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.