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Ditiocarb Sodium and HIV Infection

Evan M. Hersh, MD
JAMA. 1991;266(6):796. doi:10.1001/jama.1991.03470060057020.
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In Reply.  —The letter by O'Meara states that disulfiram (Antabuse) is rapidly metabolized to two molecules of diethyldithiocarbamate (ditiocarb) and that disulfiram and ditiocarb "are similar in many biologic effects, including the effectiveness in chelation therapy of nickel poisoning and potentiation of hyperbaric oxygen poisoning in rats."In fact, the cited articles1,2 show that (1) the 100% effective nickel chelation antidotal dose of ditiocarb (50 mg/kg) is one fifth of the 70% effective dose of disulfiram (250 mg/kg); and (2) potentiation of hyperbaric oxygen toxicity in the rat (at three times the human maximum tolerated dose) is 2½ times greater for ditiocarb than for disulfiram (87% vs 30% mortality).The pharmacokinetics of the two drugs are also different. Thus, in contrast to ditiocarb, no detectable serum levels of ditiocarb or its S-methyl ester metabolite can be detected after oral administration of disulfiram (M. Rousseau-Tsangaris, PhD, unpublished data, September 1989).


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