{"id":10805,"date":"2023-08-05T09:53:17","date_gmt":"2023-08-05T09:53:17","guid":{"rendered":"https:\/\/www.floridarehab.com\/?page_id=10805"},"modified":"2026-05-27T16:08:02","modified_gmt":"2026-05-27T16:08:02","slug":"disulfiram","status":"publish","type":"blog","link":"https:\/\/www.floridarehab.com\/treatment\/medication-assisted-treatment\/disulfiram\/","title":{"rendered":"Disulfiram for Alcohol Use Disorder: Uses, Side Effects and Treatment"},"content":{"rendered":"\r\n<p class=\"wp-block-paragraph\"><span style=\"font-weight: 400;\">Disulfiram is a prescription drug used in treatment for people who want to stop alcohol consumption and maintain abstinence. It does not reduce cravings in the same way as naltrexone or acamprosate. Instead, Antabuse creates a deterrent effect by causing an unpleasant and potentially dangerous reaction if a person drinks while taking it (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">This option is usually best for patients who have already stopped drinking, understand the risks and have a clear abstinence goal. It is not a cure for alcoholism, and it does not treat withdrawal. It is typically used with counseling, medical monitoring, relapse prevention planning and structured care (<\/span><a href=\"https:\/\/www.aafp.org\/afp\/2024\/0100\/alcohol-use-disorder\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Poorman et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Antabuse is one of several medications used for alcohol use disorder, along with naltrexone and acamprosate. These options work differently, so the right choice depends on a person\u2019s health history, liver function, mental health needs and goals (<\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2811435\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">McPheeters et al., 2023<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<h2><b>What Is Disulfiram?<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Disulfiram is an oral prescription medication used to support abstinence from alcohol. It is usually taken once daily and should only be used under medical supervision.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">The drug works by making alcohol use physically unpleasant and risky. If you drink while taking it, your body can build up acetaldehyde, a toxic byproduct of alcohol metabolism. This buildup causes the disulfiram-alcohol reaction (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Disulfiram\u2019s use does not remove the behavioral, emotional, social or mental health factors that contribute to alcohol dependence. For that reason, it is usually one part of a larger use disorder treatment plan rather than a standalone solution (<\/span><a href=\"https:\/\/www.aafp.org\/afp\/2024\/0100\/alcohol-use-disorder\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Poorman et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<h2><b>Who It May Help<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Disulfiram may be considered for someone who has stopped drinking and wants help maintaining abstinence. It is generally not the first step for someone who is still drinking heavily, at risk of withdrawal or unsure whether they want to stop.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">A doctor may consider it if you:<\/span><\/p>\r\n<ul>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Have alcohol use disorder<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Have already stopped drinking<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Want to avoid alcohol completely<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Understand what can happen if you drink while taking it<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Can avoid alcohol-containing foods, medicines and personal care products<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Can take the medication consistently<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Have medical clearance to take it safely<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Have support from a care team, family member or support network<\/span><span style=\"font-weight: 400;\"><br \/><br \/><\/span><\/li>\r\n<\/ul>\r\n<p><span style=\"font-weight: 400;\">It may not be a good fit if you expect to continue drinking, are likely to skip doses, cannot avoid products that contain alcohol or have a medical condition that makes the drug unsafe (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<h2><b>How It Works in the Body<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">When you drink alcohol, your body first breaks it down into acetaldehyde. Your body then normally uses an enzyme called aldehyde dehydrogenase to break acetaldehyde down further.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Disulfiram blocks aldehyde dehydrogenase. When this enzyme is blocked, acetaldehyde can build up quickly after alcohol is consumed. This can cause flushing, nausea, vomiting, sweating, headache, dizziness, rapid heartbeat and low blood pressure (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">The purpose is to discourage drinking. Because symptoms can be intense and sometimes dangerous, anyone taking this medication must avoid alcohol completely.<\/span><\/p>\r\n<h2><b>What Happens If You Drink While Taking It?