{"id":56749,"date":"2024-02-27T17:06:24","date_gmt":"2024-02-27T17:06:24","guid":{"rendered":"https:\/\/medsname.com\/cronotol\/"},"modified":"2026-05-01T10:49:13","modified_gmt":"2026-05-01T10:49:13","slug":"cronotol","status":"publish","type":"product","link":"https:\/\/medsbase.com\/el\/cronotol\/","title":{"rendered":"Cronotol"},"content":{"rendered":"

<\/p>\n

\n

⚡ Quick Answer — Cronotol — disulfiram 500 mg for alcohol use disorder<\/h3>\n

Cronotol is disulfiram 500 mg — the higher loading-dose strength used in the first 1–2 weeks of therapy. It blocks aldehyde dehydrogenase, so any alcohol consumed produces acetaldehyde build-up and the unpleasant disulfiram–ethanol reaction (flushing, nausea, palpitations, hypotension). It works by deterrence, not craving reduction. You must be alcohol-free for at least 12 hours before the first dose.<\/strong> Best paired with supervised dosing and behavioural support.<\/p>\n<\/div>\n

\n\u0391\u03c5\u03c4\u03cc \u03c0\u03bf\u03c5 \u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03b5\u03c4\u03b5 \u03bc\u03b5 \u03c4\u03b7\u03bd MedsBase:<\/strong> \u03a0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03b7\u03bc\u03ad\u03bd\u03bf\u03c2 \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ae\u03c2 WHO-GMP \u00b7 \u0394\u03b9\u03b1\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u00b7 \u03a0\u03b1\u03b3\u03ba\u03cc\u03c3\u03bc\u03b9\u03b1 \u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae \u00b7 1,400+ \u03b5\u03c0\u03b1\u03bb\u03b7\u03b8\u03b5\u03c5\u03bc\u03ad\u03bd\u03b5\u03c2 \u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ad\u03c2 \u03c0\u03b5\u03bb\u03b1\u03c4\u03ce\u03bd<\/a>\n<\/div>\n

\ud83d\udce6 \u039a\u03ac\u03b8\u03b5 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03ba\u03b1\u03bb\u03cd\u03c0\u03c4\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd \u03a0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae \u0395\u03b3\u03b3\u03cd\u03b7\u03c3\u03b7\u03c2 \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2<\/strong><\/a> \u2014 \u03b5\u03ac\u03bd \u03c4\u03bf \u03b4\u03ad\u03bc\u03b1 \u03c3\u03b1\u03c2 \u03b4\u03b5\u03bd \u03c6\u03c4\u03ac\u03c3\u03b5\u03b9 \u03b5\u03bd\u03c4\u03cc\u03c2 20 \u03b5\u03c1\u03b3\u03ac\u03c3\u03b9\u03bc\u03c9\u03bd \u03b7\u03bc\u03b5\u03c1\u03ce\u03bd, \u03c4\u03bf \u03b5\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03c5\u03bc\u03b5.<\/p>\n

\u0393\u03b9\u03b1\u03c4\u03af \u03bd\u03b1 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03af\u03bb\u03b5\u03c4\u03b5 \u03b1\u03c0\u03cc \u03c4\u03b7 MedsBase<\/h3>\n

