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March 22, 1971

Alcohol in Cough Medicines Hazard to Disulfiram User

JAMA. 1971;215(12):1988-1989. doi:10.1001/jama.1971.03180250080032

To the Editor.—  The use of disulfiram (Antabuse) as an adjunct to alcoholism treatment programs is well known in this country, and may be increasing.1 The minimal dose of alcohol necessary to evoke a reaction in the disulfiram treated patient is somewhat controversial,2 although it has been suggested that as little as 7 ml of alcohol may cause typical reactions.3 Thus, in disguised forms, alcohol could represent a serious hazard for patients receiving disulfiram. Our experience with a patient who had a disulfiram-alcohol reaction following the ingestion of a single dose of an over-the-counter, widely advertised cough medication, containing 25% alcohol, serves to emphasize the dangers of alcohol-containing preparations in these unique patients.

Report of a Case.—  The patient, a 46-year-old white man, was admitted to the hospital because of the abrupt onset of nausea, vomiting, and flushing of several hours' duration. He had been a heavy