Disulfiram (Antabuse): Side Effects & Uses for Alcoholism Treatment

Disulfiram, also known by the brand name Antabuse, is a medication used in the treatment of alcohol use disorders by producing unpleasant side effects and sensitivity to alcohol. It is designed as a deterrent to drinking. When alcohol enters the body, it is converted into acetaldehyde and then into acetic acid. Disulfiram, acting as an alcohol antagonist drug, blocks the conversion from acetaldehyde to acetic acid, resulting in an upsurge of acetaldehyde, which is toxic and causes the individual to become ill. 

Disulfiram Side Effects

The medication causes individuals to suffer from very unpleasant side effects ranging from headaches, nausea, and vomiting to weakness, mental confusion, and anxiety, when even trace amounts of alcohol have been ingested. Within minutes after alcohol is consumed, a combination of the following symptoms can occur:

• Headache
• Vomiting
• Nausea
• Impaired vision
• Sweating
• Weakness
• Problems breathing
• Mental confusion
• Anxiety
• Hyperventilation
• Tachycardia
• Hypotension

This was the first drug to be approved by the FDA for treatment of alcohol dependency.

How Antabuse Medication Works

When alcohol enters the body, it is converted into acetaldehyde and then into acetic acid. Disulfiram’s mechanism of action blocks the conversion of acetaldehyde to acetic acid, resulting in an upsurge of acetaldehyde. This upsurge is toxic and causes the individual to become ill. It is important to note that disulfiram does not treat withdrawal from alcohol nor does it reduce cravings for alcohol. It is designed as a deterrent to drinking. Disulfiram should be taken regularly to ensure the metabolic cycle continues, reducing the desire to drink alcohol.

Disulfiram is dispersed in tablet form and taken orally one time per day. It is whitish in color, odorless, and tasteless. Disulfiram comes in 250 mg or 500 mg tablets. The maximum recommended daily dosage is 500 mg.

Do not take Disulfiram for at least 12 hours after drinking alcohol. It is important to let your doctor and pharmacist know all drugs you are taking as some may contain even minute traces of alcohol. These drugs may include but are not limited to:

• Elavil
• Coumadin
• Flagyl
• Dilantin
• All nonprescription drugs

How Long Does Disulfiram Stay in the Body?

About 80-95 percent of Disulfiram is absorbed slowly by the gastrointestinal tract and then filtered through the rest of the body. As much as 20 percent is eliminated. The elimination of disulfiram from the body is very gradual, as it can stay in the body as long as two weeks. This means that if alcohol is consumed during that period, the effects can still be quite uncomfortable.

Disulfiram Uses in Addiction Treatment

Disulfiram, when paired with comprehensive addiction treatment, can be helpful in the recovery process. Doses of disulfiram can be continued under medical supervision until the individual is stable and has sustained long-term abstinence from alcohol. Long-term usage has no defined timeframe but has been known to last nearly two years, according to SAMHSA. After disulfiram has been discontinued it can be restarted, even briefly, to ensure success in high-risk relapse situations.

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