\u03a4\u03b1 \u03b3\u03b5\u03bd\u03cc\u03c3\u03b7\u03bc\u03b1 \u03c6\u03ac\u03c1\u03bc\u03b1\u03ba\u03ac \u03bc\u03b1\u03c2 \u03c0\u03c1\u03bf\u03ad\u03c1\u03c7\u03bf\u03bd\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ad\u03c2 \u03c0\u03bf\u03c5 \u03c0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03bf\u03cd\u03bd\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd WHO-GMP \u03ba\u03b1\u03b9 \u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03bd\u03c4\u03b1\u03b9 \u03c0\u03b1\u03b3\u03ba\u03bf\u03c3\u03bc\u03af\u03c9\u03c2 \u03c3\u03b5 \u03b4\u03b9\u03b1\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae, \u03b1\u03c0\u03bb\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u2014 \u03c7\u03c9\u03c1\u03af\u03c2 \u03cc\u03bd\u03bf\u03bc\u03b1 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03bf\u03c5 \u03c3\u03c4\u03bf \u03b5\u03be\u03c9\u03c4\u03b5\u03c1\u03b9\u03ba\u03cc \u03c4\u03bf\u03c5 \u03b4\u03ad\u03bc\u03b1\u03c4\u03bf\u03c2. \u039f\u03b9 \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ad\u03c2 \u03bc\u03b5 \u03ba\u03ac\u03c1\u03c4\u03b1 \u03b4\u03c1\u03bf\u03bc\u03bf\u03bb\u03bf\u03b3\u03bf\u03cd\u03bd\u03c4\u03b1\u03b9 \u03bc\u03ad\u03c3\u03c9 \u03c1\u03c5\u03b8\u03bc\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf\u03c5 \u03b5\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae (\u03bf\u03b9 \u03c0\u03b5\u03c1\u03b9\u03b3\u03c1\u03b1\u03c6\u03ad\u03c2 \u03b5\u03ba\u03ba\u03b1\u03b8\u03ac\u03c1\u03b9\u03c3\u03b7\u03c2 \u03c0\u03b5\u03c1\u03b9\u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03bf\u03c5\u03bd \u03c1\u03c5\u03b8\u03bc\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf \u03b5\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ce\u03bd \u03bc\u03b5 \u03ba\u03ac\u03c1\u03c4\u03b1 \u2014 \u03c0\u03bf\u03c4\u03ad \u201cMedsBase\u201d \u03ae \u03bf\u03c0\u03bf\u03b9\u03bf\u03b4\u03ae\u03c0\u03bf\u03c4\u03b5 \u03cc\u03bd\u03bf\u03bc\u03b1 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03bf\u03c5). \u0393\u03af\u03bd\u03bf\u03bd\u03c4\u03b1\u03b9 \u03b4\u03b5\u03ba\u03c4\u03ad\u03c2 \u03ba\u03b1\u03b9 \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ad\u03c2 \u03bc\u03b5 \u03ba\u03c1\u03c5\u03c0\u03c4\u03bf\u03bd\u03bf\u03bc\u03af\u03c3\u03bc\u03b1\u03c4\u03b1 \u03ba\u03b1\u03b9 \u03c4\u03c1\u03b1\u03c0\u03b5\u03b6\u03b9\u03ba\u03ae \u03bc\u03b5\u03c4\u03b1\u03c6\u03bf\u03c1\u03ac SEPA. \u039a\u03ac\u03b8\u03b5 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03ba\u03b1\u03bb\u03cd\u03c0\u03c4\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd \u03a0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2 \u0395\u03be\u03b1\u03c3\u03c6\u03b1\u03bb\u03af\u03c3\u03b5\u03ce\u03c2 \u03bc\u03b1\u03c2.<\/p>\n

Critical pre-dose rule.<\/strong> Do not take disulfiram for at least 12 hours after the last alcohol exposure<\/strong>, including hidden ethanol sources (mouthwash, cough syrup, fermented foods, vinegar, after-shave, hand-sanitiser, herbal tinctures). The disulfiram–ethanol reaction can be severe in medically vulnerable patients (severe coronary, cerebrovascular, or psychiatric disease) and has been fatal in rare cases.<\/div>\n

What is Cronotol?<\/h2>\n

Cronotol is an alcohol-aversion medication containing disulfiram 500 mg<\/strong> (tablets), supplied by WHO-GMP certified manufacturer. It is the oldest licensed pharmacotherapy for alcohol use disorder (in clinical use since 1949) and remains useful as an adjunct in motivated patients with structured supervision — it does not reduce craving directly, but the credible threat of an unpleasant reaction acts as a robust behavioural deterrent.<\/p>\n

How disulfiram works<\/h2>\n

Alcohol metabolism is a two-step process: ethanol → acetaldehyde<\/strong> (via alcohol dehydrogenase) → acetate (via aldehyde dehydrogenase, ALDH). Disulfiram irreversibly inhibits ALDH<\/strong>, so even small amounts of ethanol cause acetaldehyde to accumulate to many times normal levels. Acetaldehyde is responsible for the toxic component of a hangover; at sustained high levels it produces the disulfiram–ethanol reaction (DER): facial flushing, throbbing headache, nausea, vomiting, palpitations, dyspnoea, sweating, hypotension. Severe reactions can include arrhythmia, MI, seizures, coma. The intensity is roughly proportional to the alcohol dose — even a glass of wine usually triggers a moderate reaction.<\/p>\n

Because ALDH inhibition is covalent, it persists for up to 14 days<\/strong> after the last disulfiram dose. The DER can still be triggered up to two weeks after stopping the drug.<\/p>\n

How Cronotol is used<\/h2>\n

The 500 mg strength of Cronotol is used during the loading phase<\/strong> — the first 1–2 weeks of therapy when receptor inhibition is being established. After loading, dose is reduced to a maintenance level using a 250 mg formulation:<\/p>\n\n\n\n\n\n\n
\u03a6\u03ac\u03c3\u03b7<\/th>\nDaily dose<\/th>\n\u0394\u03b9\u03ac\u03c1\u03ba\u03b5\u03b9\u03b1<\/th>\n<\/tr>\n<\/thead>\n
Loading (with 500 mg Cronotol)<\/td>\n500 mg once daily<\/td>\n1–2 weeks<\/td>\n<\/tr>\n
Maintenance (switch to 250 mg)<\/td>\n125–250 mg once daily<\/td>\nTypically 6–12 months, occasionally longer<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Some clinicians prescribe maintenance at 250 mg in patients who can tolerate it, others step down to 125 mg if side effects appear. The lowest dose that produces a credible DER on alcohol exposure is the goal — some patients require 500 mg maintenance to maintain a clinically meaningful reaction, others get full effect at 125 mg.<\/p>\n

