Teturam (Teturam)

Composition Pharmacodynamics Indications Carefully Contraindications Dosing and Administration Side effects Form release / dosage
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Active substanceDisulfiramDisulfiram
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    • Dosage form: & nbspPills.
    Composition:
    Composition for the dosage of 150 mg:

    Active substance: Disulfiram (teturama) - 150 mg.

    Auxiliary substances: potato starch - 19.97 mg, calcium stearate - 0.601 mg, silicon colloidal dioxide (aerosil) - 9.429 mg.

    Composition for a dosage of 250 mg:

    Active substance: Disulfiram (teturam) - 250 mg.

    Auxiliary substances: potato starch - 33.283 mg, calcium stearate - 1.002 mg, silicon colloidal dioxide (aerosil) - 15.715 mg.
    Description:
    Tablets Teturam 150 mg - white or white with a slightly yellowish-greenish hue of color, round, flat-cylindrical shape with a facet; pills

    Teturam 250 mg - white or white with a slightly yellowish-greenish hue, round, flat-cylindrical with a facet and a risk.
    Pharmacotherapeutic group:An agent for the treatment of alcoholism
    ATX: & nbsp

    N.07.B.01.01   Disulfiram

    Pharmacodynamics:Disulfiram inhibits acetaldehyde dehydrogenase involved in the metabolism of ethanol; increases the concentration of acetaldehyde,which is a metabolite of ethanol and causes a number of unpleasant sensations after its use ("flushes" of blood to the skin of the face, nausea, vomiting, a feeling of malaise, tachycardia, lowering of blood pressure). As a result, a conditioned reflex reaction of aversion to taste and the smell of ethanol occurs. The duration of the drug is 48 hours.
    Pharmacokinetics:
    Absorption after oral administration is 70-90%. Rapidly metabolized in the liver by reduction to diethyl dithiocarbamate excreted as glucuronide by the kidneys, or transformed into diethylamine and carbon disulphide (the proportion of which varies from 4% to 53%). Carbon disulphide is secreted through the lungs.
    Indications:As part of a comprehensive therapy of alcoholism (behavioral therapy, psychotherapy, etc.). The drug is prescribed only if the patient wants to give up drinking alcohol at will.
    Contraindications:Hypersensitivity to the drug components, thyrotoxicosis, diseases of the cardiovascular system in the stage of compensation (including severe cardiosclerosis, cerebral artery atherosclerosis, pre- and post-infarction states,aortic aneurysm, ischemic heart disease, grade II arterial hypertension, chronic heart failure), pulmonary tuberculosis with hemoptysis, bronchial asthma, chronic obstructive pulmonary disease, erosive lesions of the gastrointestinal mucosa, peptic ulcer and duodenal ulcer in the stage of exacerbation), bleeding from the gastrointestinal tract, kidney disease, liver failure, diabetes mellitus, epilepsy, neuropsychic diseases, infectious diseases centrally nervous system, polyneuropathy, neuritis of auditory and optic nerves, glaucoma, malignant tumors, alcohol intoxication, pregnancy, lactation, children under 18 years.
    Carefully:Age over 60, peptic ulcer and 12 duodenal ulcer (at the stage of remission), endarteritis, residual phenomena of cerebral circulation, psychoses with disulfiram in the history.
    Pregnancy and lactation:Contraindicated.
    Dosing and Administration:
    Treatment is appointed after careful examination of the patient and warning of the consequences and complications.

    Usually Teturam treatment is carried out in several stages according to the following scheme. The drug is taken orally 150-500 mg 2 times a day.

    After 7-10 days from the start of treatment, the first disulfiram-alcohol test is carried out (20-30 ml 40% ethanol after taking 500 mg of the drug), with a weak reaction, the dose of alcohol is increased by 10-20 ml (the maximum dose of vodka is 100-120 ml).

    The sample is repeated after 1-2 days in the hospital and 3-5 days after an outpatient treatment with the correction of the doses of alcohol and / or the drug as needed. In the future, you can use a maintenance dose of 150-200 mg per day for 1-3 years.
    Side effects:
    "Metallic" taste in the mouth, unpleasant odor (due to carbon disulfide) in patients with colostomy, hepatitis, lower extremity polyneuropathy, neuropsychiatric disorders, memory loss, disorientation in time and space, asthenia, headache, skin allergic reactions.