<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Drinking alcohol while taking this medication can cause sudden physical symptoms. These often begin within 10 to 30 minutes, but timing and severity can vary (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Common symptoms may include nausea, vomiting, sweating, flushing, headache, dizziness, blurred vision, thirst, weakness, confusion, rapid breathing, fast heartbeat and throbbing in the head or neck.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">More serious symptoms may require emergency medical care. These can include chest pain, heart palpitations, trouble breathing, slow or irregular breathing, fainting, loss of consciousness, seizures, severe weakness or collapse.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">The reaction can be more severe if a person consumes a larger amount, takes a higher dose or has certain medical conditions (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<h2><b>When To Get Emergency Help<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Call 911 or seek emergency medical care if alcohol was consumed while taking this drug and symptoms include chest pain, trouble breathing, fainting, confusion, seizure, severe weakness, severe vomiting or loss of consciousness.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Even small amounts can trigger symptoms in some patients. If you are unsure whether a symptom is serious, it is safer to contact a medical professional right away.<\/span><\/p>\r\n<h2><b>How Long To Avoid Alcohol After Antabuse<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">You should not drink alcohol while taking this medication. You should also avoid it for up to 14 days after your last dose because symptoms may still occur after the drug has been stopped (<\/span><a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a682602.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">MedlinePlus, 2017<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">This includes more than beer, wine or liquor. You may also need to avoid products that contain small amounts of alcohol, such as cough syrups, cold medicines, mouthwash, cooking wine, certain sauces, vinegars, aftershave, lotions and alcohol-based extracts or tinctures.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Before starting treatment, ask your doctor or pharmacist which products you should avoid. Product labels can be confusing, and some items contain alcohol even when it is not obvious.<\/span><\/p>\r\n<h2><b>Purpose for Alcohol Dependence and Abstinence<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Disulfiram is used to help people maintain abstinence. It may be considered when someone has stopped drinking, wants to remain alcohol-free and understands the risks of taking the medication (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">It is not typically recommended for someone who is still actively drinking, unable to avoid alcohol-containing products or not fully informed about the risks.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">It should never be given to someone without their knowledge. The person taking it must understand why it is being used and what can happen if alcohol is consumed (<\/span><a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a682602.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">MedlinePlus, 2017<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<h2><b>Starting Medication Safely<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Disulfiram does not treat withdrawal. If you are physically dependent on alcohol, stopping suddenly can cause symptoms that may become dangerous (<\/span><a href=\"https:\/\/www.aafp.org\/afp\/2021\/0900\/p253\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Tiglao et al., 2021<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Withdrawal symptoms can include anxiety, tremors, sweating, nausea, vomiting, insomnia, high blood pressure, hallucinations, seizures and delirium tremens.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">If you drink heavily or daily, speak with a medical professional before stopping. Medical detox may be needed before another use disorder medication is considered because untreated or undertreated withdrawal can progress to seizures, delirium tremens or death (<\/span><a href=\"https:\/\/www.aafp.org\/afp\/2021\/0900\/p253\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Tiglao et al., 2021<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<h2><b>Typical Dose<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Disulfiram is usually taken once daily. A common maintenance dose is 250 mg per day, though dosing can vary based on medical history, side effects, response and prescriber guidance. The usual range is often 125 mg to 500 mg per day, and the maximum recommended daily dose is generally 500 mg (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">You should never change your dose, stop taking the drug or restart it after drinking without speaking with a medical professional.<\/span><\/p>\r\n<h2><b>Length of Use<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">The length of disulfiram treatment varies. Some people take it for a limited period during early stabilization, while others take it longer if it continues to support abstinence and remains medically safe.