A disulfiram-like reaction has occurred in a few patients taking oral metronidazole who drank alcohol. There is one report of its occurrence when metronidazole was applied as a vaginal insert, and another when metronidazole was given intravenously. The interaction is alleged to occur with all other 5-nitroimidazoles (e.g. tinidazole).
This interaction has been extensively studied but it remains slightly controversial because the incidence has been reported as between 0 and 100%. Because of its unpredictability all patients given metronidazole should be warned what may happen if they drink alcohol. The reaction, when it occurs, normally seems to be more unpleasant and possibly frightening than serious, and usually requires no treatment, although rarely fatalities have occurred.
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