case of taking ethanol, lipids are mobilized, blood vessels dilate and blood flow increases at the implantation site, resulting in an increase in the flow of disulfiram into the blood.
Indications
Contraindications
Side effects
Tablets: "metallic" taste in the mouth, unpleasant odor (due to carbon disulfide) in patients with colostomy, hepatitis, polyneuropathy of the lower extremities, neuropsychiatric disorders, memory loss, disorientation in time and space, asthenia, headache, skin allergic reactions.
Tablets for implantation: suppuration (due to friction with the belt, premature removal of sutures), rejection phenomenon (when the tablets were implanted too close to the incision), allergic dermatitis.
Side effects due to the association of disulfiram-ethanol: collapse, arrhythmia, angina pectoris, myocardial infarction, cerebral edema, hemorrhagic stroke.
Application and dosage
Tablets: inside, in the morning on an empty stomach, before breakfast, at the beginning of treatment, the average dose is 500 mg / day, subsequently it is gradually reduced to 250-125 mg / day.
P / c and / m (implantation). After thorough disinfection and local anesthesia, a small incision (approximately 6 mm) is made in the left iliac region, low enough to avoid friction with the belt. The subcutaneous tissue is parted and 2 implantation tablets (100 mg each) are introduced using a trocar to a depth of 4 cm. This procedure is repeated 4 times, introducing the tablets crosswise around the incision site, parallel to the skin surface. The total dose is 800 mg (8 tablets). The incision is closed with a suture followed by a sterile dressing.
special instructions
Before implantation, a course of gradual weaning of the patient from ethanol should be carried out.
The polyneuropathy that occurs when using the drug disappears with the appointment of B vitamins or the removal of implanted tablets.
A small tubercle often forms at the site of implantation due to fibrosis of the skin and subcutaneous fat.
In the case of simultaneous administration with oral anticoagulants, it is necessary to more frequently monitor the content of prothrombin and adjust the doses of anticoagulants, which is associated with an increased risk of bleeding.
Interaction
Effects (including neurotoxic) enhance tricyclic antidepressants (amitriptyline), metronidazole, isoniazid; reduces ascorbic acid (reaction to ethanol).
Increases the plasma concentration of drugs metabolized in the liver due to inhibition of microsomal oxidation.
Enhances the toxic effects of antipyrine, phenytoin, chlordiazepoxide and diazepam by inhibiting their metabolism.
Isoniazid increases the risk of behavioral and motor coordination disorders.
Phenytoin increases the risk of side effects, metronidazole - the risk of mental disorders, delirium.
Enhances the effect of indirect anticoagulants and increases the risk of bleeding.
Reviews about the drug Teturam: 1
I bought a large batch of teturam and kolma at the pharmacy without a prescription. There was such a situation this is the 10th grade and in our class everyone drank for the holiday, each girl drank champagne on New Year's Eve out of 10 girls in class 2 drank once a week 2 sometimes quite a lot. Another 5 drank only on holidays and there were not so few of these holidays a year 9 cl NG, 3-4 DR of their girlfriends, a couple of other guys, graduation, March 8 - and that is about 8 holidays a year, they are not embarrassed they said that on these holidays they drank a couple, pay attention to a COUPLE, and not 1 glass of champagne, sometimes wine, in most cases, 2 glasses or even 3 (600 ml of wine) a couple of times. 2 more also drank only a little bit 1 of these 2 drank a glass of champagne on New Year's Eve and others of her girlfriend and boyfriend, and that turned out 3-4 times a year, and maybe a little wine. 2-I drank very little, but on NG I didn’t hesitate to drink a glass of champagne and on my 17th birthday with my friends I succumbed to the persuasion to drink a little wine, about a glass. But the 10th didn’t drink at all and didn’t talk much with guys and her communication was limited to school and conversations on everyday topics with the class (but she wasn’t a clear outsider in the team), she didn’t go out and spent all the time at home with her 3-year-old sister and mother, but from 10 class, she wanted to grow up at least a little and her desire was noticed by a couple of guys and 1 girl. This was manifested in the fact that this girl tried to communicate with everyone not as a girl, but as a girl. And she became close with these 3 girls, she was one of those 5 and she talked with a little crazy girl and she herself drank 10 times a year, 2 glasses. And I also sideways got into this company, I realized that they would persuade her to drink