Take in the morning with water; an evening dose is acceptable if morning drowsiness is a problem. Supervised dosing<\/strong> (a partner, family member, or pharmacist watches the dose go down) substantially raises adherence and is a cornerstone of disulfiram’s evidence base.<\/p>\n

Hidden ethanol sources to avoid.<\/strong> Patients on disulfiram routinely have unintentional reactions from sources they did not consider alcoholic. Avoid: alcohol-containing mouthwashes (most major brands; switch to alcohol-free), cough and cold syrups (many contain 5–25% ethanol), tonics and herbal tinctures, vinegar in large quantity, fermented sauces (soy, fish), kombucha, communion wine, alcohol-based hand sanitisers in heavy occupational use, after-shaves and perfumes (topical absorption is small but accumulates with daily use), some inhalers, and certain pre-mouthrinse and oral hygiene products. Read every medicine label.<\/div>\n

Side effects (independent of alcohol)<\/h2>\n

Even without an alcohol reaction, disulfiram has its own adverse-effect profile:<\/p>\n

    \n
  • Drowsiness, fatigue<\/strong> in the first 1–2 weeks (most common; usually settles)<\/li>\n
  • Metallic or garlic-like aftertaste<\/strong> — characteristic and often persistent<\/li>\n
  • Headache, dizziness, dermatitis<\/li>\n
  • Reduced libido, erectile difficulty (uncommon)<\/li>\n
  • Hepatotoxicity (rare but serious)<\/strong> — idiosyncratic hepatitis, sometimes fatal. Baseline LFTs, repeat at 2 weeks, then monthly for the first 3 months, then 3-monthly. Stop immediately if jaundice, dark urine, RUQ pain, or marked transaminase rise.<\/li>\n
  • Peripheral neuropathy and rarely optic neuritis<\/strong> at higher doses or longer courses — report numbness, tingling, or visual changes<\/li>\n
  • Disulfiram-induced psychosis<\/strong> — rare; usually associated with very high doses or pre-existing schizophrenia<\/li>\n<\/ul>\n

    \u0391\u03bb\u03bb\u03b7\u03bb\u03b5\u03c0\u03b9\u03b4\u03c1\u03ac\u03c3\u03b5\u03b9\u03c2 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03c9\u03bd<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    \u03a6\u03ac\u03c1\u03bc\u03b1\u03ba\u03bf \/ \u03ba\u03b1\u03c4\u03b7\u03b3\u03bf\u03c1\u03af\u03b1<\/th>\nEffect \/ risk<\/th>\nAction<\/th>\n<\/tr>\n<\/thead>\n
    Metronidazole, tinidazole<\/strong><\/td>\nConfusion, psychosis — potentiated CNS toxicity<\/td>\nAvoid combination<\/strong><\/td>\n<\/tr>\n
    Isoniazid<\/strong><\/td>\nAtaxia, irritability, psychosis<\/td>\nAvoid; if essential, monitor closely and use lowest effective dose<\/td>\n<\/tr>\n
    \u0392\u03b1\u03c1\u03c6\u03b1\u03c1\u03af\u03bd\u03b7<\/strong><\/td>\nINR rises (CYP2C9 inhibition); bleeding risk<\/td>\nReduce warfarin dose; monitor INR weekly initially<\/td>\n<\/tr>\n
    \u03a6\u03b1\u03b9\u03bd\u03c5\u03c4\u03bf\u0390\u03bd\u03b7<\/strong><\/td>\nPhenytoin level rises (CYP2C9\/2C19 inhibition); toxicity<\/td>\nReduce phenytoin dose; monitor levels<\/td>\n<\/tr>\n
    \u0398\u03b5\u03bf\u03c6\u03c5\u03bb\u03bb\u03af\u03bd\u03b7<\/strong><\/td>\nTheophylline level rises<\/td>\nMonitor or use alternative bronchodilator<\/td>\n<\/tr>\n
    Benzodiazepines (CYP-metabolised: diazepam, alprazolam, midazolam)<\/strong><\/td>\nSedation potentiated<\/td>\nUse lorazepam or oxazepam (non-CYP) if sedative needed<\/td>\n<\/tr>\n
    Tricyclic antidepressants<\/strong><\/td>\nAcute organic brain syndrome reports<\/td>\n\u03a7\u03c1\u03ae\u03c3\u03b7 \u03bc\u03b5 \u03c0\u03c1\u03bf\u03c3\u03bf\u03c7\u03ae<\/td>\n<\/tr>\n
    Amitriptyline<\/strong><\/td>\nMay enhance DER intensity<\/td>\nUse cautiously<\/td>\n<\/tr>\n
    Cannabis<\/strong><\/td>\nHypomania reports<\/td>\nCounsel patient<\/td>\n<\/tr>\n
    Levodopa<\/strong><\/td>\nReduced effect<\/td>\nMonitor Parkinsonian control<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    \u0391\u03bd\u03c4\u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2<\/h2>\n