Which drug requires avoidance of alcohol due to a disulfiram reaction?

The drug that requires avoidance of alcohol due to a disulfiram-like reaction is Flagyl, commonly known as metronidazole. When ingested with alcohol, metronidazole can lead to unpleasant and severe reactions, including flushing, nausea, vomiting, palpitations, and abdominal cramps. This occurs because metronidazole interferes with the normal metabolism of alcohol in the body, similar to the medication disulfiram, which is used to help people abstain from alcohol.

The mechanism behind this reaction involves the accumulation of acetaldehyde, a toxic byproduct of alcohol metabolism; normally, this substance is quickly broken down. Metronidazole inhibits the enzyme responsible for this breakdown, leading to heightened levels of acetaldehyde in the system. This can produce significant discomfort and health risks, so patients taking metronidazole are strongly advised against consuming alcohol during treatment and for at least 48 hours after stopping the medication.

Other drugs listed, such as Vibramycin (doxycycline), Clindamycin, and Lincocin (lincomycin), do not have the same interaction with alcohol and do not require such strict avoidance. Thus, metronidazole stands out as the correct choice due to its potential for