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Your doctor may consider your alcohol use history, relapse risk, liver function, adverse effects, progress in treatment, support system and ability to take the medication consistently. Ongoing review helps make sure the benefits still outweigh the risks.<\/span><\/p>\r\n<h2><b>Effectiveness for Alcoholism<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Disulfiram can be effective for some people, especially when they are committed to abstinence and have support to take it consistently. It may help strengthen motivation by creating a clear consequence if alcohol is used.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Effectiveness depends heavily on adherence. If someone skips doses before drinking, the medication cannot provide the intended deterrent effect. A Cochrane review found that benefits are more apparent in open-label or supervised settings, while blinded studies show less consistent benefit (<\/span><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6513584\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Pedersen et al., 2018<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Some research has looked at abstinence rates and adherence in supervised care, but results vary by study design, patient selection and whether dosing is observed. A pharmacotherapy trial or review may also compare outcomes across medications, so the best option should be chosen with medical guidance.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">This drug may be less helpful for someone who does not want to stop drinking, is likely to stop taking it before alcohol use or does not have enough support to use it safely.<\/span><\/p>\r\n<h2><b>Why Supervised Dosing Matters<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Supervised dosing means a trusted family member, pharmacist, clinician or treatment provider helps confirm that disulfiram administration happens as prescribed.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">This can matter because the medication only works when it is taken consistently. Someone who wants to drink can avoid symptoms by skipping doses. Supervision adds accountability and may make disulfiram therapy more useful during early treatment or after repeated relapse (<\/span><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6513584\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Pedersen et al., 2018<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Supervised dosing may be especially helpful if you are early in care, rebuilding daily routines or need additional structure while working toward long-term abstinence.<\/span><\/p>\r\n<h2><b>Comparing Medication Options for Substance Use Disorders<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Several medications may be used for substance use disorders involving alcohol. FDA-approved options include naltrexone, acamprosate and Antabuse (<\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2811435\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">McPheeters et al., 2023<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">These drugs work differently. Antabuse discourages drinking by causing physical symptoms if alcohol is consumed. Naltrexone may help reduce the rewarding effects of drinking and may help some patients reduce heavy use or maintain abstinence. Acamprosate may help support abstinence after someone has stopped.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">A 2023 systematic review in <\/span><i><span style=\"font-weight: 400;\">JAMA<\/span><\/i><span style=\"font-weight: 400;\"> found the strongest evidence for oral naltrexone and acamprosate as first-line pharmacotherapies, while disulfiram may be useful for selected patients, especially when abstinence is the goal and adherence can be supported (<\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2811435\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">McPheeters et al., 2023<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">The right medication depends on your medical history, liver function, kidney function, goals, other medications and whether you want abstinence or reduced use. A medical provider can help determine which option is safest and most appropriate.<\/span><\/p>\r\n<h2><b>Possible Adverse Effects<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Some side effects are mild, while other adverse effects require medical attention.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Possible symptoms include mild headache, skin rash, metallic or garlic-like taste, upset stomach, drowsiness, fatigue, acne-like skin changes and sexual dysfunction in males.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Contact a medical professional if you experience severe tiredness, weakness, vomiting, yellowing of the skin or eyes, dark urine, loss of appetite, persistent nausea, abdominal pain, numbness, tingling, nerve pain, vision changes, confusion, paranoia or hallucinations.