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We all know that you can't drink alcohol when you take the class of medications called cephalosporins, and that you may experience serious conditions (disulfiram-like reactions) when you drink alcohol. So exactly which cephalosporins should not be drunk after taking them?

First, understand the disulfiram reaction:

Disulfiram is actually a drug whose real purpose is an alcohol withdrawal drug, and when you take the drug and then drink alcohol, your body will have a severe reaction to the withdrawal.

Disulfiram reaction: some drugs, if drinking alcohol after taking, a series of reactions similar to disulfiram after drinking, such as facial flushing, conjunctival congestion, blurred vision, headache, dizziness, nausea, vomiting, sweating, dry mouth, chest pain, and even infarction, acute heart failure, respiratory distress, acute liver injury, convulsions and death.

In some people, even applying a small amount of something containing alcohol can cause a disulfiram-like reaction after taking such medications, such as alcohol-containing chocolates, patchouli, and treating the skin with alcohol.

Second, cephalosporins are the most common drugs that cause disulfiram-like reactions.

Cefoperazone, cefoperazone sulbactam, ceftriaxone, cefazolin, ceftazidime, ceftaridine, cefradine, cefmetazole, cefminox, radox cephalosporin, cefmetazole, cefamandole, cefadroxil, cefadroxil, cefadroxil, and cefaclor can cause disulfiram-like reactions. Among them, cefoperazone is the most sensitive and most reported.

Cefotaxime, cefsulodine, cefazodime, and cefixime do not cause disulfiram-like reactions when alcohol is consumed during application.

For everyone, even doctors, are not always sure if certain medications cause disulfiram-like reactions, so read the instructions carefully before taking the medication, and it is recommended that you don't drink alcohol for 5 days after taking antibiotic medications.

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We are more familiar with the application of cephalosporin antibiotics at the same time can not drink alcohol, cephalosporin antibiotics are the main drugs that cause disulfiram-like reaction, accounting for about 89.55% of all the drugs that can cause disulfiram-like reaction, of which cefoperazone to cause disulfiram-like reaction is the most and the most sensitive, accounting for about 51.54% of all the cephalosporin class of drugs. And cephalosporins are a large class of antibiotics, we will have questions, whether to eat all the cephalosporins can not drink alcohol or take alcohol-containing food?

It depends critically on what structure the cephalosporins that can cause a disulfiram reaction contain. Cefoperazone, cefminox, cephalexin, cefmenoxime, cefamandole, cefmetazole in its parent nucleus 7-amino cephalosporanic acid (7-ACA) ring in the third position contains N-methyl thiotetrazole (N-MTZ) group, the group and the molecular structure of the bisulfite similar to the coenzyme Ⅰ competition for the active center of the enzyme dehydrogenase of acetaldehyde, which can prevent the oxidation of acetaldehyde continues to lead to the accumulation of acetaldehyde, which can lead to the withdrawal of the thiomorphism reaction. reaction. It should be noted that cephalosporins that do not contain N-MTZ but contain methylthiozine side chain, such as ceftriaxone and cefazolin, have also been reported to occur disulfiram reaction, and it was found that it may be related to the methylthiozine side chain in the molecular structure of the drug, or these drugs are metabolized to produce products similar to the N-MTZ moiety in vivo, which can inhibit the metabolism of acetaldehyde.

Then cephalosporins that do not contain N-MTZ group or methylthiotriazine side chain, such as cefotaxime, cefazoxime, cefixime, ceftazidime, cefathiamidine, theoretically speaking, simultaneous consumption of alcohol will not produce a disulfiram reaction, of which cefathiamidine is a new drug developed domestically and is not in use internationally, and there is no foreign data on ADR, which needs to be noted. Once disulfiram reaction occurs, the clinical manifestations of patients are usually flushing, conjunctival congestion, blurred vision, restlessness, chest tightness, palpitations, shortness of breath, sweating, nausea and vomiting, abdominal pain, and in severe cases, blood pressure can drop or even shock, and death may occur in a short period of time! In addition to this, due to the accumulation of acetaldehyde in the body, and acetaldehyde has myocardial toxicity and arrhythmogenic effect, resulting in accelerated heart rate, increased myocardial oxygen consumption, shortening of myocardial diastole, coronary artery blood flow reduction, thus causing the occurrence of cardiac arrhythmia. It is therefore recommended that you try not to drink alcohol or alcoholic foods while being given cephalosporin antibiotics to reduce the risk of disulfiram reactions.

Clinical Pharmacist: Tianxin Hu

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