Disulfiram-like reactions have been seen in patients taking cefamandole, cefmenox- ime, cefoperazone, cefotetan, latamoxef (moxalactam) and possibly cefonicid after drinking
alcohol or following an injection of
alcohol. This is not a general reaction of the cephalosporins, but is confined to those with particular chemical structures. Due to their structure ceforanide, cefotiam, and cefpiramide also present a risk. Other
cephalosporins are not expected to interact.
The reaction appears normally to be more embarrassing or unpleasant and frightening than serious, with the
symptoms subsiding spontaneously after a few hours. Treatment is not usually needed although two elderly patients needed treatment for hypotension. Patients taking the interacting
cephalosporins should be advised to avoid
alcohol during treatment and for up to 3 days (7 in the presence of
renal or
hepatic impairment) after treatment is finished.