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">These symptoms may be signs of serious problems, including liver injury, nerve issues or psychiatric reactions. This medication has been associated with rare but serious adverse outcomes, including hepatotoxicity, neuropathy and psychosis (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<h2><b>Liver Monitoring<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">This drug can affect the liver. While serious liver problems are uncommon, they can happen and may become dangerous if not identified early (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Before taking it, tell your doctor if you have hepatitis, cirrhosis, abnormal liver tests, heavy long-term alcohol use, a history of liver injury or current symptoms such as yellowing skin, dark urine or severe fatigue.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Your provider may order blood tests to check liver function before treatment and during ongoing use. This monitoring helps reduce the risk of missing early signs of liver injury.<\/span><\/p>\r\n<h2><b>Who Should Avoid It?<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">This medication is not safe or appropriate for everyone. A doctor should review your medical history, mental health history, current medications and alcohol use before prescribing it.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">It may not be recommended for patients with current intoxication, recent alcohol use without medical clearance, severe heart disease, coronary artery disease, history of psychosis, severe liver disease, allergy to related chemicals, seizure disorders, high impulsivity, suicidal thoughts or pregnancy-related concerns.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">The drug should only be used when the person understands the risks and can follow alcohol-avoidance instructions (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<h2><b>Medication Interactions<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Disulfiram can interact with several medications. Tell your doctor and pharmacist about all prescriptions, over-the-counter medicines, supplements and herbal products you take (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Medications that may interact with it include warfarin, phenytoin, chlordiazepoxide, diazepam, tricyclic antidepressants such as amitriptyline, metronidazole and certain drugs that may cause disulfiram-like reactions with alcohol.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Some medications are not disulfiram but can still cause a similar reaction when mixed with alcohol. These may include metronidazole, tinidazole, certain antibiotics, some diabetes medications and some heart medications. Always ask your doctor before drinking while taking any drug.<\/span><\/p>\r\n<h2><b>How Medication Fits Into Treatment<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">This medication is usually used as part of a comprehensive treatment plan. It is not meant to be the only form of care.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">A plan may include medical evaluation, detox if withdrawal symptoms are possible, individual therapy, group therapy, relapse prevention planning, family support, mental health care, peer support, medication management and routine monitoring.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Medication can help reinforce abstinence, but care also needs to address triggers, routines, stressors and mental health symptoms that can contribute to alcohol use. Clinical reviews support combining medications with behavioral interventions rather than relying on medication alone (<\/span><a href=\"https:\/\/www.aafp.org\/afp\/2024\/0100\/alcohol-use-disorder\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Poorman et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">). The NIAAA and SAMHSA also recognize medications as part of care for alcohol-related conditions when clinically appropriate.<\/span><\/p>\r\n<h2><b>Questions To Ask Your Doctor<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">Before starting disulfiram, ask your doctor:<\/span><\/p>\r\n<ul>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Am I medically safe to take this medication?<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Do I need detox before starting it?<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">What dose will I take?<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">How often will my liver function be checked?<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">What products should I avoid?<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">What should I do if I accidentally consume alcohol?<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">What adverse effects should I watch for?<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Could it interact with my current medications?<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">How long should I take it?<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Should someone supervise my dosing?<\/span><span style=\"font-weight: 400;\"><br \/><\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">What therapy or support should I use with it?<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\">Would naltrexone, acamprosate or another option be safer for me?