a little on NG and I treated them almost every school day to lemonade with tetraam and colma in a double dose, and now NG persuaded her to drink a sip of shampoo, she took a sip, but no more gave up, saying that it was somehow unusual for me to take 1 sip, but then after about a month this new girlfriend of hers had a DR and she was persuaded to drink a glass of wine and the trio herself drank glasses of 3 wines and shampoo (in NG current according to glass) - and after that my object became ill, but not much - she was a little bit sick of weakness and a strong aversion to champagne, and the trio from about half a bottle of champagne had such a waste as if from 2 glasses of funka for each to her girlfriend the next day, an ambulance even came and the doctor was surprised that she drank only 2 glasses of wine and half a glass of champagne, which she could not finish, and concluded that it was scorched and punished, if you don’t want this, don’t drink at all. Then, with even greater force, I began to give them tetraam and colme to drink, and during this period only 1 time out of 2 boys tried to drink 1 jaguar and got the most unpleasant sensation, but without acute poisoning. But here is the last call, and here they took expensive champagne and thinking that this would help in the evening, they decided to celebrate at least a little, there were 2 bottles of champagne for 4 and got exactly the same as on the other current, my object drank a glass and a half and she became very ill the pace rose to 39, her hands were shaking a lot and there was such an aversion to champagne that for 2 years she hadn’t even drank even a small sip NOT ONCE, but they endured all this 4 in the guy’s apartment until the next day (there was no one at home ) and they went to him like to spend the night with a friend. I sometimes give it to them now, in order to maintain the effect, mainly to her. My object now doesn’t drink principally all his life and doesn’t know why it happened to her that she couldn’t drink at all, and even those 3 also very rarely quit along the way.
- a popular drug for the treatment of alcohol dependence, produced in the form of tablets with the active ingredient disulfiram. It increases the concentration of acetaldehyde, a breakdown product of alcohol, causing a lot of unpleasant symptoms after drinking alcohol: nausea, vomiting, hypotension, asthenia, chills. The material is devoted to analogues of "Teturam" with the same active substance or with a similar pharmacological action, as well as over-the-counter analogues.
Release form: pills.
Active substance: disulfiram, 1 tablet 150 mg, 30 tablets per pack.
Price: from 168 rubles
Prescription analogues
Analogues with the same active substance
Preparations that do not differ in composition from teturam, but differ in the amount of active substance and the form of release.
Release form: pills.
Active substance: disulfiram; in the 1st tablet 500 mg; in a package of 20 tablets.
Price: from 1472 rub.
Release form: effervescent tablets for dilution in water.
Active substance: disulfiram; in the 1st tablet 400 mg; in a package of 50 tablets.
Price: from 587 rub.
It has more pronounced side effects compared to teturam.
Release form: pills.
Active substance: disulfiram 500 mg, nicotinamide (vitamin B 3) 300 mcg, adenine (vitamin B 4) 500 mcg in 1 tablet; in a package of 20 tablets.
Price: from 1585 rub.
The use of disulfiram together with vitamins B 3 and B 4 enhances the effect of the drug after taking alcohol. But at the same time, it reduces the toxicity of disulfiram, so Lidevin is an analogue of Teturam with fewer side effects.
Analogues with a similar clinical effect
Drugs containing other active substances, but a similar effect of aversion to alcohol
Release form: drops.
Active substance:
Price: from 4250 rub.
It works similarly to disulfiram-based drugs (increases the level of acetaldehyde in the blood, which leads to a deterioration in well-being after drinking alcohol), but does not lead to a decrease in blood pressure, so the side effects are not as strong. Because Since this analogue of "Teturama" is produced in liquid form, the process of absorption into the blood takes less time and the effect of taking it will be visible already 60 minutes after taking it (as opposed to 12 hours after taking "Teturama").
Updated: Kolme has been out of production since 2017. Analogues of the drug are listed in.
Release form: drops.
Active substance: cyanamide, 15 ml in one ampoule, 4 ampoules in a package.
Price: from 2200 rub.
The drug is similar to the drops of "Colma".
Analogues with other clinical effects
Release form: tablets, solution for injections.
Active substance: metadoxine, 500 mg per 1 tablet, 30 tablets per pack; 300 mg of metadoxine in 5 ml of solution.
Price: from 1335 rub.
