Which antibiotic can cause a disulfiram-like reaction with alcohol?

Which antibiotic can cause a disulfiram-like reaction with alcohol?

• A. Azithromycin
• B. Metronidazole
• C. Doxycycline
• D. Clarithromycin

Answer: (B)

A disulfiram-like reaction happens when certain drugs interfere with how the body metabolizes alcohol, causing a buildup of acetaldehyde which produces flushing, nausea, vomiting, headache, dizziness, palpitations, and sometimes low blood pressure. Metronidazole is the antibiotic most classically linked to this interaction. When alcohol is consumed during or shortly after metronidazole therapy, these unpleasant symptoms can appear because the drug inhibits aldehyde dehydrogenase, slowing acetaldehyde clearance. Because of this, avoid alcohol during treatment and for about a day or two after the last dose. Other antibiotics listed—azithromycin, doxycycline, and clarithromycin—do not have a disulfiram-like interaction with alcohol, so they don’t carry this same risk.

A disulfiram-like reaction happens when certain drugs interfere with how the body metabolizes alcohol, causing a buildup of acetaldehyde which produces flushing, nausea, vomiting, headache, dizziness, palpitations, and sometimes low blood pressure. Metronidazole is the antibiotic most classically linked to this interaction. When alcohol is consumed during or shortly after metronidazole therapy, these unpleasant symptoms can appear because the drug inhibits aldehyde dehydrogenase, slowing acetaldehyde clearance. Because of this, avoid alcohol during treatment and for about a day or two after the last dose. Other antibiotics listed—azithromycin, doxycycline, and clarithromycin—do not have a disulfiram-like interaction with alcohol, so they don’t carry this same risk.