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This is a combination of two small molecule drugs: **disulfiram**, an aldehyde dehydrogenase inhibitor used as a deterrent in the treatment of alcohol dependence, and **efavirenz**, a non-nucleoside reverse transcriptase inhibitor used as part of antiretroviral therapy for HIV infection. Disulfiram works by irreversibly inhibiting aldehyde dehydrogenase, leading to accumulation of acetaldehyde when alcohol is consumed, causing unpleasant effects that discourage drinking[1][3]. Efavirenz inhibits HIV reverse transcriptase by binding to an allosteric site on the enzyme, preventing viral replication[2]. When co-administered, efavirenz can increase the inhibitory effect of disulfiram on aldehyde dehydrogenase due to induction of CYP3A4-mediated metabolism that increases levels of the active metabolite responsible for ALDH inhibition[1][4]. This combination may be considered in patients with co-occurring HIV infection and alcohol use disorder.
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