Helps to get rid of the withdrawal syndrome (withdrawal syndrome). Acts as a hepatoprotective agent: accelerates the removal of acetaldehyde from the body. Relieves hangover symptoms.
OTC analogues
Drugs in this category do not cause aversion to alcohol (as Teturam does), but they help to cope with a hangover syndrome and significantly reduce the harm caused to the body by ethanol. And most importantly, they are sold without a prescription.
Release form: granules.
Active substance: glucose monohydrate 17.5 g, sodium formate 3.5 g, glycine 7 g in 2 bags, 1, 7 or 21 bags in a package.
Promotes the removal of toxic aldehydes from the body, removing signs of ethanol poisoning.
Price: from 320 rub.
Release form: drops, lozenges.
Active substance: antibodies to the brain-specific protein S-100; 1 g in 100 g drops, 3 mg in the 1st tablet; in a package of 20, 40 or 100 tablets and 25 ml in a bottle in the form of drops.
Price: from 243 rub.
Normalizes the synthesis of the neuronal membrane, restoring the functions of the brain structure. It does not allow the formation of alcohol dependence with the constant use of alcohol.
Release form: powder for dissolving in water, drops.
Active substance: fibregam, pyridoxine, artichoke extract, motherwort extract, succinic acid.
Price: from 990 rub.
Promotion for : discount 50%
Go to the official site
The product is certified
To develop an aversion to alcohol, doctors use the drug Teturam, which, when interacting with even a small amount of alcohol, causes convulsions, dilates blood vessels and leads to nausea. The use of the drug is justified in cases of treatment of alcoholism. The principle of the drug is that it inhibits the acetaldehyde dehydrogenase enzymes involved in the metabolism of ethanol.
The drug based on the substance disulfiram enjoys well-deserved popularity and can bring real benefits, subject to the rules of use. The action of the drug is based on the principle of "knock out with a wedge", so it should be used with caution, following the instructions. You need to realize that Teturam contributes to a short-term strong intoxication of the body, which creates a conditioned reflex in the drinker: alcohol is pain and suffering. The drug is able to influence the behavior of the addict much more than the persuasion of loved ones.
Related articles Pills for alcohol addiction Coding drugs for alcohol addiction Pills for alcohol addiction without the knowledge of the patient
Composition and form of release
The drug is produced in the form of tablets having a flat-cylindrical shape. The color of the drug is white, sometimes with a yellow-greenish tint, there is no smell. The drug is intended for oral administration. Tablets are packaged in blisters, which are placed in cardboard boxes for sale through pharmaceutical networks. The volume of the active substance can be 100, 150, 200 mg.
Pharmacodynamics and pharmacokinetics
The agent affects the metabolism of ethyl alcohol that has entered the body, as a result of which the concentration of toxic decomposition products of alcohol in the tissues increases. A person begins to feel a flush of blood to the face, the urge to nausea (possible complications, reaching vomiting), changes in blood pressure. The peak of the therapeutic effect is reached after 12 hours after ingestion and can last up to two weeks.
Absorption of the drug in the stomach and intestines is at least 70% and can reach up to 90%. In the process of metabolism, which occurs in a short time, Teturam is reduced to dithiocarbamate, which is excreted from the body in the form of glucuron conjugate. Part of the dithiocarbamate can be transformed into diethylamine and carbon sulfite, which can be excreted through the lungs, the rest is excreted in the urine.
Indications for use
The tool is used as an effective method for the prevention of chronic alcoholism. Teturam can be used as a drug that guarantees the absence of relapses during the main treatment with other specific methods. The tool can be used by relatives both in secret from an alcoholic, and used by a drinker consciously. The active substance of Teturama - disulfiram is an antidote for nickel, for this reason it is permissible to use the agent for detoxification in case of poisoning with this metal.
Method of application and dosage
According to the instructions, Teturam is taken orally by mouth. Dosages should be in the range of 150-500 mg per day. The specific dosage and regimen are determined individually by the narcologist, depending on the patient's condition. After 8-10 days, an experimental test for the action of the agent is carried out. The test produces a psychological effect. After taking the pill, the patient is given 30 mg of vodka. The strength of the reaction is a dosage adjustment factor. After the revision, a second test is carried out after 3-4 days. The maintenance dose is 150-200 mg per day.
