Disulfiram Use in Patients With Abnormal Liver Function Test Results

Background: Concern about the precipitation of severehepatitis by disulfiram often causes clinicians to avoid usingthis effective treatment in patients who have elevated baselinetransaminase levels, even though no empirical evidence has so farshown severe hepatotoxicity to be related to such laboratoryabnormalities. This study examines the effects of disulfiram inalcohol-dependent patients with elevated liver function testresults and/or serologic evidence of hepatitis C virus (HCV)infection.

Method: Hepatitis serologies and baselinetransaminase levels were obtained for 57 male alcoholics startingtreatment with disulfiram. Sequential liver function test resultswere obtained for up to 12 weeks while subjects took disulfiram.

Results: Although subjects with elevatedbaseline transaminase levels and serologic evidence of HCVinfection were the most likely to evidence marked elevations intransaminase levels while taking disulfiram, most subjects tookdisulfiram without other adverse consequences. In only 1 subjectdid elevations appear directly related to disulfiram.

Conclusion: Monitoring of liver function testresults is warranted for patients taking disulfiram and permitsmost patients with moderately elevated transaminase levels totake it safely.