<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<h2 class=\"wp-block-heading\">The Recovery Village Palm Beach at Baptist Health Offers Disulfiram Treatment to Help You Recover<\/h2>\r\n\r\n\r\n\r\n<p class=\"wp-block-paragraph\">The Recovery Village Palm Beach at Baptist Health provides a personalized treatment approach to alcohol and drug addiction. Treatment is evidence-based and individualized to provide the best chance for sustained recovery. The use of Antabuse (disulfiram) in alcohol dependence treatment is part of a multidisciplinary treatment approach that includes psychiatric, psychosocial and behavioral services to help each patient achieve their best path to recovery.<\/p>\r\n<h2><b>Frequently Asked Questions<\/b><\/h2>\r\n<h3><b>What is Disulfiram used for?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Disulfiram is used to help people with alcohol use disorder avoid drinking. It causes an unpleasant physical reaction if alcohol is consumed, which can help reinforce abstinence.<\/span><\/p>\r\n<h3><b>Is it the same as Antabuse?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Yes. Antabuse is a brand name for disulfiram.<\/span><\/p>\r\n<h3><b>Does it stop cravings?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Disulfiram does not primarily work by reducing cravings. It works by creating a deterrent effect if alcohol is consumed. Other medications, such as naltrexone or acamprosate, may be considered when cravings are a major concern.<\/span><\/p>\r\n<h3><b>What happens if you drink on it?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Drinking on disulfiram can cause flushing, nausea, vomiting, sweating, headache, dizziness, fast heartbeat, chest pain, breathing problems, fainting or seizures. Severe symptoms require emergency medical care.<\/span><\/p>\r\n<h3><b>How quickly can a reaction start?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">A reaction can begin about 10 to 30 minutes after alcohol is consumed.<\/span><\/p>\r\n<h3><b>How long should you avoid alcohol after stopping it?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">You should avoid alcohol for up to 14 days after your last dose, unless your doctor gives different instructions.<\/span><\/p>\r\n<h3><b>Can mouthwash or cough medicine trigger a reaction?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Yes. Some mouthwashes, cough medicines, sauces, vinegars, extracts, lotions and other products contain alcohol and may trigger a reaction. Ask your doctor or pharmacist what to avoid.<\/span><\/p>\r\n<h3><b>Can it be taken while still drinking?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Disulfiram should not be started while someone is intoxicated or actively drinking. It is intended for people who have stopped drinking and are working toward abstinence.<\/span><\/p>\r\n<h3><b>Is it safe?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Disulfiram can be safe for appropriate candidates under medical supervision, but it has risks. It can cause serious reactions with alcohol, interact with medications and affect the liver.<\/span><\/p>\r\n<h3><b>Who should not take it?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">People with certain heart conditions, liver disease, psychosis, seizure disorders, suicidal thoughts, pregnancy-related concerns or allergy to disulfiram may not be good candidates. A doctor should determine whether it is safe.<\/span><\/p>\r\n<h3><b>Does it treat withdrawal symptoms?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">No. Disulfiram does not treat alcohol withdrawal. If you are physically dependent on alcohol, medical detox may be needed before starting medication-assisted treatment.<\/span><\/p>\r\n<h3><b>Is it effective?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Disulfiram can be effective for people who are committed to abstinence and take it consistently, especially when dosing is supervised and combined with counseling or structured treatment.<\/span><\/p>\r\n<h3><b>What is the typical dose?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">A common daily dose is 250 mg, but some people may be prescribed 125 mg to 500 mg per day depending on medical history, side effects and prescriber guidance.<\/span><\/p>\r\n<h3><b>Does it require liver testing?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Your provider may check liver function before and during disulfiram treatment because the medication can affect the liver in some people.<\/span><\/p>\r\n<h3><b>Can it be used with therapy?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Yes. Disulfiram is usually used with counseling, behavioral therapy, relapse-prevention planning and recovery support.<\/span><\/p>\r\n<h3><b>How is it different from naltrexone?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Disulfiram creates a reaction if alcohol is consumed. Naltrexone works differently by helping reduce the rewarding effects of alcohol and may help with cravings for some people.<\/span><\/p>\r\n<h3><b>How is it different from acamprosate?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Disulfiram discourages drinking through an alcohol reaction. Acamprosate is generally used to help support abstinence after someone has stopped drinking.<\/span><\/p>\r\n<h3><b>Can medication help alcohol use disorder?<\/b><\/h3>\r\n<p><span style=\"font-weight: 400;\">Medication can be part of a larger care plan for alcohol use disorder. The Recovery Village Palm Beach at Baptist Health can help determine whether medication, detox, inpatient care or outpatient care fits your needs.