Antabuse drug to stay off alcohol no longer available, a 'disaster' for alcoholics

Antabuse drug to stay off alcohol no longer available, a 'disaster' for alcoholics
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Pharmaceutical company Sanofi is stopping its worldwide production of 'Antabuse', a drug that helps about 10% to 15% of (recovering) alcoholics in Belgium not to drink by making them sick if they do.

Antabuse stops a person's body from breaking down the ethanol in alcoholic beverages: anyone who takes the drug and still drinks alcohol gets ill from the very first sip, resulting in headaches, nausea and even vomiting. Though unsavoury, the treatment is an effective means of blocking consumption.

"By taking Antabuse, alcoholics know that they cannot drink that day. It removes the constant internal discussion," Frieda Matthys, professor of Psychiatry at the Vrije Universiteit Brussel (VUB), who specialises in addictions, told VRT. "The drug provides peace of mind and for some is the difference between functioning or relapse. For them, this is a disaster."

There are no exact figures on the number of Antabuse users in Belgium as producer Sanofi does not disclose sales figures. Still, several tens of thousands of patients need the drug in the course of their trajectory, according to the Flemish Expertise Centre for Alcohol and Other Drugs (VAD).

Stock shortages and nitrosamine

Sanofi is reportedly taking the drug off the market following stock shortages, long-term supply issues with the raw compound with which Antabuse is made (disulfiram), and likely also commercial interests, according to VAD psychiatrist Hendrik Peuskens.

"The drug has been available for a long time at a low price," confirmed Matthys. "Pharmaceutical companies are not allowed to set that price themselves. Perhaps its low-profit production was no longer interesting for Sanofi."

In a written response to VRT, Sanofi said that the company already recalled all Antabuse (disulfiram 400 mg) packaging from the market in December 2022 – at the request of Belgium's Federal Agency for Medicines and Health Products (FAMHP).

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This decision was made as Antabuse is said to contain high concentrations of the carcinogenic substance nitrosamine, which is a contaminant that can unintentionally be created when making certain products, including pharmaceuticals. Some nitrosamines can become carcinogenic after prolonged exposure.

On 13 March 2023, Sanofi published the decision to no longer manufacture the drug. Now, in close cooperation with health authorities, the company is taking steps to ensure the safety and well-being of the patients.

Those looking for an alternative have two options, said Koen Straetmans of the General Pharmaceutical Association (APB): in consultation with a GP, people can switch to an alternative drug with a different active substance, or they can have a similar medicine delivered through the pharmacist from the Netherlands, produced by other manufacturers (10-21 days waiting time).

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