Calcium carbimide, also known as Temposil, is a prescription medication used in treating alcohol use disorders. Use this medication only as prescribed and in conjunction with treatment approaches such as psychotherapy.

Calcium carbimide brand names

Calcium Carbimide is available in Canada, the United Kingdom, and Europe under the brand name Temposil. [3]

The U.S. Food and Drug Administration (FDA) has not approved calcium carbimide. It is unavailable in the United States.

What is calcium carbimide prescribed for?

Calcium carbimide is an alcohol-sensitizing drug used to treat patients with alcohol use disorders. It may help prevent relapse, especially during highly triggering situations.

How does calcium carbimide work?

Calcium carbimide has an adverse reaction to alcohol use resulting in an unpleasant experience if someone drinks alcohol.

Calcium carbimide does not reduce the cravings associated with alcohol use disorders.

Calcium carbimide affects how the body absorbs and metabolizes alcohol. It disrupts the normal metabolism of alcohol by stopping the breakdown of acetaldehyde, a by-product of alcohol. This causes acetaldehyde to accumulate, which in turn causes an aversion to alcohol[3]

Acetaldehyde is a toxic molecule to the body. As this molecule accumulates in the body, a toxic response develops.

The toxic response of alcohol and calcium carbimide causes [1]:

  • Intense flushing
  • Rapid pulse rate
  • Panting
  • Headache
  • Tremors
  • Vertigo
  • Drowsiness
  • Nausea with or without vomiting
  • Generalized feeling of malaise 

How is calcium carbimide usually taken?

Calcium carbimide is taken orally in tablet form. Take this medication only as prescribed.

The typical dosage of this medicine is 50mg. Calcium carbimide is fast acting and may be prescribed twice daily to ensure full-day coverage [1].

Use this medication in combination with other treatments for alcohol use disorder, including psychotherapy, family counseling, and peer support groups.

How long does calcium carbimide stay in your system?

Calcium carbimide is metabolized quickly by the body, with a half-life of around 92 minutes [3].

The effects of this medication last between 12-24 hours [1]. Any consumption of alcohol within 24 hours of taking calcium carbimide will trigger the aversive reaction.

Calcium carbimide side effects

Calcium carbimide may have adverse effects from its use and may not be the safest option for people with certain medical conditions.

Some people have experienced liver toxicity from using calcium carbimide [5]. This medication may not be a suitable option for people with pre-existing liver or kidney problems.

Calcium carbimide and alcohol use may cause potentially life-threatening cardiac events requiring medical intervention for some people. These events may include [4]:

  • Dangerously low blood pressure 
  • Dangerously fast heart rate
  • Dangerously slow heart rate 

Other calcium carbimide side effects include [1]:

  • Giddiness
  • Fatigue
  • Rash
  • Ringing in the ears
  • Depression symptoms
  • Sexual dysfunction
  • Changes in kidney functioning and urine retention

This is not a complete list, so discuss any side effects with your doctor as soon as possible to avoid further complications. 

As with any prescription medication, an allergic reaction to calcium carbimide may occur. Seek immediate medical treatment in the event of an allergic reaction.

Signs of an allergic reaction include:

  • Rash development
  • Itchiness
  • Fever
  • Difficulty breathing
  • Swelling in the face, hands, mouth, tongue, or extremities. 

Calcium carbimide precautions

Calcium carbimide use carries risks, which the doctor will fully discuss prior to prescribing this medicine.

An increase in white blood cells may occur for some people taking this medication. This should return to normal after the discontinuation of calcium carbimide [1].

Be sure to discuss with the doctor any personal or familial history of any of the following conditions before taking calcium carbimide [1]:

  • Asthma
  • Coronary artery disease
  • Myocardial disease

Never administer this medication to anyone without their knowledge or share it with someone else.

Avoid taking calcium carbimide within 36 hours of consuming alcohol [1].

Do not drink alcohol after taking this medication.

Calcium carbimide may not be safe for use during pregnancy or while breastfeeding. Discuss with the doctor alternative treatment options if pregnant or breastfeeding. 

Calcium carbimide interactions

Calcium carbimide is known to interact with certain other medications, particularly other medications used for the treatment of alcoholism. 

Discuss with the doctor all prescription medications, over-the-counter medications, vitamins, and herbal supplements being taken before using this medicine.

Calcium carbimide causes an intense aversive reaction when taken with alcohol. Do not consume alcohol after having taken this medicine.

Other medications to avoid while taking calcium carbimide include [2]:

  • Cinnamaldehyde (and products containing cinnamon)
  • Disulfiram (Antabuse)
  • Ethanol (alcohol)
  • Formaldehyde

Be sure to check with the doctor or pharmacist before taking any over-the-counter medications for cold or flu symptoms that may contain alcohol or an alcohol derivative, as these could cause dangerous drug interactions.

What to do if you overdose on calcium carbimide

Calcium carbimide can cause damage to the liver, kidney, and heart. If an overdose of calcium carbimide is suspected or has occurred, seek immediate emergency care.

Emergency care may also be needed if a severe reaction occurs between this medication and alcohol. 

Resources:

  1. Calcium Carbimide Full Prescribing Information | HealthyPlace. (2009, January 3). https://www.healthyplace.com/other-info/psychiatric-medications/calcium-carbimide-temposil-full-prescribing-information
  2. Calcium carbimide: Uses, Interactions, Mechanism of Action | DrugBank Online. (n.d.). DrugBank. https://go.drugbank.com/drugs/DB09116
  3. National Center for Biotechnology Information (2022). PubChem Compound Summary for CID 6335910, Temposil. Retrieved November 13, 2022 from https://pubchem.ncbi.nlm.nih.gov/compound/Temposil.
  4. Peachey, J.E., Maglana, S., Robinson, G.M., Hemy, M. and Brien, J.F. (1981), Cardiovascular changes during the calcium carbimide–ethanol interaction. Clinical Pharmacology & Therapeutics, 29: 40-46. 
  5. Verge, C., Lucena, M. I., López-Torres, E., Puche-Garcia, M. J., Fraga, E., Romero-Gomez, M., & Andrade, R. J. (2006). Adverse hepatic reactions associated with calcium carbimide and disulfiram therapy: is there still a role for these drugs?. World journal of gastroenterology, 12(31), 5078–5080. https://doi.org/10.3748/wjg.v12.i31.5078