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.
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