Drug & supplement interaction

Nickel + Disulfiram

Disulfiram brand name: Antabuse.

Moderate Interaction
The bottom line Moderate

Nickel has a moderate interaction with Disulfiram. Disulfiram can reduce the absorption and clinical effects of nickel.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Nickel and Disulfiram

Here is the interaction we found between these two, with the evidence behind it.

Moderate

DISULFIRAM (Antabuse)

Disulfiram can reduce the absorption and clinical effects of nickel.
Disulfiram can chelate nickel, preventing its absorption. This interaction has been used therapeutically to reduce eczema in people with severe nickel hypersensitivity.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's an interesting one. This interaction actually runs the opposite way from what most people expect. Disulfiram (Antabuse) doesn't get weakened by nickel; instead, it grabs onto nickel and stops your body from absorbing it. Disulfiram acts like a chelator, binding the nickel so it largely passes through rather than getting into your system.

So if you were taking a nickel supplement hoping to absorb it, the disulfiram would likely cancel most of that out. The flip side is the useful part: doctors have actually used disulfiram on purpose to lower nickel levels in people with severe nickel allergies and eczema. This won't change how your disulfiram works for alcohol, and it won't cause that classic flushing or nausea reaction. Still, since nickel supplements aren't recommended for most people anyway, check with your pharmacist before combining the two.

References
  1. Sharma AD. Disulfiram and low nickel diet in the management of hand eczema: a clinical study. Indian J Dermatol Venereol Leprol 2006;72:113-8. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

From our Q&A

Questions About Nickel or Disulfiram

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Nickel or Disulfiram, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Disulfiram

This page covers Nickel only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Disulfiram page lists 45 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Bach Flower Remedies (major), Beer (major), Wine (major) and Biofeedback (moderate).

By severity: 4 major · 30 moderate · 11 minor.

Open the Disulfiram interaction page

One more smart check

Taking Nickel as Part of a Dietary Supplement Product? Check It for Interactions

We hold 685 real supplement products containing Nickel, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Nickel. Your product may carry other ingredients that interact with Disulfiram too, on top of Nickel — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Nickel and Disulfiram Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Nickel
Top 25%

#279 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Disulfiram
Top 25%

#292 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Nickel

What is Nickel?

  • General trace-mineral supplementation
  • Supporting iron and other nutrient metabolism (theoretical)
  • Marketed for bone or hormone support

Nickel is a trace element found in tiny amounts in many foods, and most people get plenty through diet. There is no proven need for nickel supplements, and because nickel is a common cause of allergic reactions and can be toxic in higher amounts, most people should not take it. Talk with your pharmacist or doctor before using any nickel-containing supplement.

Read the full Nickel monograph & all interactions
Medication

About Disulfiram

What Is Disulfiram Used For?

Brand name: Antabuse

Disulfiram is used as part of a treatment program for people with chronic alcoholism who want to stop drinking. It works by making the body react very unpleasantly to alcohol, which helps reinforce the commitment to stay sober.

It is not a cure for alcoholism, and it works best when combined with counseling, motivation, and support. Used alone, without those supports, it is unlikely to make a lasting difference.

See full Disulfiram drug information
Keep checking

Other Drugs & Nickel

Browse every other medication we’ve checked against Nickel — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Nickel and Disulfiram Together: Common Questions

Can you take Nickel with Disulfiram?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Nickel and Disulfiram interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Disulfiram and Nickel?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.