    Side effects caused by the simultaneous use of disulfiram and the use of ethanol: cardiovascular collapse, arrhythmia, angina pectoris, myocardial infarction, cerebral edema, hemorrhagic stroke, described cases of respiratory failure (respiratory depression, meningeal bleeding, convulsions).

    At reception of doses of alcohol over 50-80 ml (in recalculation on 40% ethanol) on the background of taking the drug, severe disorders of the cardiovascular and respiratory systems develop, swelling, convulsions. In this case, urgently spend detoxication therapy, inject analeptics.
    Overdose:
    Symptoms: coma, collapse, neurological complications.

    We perform symptomatic treatment aimed at restoring and maintaining the functional state of the cardiovascular system, the respiratory system.
    Interaction:
    Contraindicated combinations:

    - Alcohol. The reaction of intolerance ("hot flashes" of blood, erythema, vomiting, tachycardia). Avoid taking alcohol and medications containing alcohol.

    Unwanted combinations:

    - Isoniazid. Violations of behavior and coordination.

    - The derivatives of nitroimidazole (metronidazole, ordinazole, secnidazole, tinidazole). Delirious disorders, confusion.

    - Phenytoin. Significant and rapid rise in the concentration of phenytoin in the plasma with toxic symptoms (suppression of its metabolism).

    If the combination can not be avoided, clinical observation and control of plasma disulfiram concentration should be performed during and after Teturam treatment.

    Combinations requiring caution:

    - Warfarin (and other indirect anticoagulants). The increased effect of indirect anticoagulants and the risk of bleeding (slowing metabolism of warfarin in the liver). It is recommended more frequent monitoring of the concentration of warfarin and correction of the dose of anticoagulants within 8 days after the abolition of Teturam.

    - Theophylline. Disulfiram inhibits theophylline metabolism. As a result, the dose of theophylline should be reduced, depending on the clinical symptoms and the concentration of the drug in the plasma.

    - Benzodiazepines. Teturam may potentiate the sedative effect of benzodiazepines by inhibiting their oxidative metabolism (especially chlordiazepoxide and diazepam). The dose of benzodiazepine derivatives should be adjusted in accordance with clinical manifestations.

    - Tricyclic antidepressants. Reinforcing the reaction of alcohol intolerance, if patients treated with Teturam, take alcohol.
    Special instructions:
    Patients should be warned about the dangers of alcohol intolerance reaction.

    Teturam should be taken with caution in patients with renal insufficiency or hypothyroidism, especially at the risk of a possible combination with alcohol.Polyneuropathy, which occurs when the drug is used, disappears when the group B vitamins are prescribed.

    In the case of simultaneous use with indirect anticoagulants, it is necessary to carry out more frequent monitoring of the international normalized ratio and correction of anticoagulant doses, which is associated with an increased risk of bleeding. Before using the drug, it is necessary to completely eliminate the abstinence phenomena.

    For 1-3 days, you should completely cancel the use of hypnotics, tranquilizers, antidepressants and antipsychotics.
    Effect on the ability to drive transp. cf. and fur:Teturam is contraindicated during the work of transport drivers and other persons performing work requiring quick reactions, precise movements and concentration of attention.
    Form release / dosage:Tablets of 150 mg and 250 mg.
    Packaging:10 tablets per contour cell pack. 3 or 5 contour packs together with instructions for use are placed in a cardboard pack.
    Storage conditions:Store in a dry, dark place at a temperature of no higher than 25 ° C. Keep out of the reach of children.
    Shelf life:4 years. Do not use the product after the expiry date printed on the package.
    Terms of leave from pharmacies:On prescription
    Registration number:LS-000503
    Date of registration:24.05.2010/02.10.2012
    The owner of the registration certificate:TATHIMFARMPREPARATY, JSC TATHIMFARMPREPARATY, JSC Russia
    Manufacturer: & nbsp
    Information update date: & nbsp24.04.2016
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