How to take Teturam on your own
Often the drug is used by patients on their own or through loved ones. This is an acceptable practice, but it must be preceded by a mandatory consultation with a doctor with the appointment of a regimen. The doctor has knowledge of the risks of using the drug against the background of the patient's pathologies and health status. Neglecting these factors can be harmful. According to doctors, 1-3 tablets per day (150-450 mg) are prescribed. The process of admission should be accompanied by periodic supervision by a doctor.
The duration of the course of treatment
The duration of the main course of therapy is 4-6 weeks. The maintenance dose can last from one to three years. The decision on specific timing should be made by the responsible doctor. The individual characteristics of the patient have a decisive influence on the period of treatment. The duration and reliability of therapy largely depend on the complexity of the approach. Measures for the patient's social adaptation reinforce the effect achieved with Teturam. Possible implantation of tablets.
Teturam and alcohol
The therapeutic effect is achieved by suppressing the ability of the liver to produce acetaldehyde dehydrogenase, an enzyme that stops the breakdown of alcohol to water and carbon dioxide at the intermediate stage of acetaldehyde. This substance is a toxic poison, which is 20-30 times stronger than alcohol in terms of negative effects. The concentration of acetaldehyde accumulates in the tissues and causes a number of manifestations in a person under alcohol dependence, as a result of which he is forced to stop the process of drinking alcoholic beverages.
drug interaction
Teturam tablets cannot be combined with certain drugs due to the manifestation of negative reactions. Example of combinations and effects:
- according to reviews, anticoagulants, coumarin derivatives, warfarin increase the risk of bleeding;
- disulfiram disrupts the metabolism of liver enzyme inhibitor drugs;
- tricyclic antidepressants, phenothiazine derivatives increase the risk of side effects;
- Buspirone can cause mania when combined with Teturam;
- the drug reduces the clearance of Desipramine, Imipramine;
- Amitriptyline enhances the therapeutic effect of the drug, but the toxicity of the drug itself increases in parallel;
- Disulfiram increases the plasma concentration of Diazepam and Chlordiazepoxide, their administration is accompanied by dizziness, Diazepam also reduces the intensity of the reaction with ethanol, there are cases of increased toxicity of Temazepam;
- Isoniazid can cause dizziness, depression, caffeine - a decrease in excretion from the body, Metronidazole - acute psychosis and confusion, Omeprazole - impaired consciousness and catatonia;
- Perphenazine can lead to psychotic symptoms;
- Disulfiram inhibits the metabolism and excretion of Rifampicin, increases the withdrawal period of Phenazone, enhances the effect of Phenytoin, increases the concentration of Chlorzoxazone, enhances the effect of arterial hypotension Chlorpromazine.
Side effects of Teturama
The most common side effect of the drug is a teturam-like effect (total alcohol intolerance due to alcohol biotransformation), which cannot be considered an achievement, since alcohol in minimal doses is produced by the human body by default. Other negative reactions from taking the medication are:
- metallic taste in the mouth, hepatitis, confusion;
- polyneuritis of the lower extremities, memory disorders, headache;
- neuropsychiatric abnormalities, allergic reactions in the form of skin rash and itching;
- collapse due to the use of alcohol, heart rhythm disturbances, angina pectoris, myocardial infarction, cerebral edema.
Contraindications
The use of Teturam for alcoholism is prohibited for certain groups of patients with specific conditions, as well as those undergoing therapy with certain drugs:
- severe course of cardiovascular diseases;
- diabetes;
- epilepsy;
- neuropsychiatric diseases;
- combination with alcohol, phenytoin, isoniazid, metronidazole;
- pregnancy, lactation, liver disease;
- hypersensitivity to components.
Terms of sale and storage
The medicine Teturam is dispensed by prescription, stored for four years, provided that the temperature regime is not higher than 25 degrees.
Teturam analogue
It is acceptable to use analogs of a drug that have an identical active substance or have a similar pharmacological effect. Analogues of the drug are presented below:
- Esperal;
- disulfiram;
- Antabuse;
- Tetlong;
- Alcodez;
- Liveria;
- Antakson;
- Vivitrol;
- Naltrex;
- Naltrexin;
- Biotredin;
- Colme;
- Naxon.
Teturam price
When buying Teturam, it is recommended to check the price monitoring, in different pharmacies and pharmaceutical chains, the drug is sold at different prices. The price level of the drug depends on the manufacturer and the seller's margin. The average prices for the drug are indicated in the table.
