Disulfiram (Antabuse) is the oldest medicine for alcohol use disorder. It does not reduce cravings. Instead, it makes drinking physically unpleasant, so it works as a deterrent.
How it works
Disulfiram blocks an enzyme the body uses to break down alcohol. If you drink, a toxic byproduct builds up within minutes, causing flushing, pounding headache, nausea, vomiting, a racing heart and low blood pressure. Severe reactions can cause breathing problems, heart rhythm problems, seizures and, rarely, death. Call 911 for chest pain, trouble breathing, fainting or a seizure.
Who it may suit
People fully committed to not drinking who want a firm barrier, especially when someone they trust watches them take each dose. Without that supervision, many people simply stop taking it. Disulfiram must never be given to anyone without their full knowledge and consent.
Important precautions
- Start only after at least 12 hours without alcohol
- Avoid hidden alcohol in mouthwash, cough syrups, sauces, vinegars and some skin products
- The effect can last up to two weeks after the last dose
- Not for people with serious heart disease, psychosis or pregnancy; liver tests are checked
- Rarely, it causes serious liver injury: stop it and call your provider right away for yellow skin or eyes, dark urine, or unusual tiredness or stomach pain
- It interacts with some medicines, including metronidazole and warfarin, so tell every prescriber and pharmacist you take it, and carry a card that says so
Ready to Start Treatment?
Confidential, evidence-based care in West Ashley. New patients are often able to be scheduled within a week of requesting an appointment.
Where it fits today
Naltrexone and acamprosate are usually tried first. Disulfiram can be a good option for the right person with a supportive partner.
Learn more about alcohol use disorder treatment in Charleston.
Help at Hope Addiction Medicine
Our team combines medication with counseling and behavioral therapies, in person at our West Ashley office in Charleston and by telehealth when appropriate. New patients are often able to be scheduled within a week of requesting an appointment. Request an appointment or call our office.
This article is general health information and does not replace advice from your own provider. Never start, stop or change a medication without talking with your prescriber. If someone may be overdosing, call 911 and give naloxone if you have it.
Frequently Asked Questions
Within minutes, a toxic byproduct builds up and causes flushing, pounding headache, nausea, vomiting, a racing heart and low blood pressure. Severe reactions can be life-threatening; call 911 for chest pain, trouble breathing, fainting or a seizure.
Its effect can last up to two weeks after the last dose, so alcohol should be avoided during that time.
No. It works as a deterrent. Naltrexone and acamprosate are the medicines that target cravings and staying sober.