Chlorpropamide ? alcohol flush: the case in favour

Johnston, C.F.; Wiles, Philip; Pyke, D A

doi:10.1007/bf00252253

Cited by 12 publications

(6 citation statements)

References 32 publications

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“…Uncertainty exists on how chlorpropamide-alcohol flushing is best tested for, or its mechanism, its possible inheritance and its association with a relative freedom from diabetic vascular diseases (Johnston et al 1984). Uncertainty exists on how chlorpropamide-alcohol flushing is best tested for, or its mechanism, its possible inheritance and its association with a relative freedom from diabetic vascular diseases (Johnston et al 1984).…”

Section: Chlorpropamide-alcohol Flushmentioning

confidence: 99%

Adverse Cardiovascular Effects of Sulphonylurea Drugs

Huupponen

1987

Medical Toxicology

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Sulphonylureas are widely used in the treatment of diabetes mellitus. Since the publication of the University Groups Diabetes Program (UGDP) results the discussion on their possible cardiovascular side effects has been lively and sometimes even passionate. The initial UGDP findings about the adverse effects of tolbutamide on the cardiovascular system have been criticised, particularly for shortcomings in the study design. The results of other epidemiological studies of the sulphonylurea effects on cardiovascular morbidity and mortality published this far have been contradictory. This is understandable because the factors involved are very complex. Most of these studies have used tolbutamide only, and the findings cannot necessarily be directly extrapolated to other sulphonylureas. Only properly performed prospective studies may provide further information on this issue. High concentrations of several sulphonylureas may have inotropic effects on heart muscle in in vitro animal models, but human studies performed in vivo do not support the view of clinically significant inotropy for sulphonylureas. High concentrations of tolbutamide or glibenclamide (glyburide) may affect the myocardial metabolism in isolated organs, but the possible clinical significance of these findings remains unknown. Some epidemiological and experimental studies have associated oral antidiabetic treatment with the occurrence of cardiac arrhythmias or increased digitalis toxicity. Only a few results are available, and there may be differences between the sulphonylureas in this respect. Antiaggregatory properties have been postulated for some sulphonylureas. Gliclazide, in particular, has been studied, but some other compounds of this class have also been effective in short term studies. If confirmed, these effects on haemostasis would be noteworthy. The sulphonylurea effects on serum lipids, especially on HDL-cholesterol, have been discussed widely during the last few years. Decreases in HDL-cholesterol concentrations were suggested to be associated with sulphonylurea therapy. However, these findings were not confirmed in recent cross-sectional and longitudinal studies performed with different sulphonylureas. Chlorpropamide, and to a lesser extent tolbutamide, may cause dilutional hyponatraemia and aggravate existing heart failure. Glibenclamide may increase the clearance of water in the kidney.

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Section: Chlorpropamide-alcohol Flushmentioning

confidence: 99%

Adverse Cardiovascular Effects of Sulphonylurea Drugs

Huupponen

1987

Medical Toxicology

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“…Disulfiram-like reactions have also been reported with concomitant use of chlorpropamide and alcohol [7,55,56]. Chlorpropamide decrease the activity of aldehyde dehydrogenase [48].…”

Section: Other Disulfiram-like Reactions Inducersmentioning

confidence: 99%

Alcohol-Medication Interactions: The Acetaldehyde Syndrome

Oliveira¹

2014

J Pharmacovigil

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Medications that inhibit aldehyde dehydrogenase when coadministered with alcohol produce accumulation of acetaldehyde. Acetaldehyde toxic effects are characterized by facial flushing, nausea, vomiting, tachycardia and hypotension, symptoms known as acetaldehyde syndrome, disulfiram-like reactions or antabuse effects. Severe and even fatal outcomes are reported. Besides the aversive drugs used in alcohol dependence disulfiram and cyanamide (carbimide), several other pharmaceutical agents are known to produce alcohol intolerance, such as certain anti-infectives, as cephalosporins, nitroimidazoles and furazolidone, dermatological preparations, as tacrolimus and pimecrolimus, as well as chlorpropamide and nilutamide. The reactions are also observed in some individuals after the simultaneous use of products containing alcohol and disulfiram-like reactions inducers. Depending on the pharmacological inducer, reactions may occur several days after treatment completion. Disulfiram-alcohol reaction includes moderate decrease in blood pressure, but severe life-threatening arterial hypotension and shock sometimes develop. Myocardial infarction secondary to disulfiram-alcohol reaction has been also reported. For severe hypotension resulting from a disulfiram-ethanol reaction, adrenaline or noradrenaline have been employed as the pressor agent of choice. Fomepizole, an alcohol dehydrogenase inhibitor, may be a safe and effective treatment of severe reactions. When medications that produce antabuse effects are prescribed or dispensed, patients should be instructed to avoid medicines and other products containing alcohol, such as syrups, fermented vinegar, sauces and lotions. It is essential that doctors, nurses and pharmacists instruct patients to avoid alcohol during treatment with aversive drugs and disulfiram-like reactions inducers. Likewise, even when scientific evidence is inconclusive, such instructions should be provided in leaflets, which are often the only source of information for patients and a guide for health professionals.

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“…[6,[15][16][17] Nilutamide, an antiandrogen also shows disulfiram-like reactions, manifested as skin rash and hot flashes. [7,18,19] …”

Section: Othersmentioning

confidence: 99%

Alcohol-medication interactions: A review

Nagaraj¹,

Saxena²,

Sahu³

et al. 2017

JMRPS

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Some medications when taken with alcohol cause accumulation of acetaldehyde by inhibiting aldehyde dehydrogenase (ALDH) enzyme. Acetaldehyde causes toxic effects in the body which are characterized by nausea, vomiting, facial flushing, hypotension and tachycardia, symptoms known as disulfiram-like reactions/antabuse effects or acetaldehyde syndrome. Alcohol interacts with many medications, thereby altering the metabolism of medications and/or alcohol. Alcohol dependence is an increasing and pervasive issue in today's world. Withdrawal symptoms of alcohol are because of dependence syndrome and are seen mostly in hospitals. The signs and symptoms of alcohol withdrawal syndrome can be mild to severe. The severe and complicated alcohol withdrawal may manifest as seizures, hallucinations and delirium tremens. This article aims to review various alcohol-medication interactions.

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Chlorpropamide ? alcohol flush: the case in favour

Cited by 12 publications

References 32 publications

Adverse Cardiovascular Effects of Sulphonylurea Drugs

Adverse Cardiovascular Effects of Sulphonylurea Drugs

Alcohol-Medication Interactions: The Acetaldehyde Syndrome

Alcohol-medication interactions: A review

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