Rifampin With Disulfiram

To the Editor.— Rifampin is an effective antituberculous drug recently approved by the Food and Drug Administration for general use. Users are warned that Rifampin has been shown to produce liver dysfunction. There have been fatalities associated with jaundice in patients with liver disease or receiving rifampin concomitantly with other hepatotoxic agents. Since an increased risk may exist for individuals with liver disease, benefits must be weighed carefully against the risk of further liver damage. Periodic liver function monitoring is mandatory. Ethyl alcohol is probably the most common hepatotoxic agent ingested, and in the quantities consumed by the chronic alcoholic patient its effects are well known. In our hands a widely based alcoholism therapeutic program in which disulfiram plays an important role provides the greatest likelihood that alcohol ingestion will be minimal, and, not infrequently, totally absent. Disulfiram is not hepatotoxic in the usual sense, but does interfere sharply with