Disulfiram (Antabuse): Side Effects & Uses for Alcohol Use Disorder
Disulfiram, formerly known by the brand name Antabuse, is a medication approved by the U.S. Food and Drug Administration (FDA) that is used in the treatment of alcohol use disorders (AUD).1 Disulfiram produces unpleasant side effects and sensitivity when mixed with alcohol. It is designed as a deterrent to drinking.2
Normally, when alcohol enters the body, it is converted into acetaldehyde and then into acetic acid. Disulfiram, acting as an alcohol antagonist drug, blocks this conversion from acetaldehyde to acetic acid, resulting in an upsurge of acetaldehyde, which is toxic and causes a person to become ill. 2
Disulfiram is most effective for patients who have already stopped drinking or are in the initial stages of abstinence, are deeply committed to maintaining recovery, and receive adequate supervision from friends and family or in a treatment program that supports the self-administration of disulfiram.2,4,5
Disulfiram Side Effects
Any alcohol use–even in small amounts, including those found in foods, medications, tonics, and other sources–combined with disulfiram can cause adverse effects. These unpleasant symptoms, known as the disulfiram-alcohol reaction, begin quickly after alcohol is consumed, typically within 10 to 30 minutes after drinking, and generally last for anywhere between 30 to 60 minutes. These side effects make the person not want to drink, and therefore, the goal of this medication is to abstain from drinking. Therefore, if an individual does not drink while taking disulfiram, they are not at risk for these side effects.2,3
Reactions vary by individual and range from mild to severe depending on the amount of alcohol consumed but may include:2,3
- Sweating.
- Flushing.
- Headache.
- Difficulty breathing.
- Nausea and vomiting.
- Chest pain.
- Increased heart rate.
- Dizziness or weakness.
How Disulfiram Medication Works
Unlike acamprosate and naltrexone–the two other FDA-approved medications for alcohol use disorder (MAUD)–disulfriam does not manage alcohol withdrawal symptoms or reduce cravings. It works as an alcohol deterrent therapy. The drug’s primary therapeutic effect does not involve altered brain chemistry. Instead, its effectiveness lies in its ability to create unpleasant, aversive reactions when an individual consumes alcohol.2
As previously mentioned, disulfiram works by interfering with the body’s ability to break down alcohol. The medication blocks the enzyme aldehyde dehydrogenase, resulting in an accumulation of acetaldehyde in the body shortly after an individual consumes alcohol.2 The buildup of acetaldehyde is what leads to those unpleasant symptoms mentioned above.3
Though typically prescribed as a 250 mg dose, doses can range from 125 mg to 500 mg and are taken orally in tablet form once a day. Additionally, it can be crushed and mixed with a non-alcoholic beverage such as water, coffee, tea, milk, or juice.5
When taken as prescribed under the guidance of a doctor, disulfiram is considered to be safe for most people with alcohol use disorder who do not have a significant risk of liver or heart disease.6
That being said, disulfiram can have several interactions with other drugs, so individuals should tell their doctors if they are taking any medication, specifically phenytoin, a medication used to treat seizures, and any chemically related compounds; oral blood thinners; isoniazid, a medication used to treat tuberculosis; or extended-release naltrexone.3
Disulfiram Uses in Addiction Treatment
While there are mixed reviews on the efficacy of disulfiram, it can be a valuable part of a comprehensive approach for treating alcohol use disorder in some people–especially those who are motivated to remain sober–when used alongside behavioral therapies and other interventions.2,3,7
Treatment for AUD varies by a person’s specific needs and goals, which can include reducing or managing symptoms of AUD, changing unhelpful or maladaptive behaviors, and improving their overall health and functioning.7,8
Disulfiram, when used as part of a treatment program for AUD, must be taken daily. Use can continue for months or even years until the individual feels a permanent self-control.3
If you or a loved one struggle with alcohol use and would like to learn more about your treatment options, call American Addiction Centers (AAC) at to connect with a knowledgeable and compassionate admissions navigator who can discuss the treatment options that may be available to you. Additionally, AAC can verify your insurance coverage for treatment if you fill out the form below.
How Long Does Disulfiram Stay in the Body?
As previously mentioned, disulfiram produces the disulfiram-alcohol reaction within 10 to 30 minutes after alcohol consumption, and effects typically last 30 to 60 minutes, though disulfiram’s effects can last up to 14 days after the medication is last used with alcohol.2,3
That’s because approximately 80% to 95% of disulfiram is absorbed by the gastrointestinal tract and is distributed throughout the body. Therefore, after taking disulfiram, it can take 2 weeks for the body to produce enough unbound enzymes to metabolize alcohol effectively, which is why uncomfortable symptoms can linger for up to 2 weeks after the last dose of disulfiram if alcohol is consumed.2
Finding Medication-Assisted Treatment That Works For You
Medications like disulfiram can be an important component of a more comprehensive treatment plan that includes other interventions, including other medications, behavioral therapies such as cognitive-behavioral therapy (CBT), and mutual-help groups like Alcoholics Anonymous (AA).3,8
AAC is a leading provider of treatment for AUD and operates treatment centers throughout the country. AAC offers a complete continuum of care, utilizes a wide range of evidence-based therapies, and creates customized treatment plans to suit each patient’s individual needs. Call to speak to a caring admissions navigator who can explain your treatment options, quickly verify your insurance, and help you find lasting recovery.