<\/span><\/p>\r\n<h2><b>References<\/b><\/h2>\r\n<p><span style=\"font-weight: 400;\">McPheeters, M., O\u2019Connor, E. A., Riley, S., Kennedy, S. M., Voisin, C., Kuznacic, K., Coffey, C. P., Edlund, M. J., Bobashev, G., &amp; Jonas, D. E. (2023). Pharmacotherapy for alcohol use disorder: A systematic review and meta-analysis. <\/span><i><span style=\"font-weight: 400;\">JAMA, 330<\/span><\/i><span style=\"font-weight: 400;\">(17), 1653\u20131665.<\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2811435\" target=\"_blank\" rel=\"noopener\"> <span style=\"font-weight: 400;\">https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2811435<\/span><\/a><\/p>\r\n<p><span style=\"font-weight: 400;\">MedlinePlus. (2017). <\/span><i><span style=\"font-weight: 400;\">Disulfiram<\/span><\/i><span style=\"font-weight: 400;\">. U.S. National Library of Medicine.<\/span><a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a682602.html\" target=\"_blank\" rel=\"noopener\"> <span style=\"font-weight: 400;\">https:\/\/medlineplus.gov\/druginfo\/meds\/a682602.html<\/span><\/a><\/p>\r\n<p><span style=\"font-weight: 400;\">Pedersen, B., Alva-J\u00f8rgensen, P., Raffing, R., Lindschou, J., Winkel, P., &amp; Gluud, C. (2018). Disulfiram for alcohol use disorder. <\/span><i><span style=\"font-weight: 400;\">Cochrane Database of Systematic Reviews<\/span><\/i><span style=\"font-weight: 400;\">.<\/span><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6513584\/\" target=\"_blank\" rel=\"noopener\"> <span style=\"font-weight: 400;\">https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6513584\/<\/span><\/a><\/p>\r\n<p><span style=\"font-weight: 400;\">Poorman, E., McPheeters, M., &amp; Jonas, D. E. (2024). Medications for alcohol use disorder. <\/span><i><span style=\"font-weight: 400;\">American Family Physician<\/span><\/i><span style=\"font-weight: 400;\">.<\/span><a href=\"https:\/\/www.aafp.org\/afp\/2024\/0100\/alcohol-use-disorder\" target=\"_blank\" rel=\"noopener\"> <span style=\"font-weight: 400;\">https:\/\/www.aafp.org\/afp\/2024\/0100\/alcohol-use-disorder<\/span><\/a><\/p>\r\n<p><span style=\"font-weight: 400;\">Stokes, M., Patel, P., &amp; Abdijadid, S. (2024). Disulfiram. In <\/span><i><span style=\"font-weight: 400;\">StatPearls<\/span><\/i><span style=\"font-weight: 400;\">. StatPearls Publishing.<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\" target=\"_blank\" rel=\"noopener\"> <span style=\"font-weight: 400;\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/<\/span><\/a><\/p>\r\n<p><span style=\"font-weight: 400;\">Tiglao, S. M., Meisenheimer, E. S., &amp; Oh, R. C. (2021). Alcohol withdrawal syndrome: Outpatient management. <\/span><i><span style=\"font-weight: 400;\">American Family Physician, 104<\/span><\/i><span style=\"font-weight: 400;\">(3), 253\u2013262.<\/span><a href=\"https:\/\/www.aafp.org\/afp\/2021\/0900\/p253\" target=\"_blank\" rel=\"noopener\"> <span style=\"font-weight: 400;\">https:\/\/www.aafp.org\/afp\/2021\/0900\/p253<\/span><\/a><\/p>\r\n","protected":false},"excerpt":{"rendered":"<p>Disulfiram is a prescription drug used in treatment for people who want to stop alcohol consumption and maintain abstinence. It does not reduce cravings in the same way as naltrexone or acamprosate. Instead, Antabuse creates a deterrent effect by causing an unpleasant and potentially dangerous reaction if a person drinks while taking it (Stokes et [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false},"categories":[],"tags":[],"class_list":["post-10805","blog","type-blog","status-publish","hentry"],"acf":{"written_by":317,"enable_medically_and_up":["Yes"],"medically_reviewed_by":283,"medically_reviewed_content":"This article was reviewed by a medical professional to guarantee the delivery of accurate and up-to- date information. <a href=\"\/research\/\">View our research policy.<\/a>","up_to_date":"<i>Last Updated<\/i> - <b>12\/29\/2022<\/b>","page_first_published_date":"20221229","page_last_edit_date":"20221229","highlighted_description":"If you or a loved one is struggling with addiction, help is available. Speak with a Recovery Advocate by calling <a href=\"tel:8886480738\"> (561) 340-7269<\/a> now.","key_takeaways":"<b>Key Takeaways<\/b>\r\n<ul>\r\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Disulfiram (Antabuse) is not the strongest first-line medication option for every person with alcohol use disorder. A 2023 systematic review <\/span><b>found stronger evidence for oral naltrexone and acamprosate<\/b><span style=\"font-weight: 400;\">, while disulfiram may be useful for selected patients whose goal is abstinence and who have adherence support (<\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2811435\"><span style=\"font-weight: 400;\">McPheeters et al., 2023<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/li>\r\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Disulfiram is usually best for people who have already stopped drinking and want to remain abstinent. It is not meant for people who are intoxicated, still actively drinking or unsure whether they want to stop (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/li>\r\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drinking while taking it can trigger symptoms within about 10 to 30 minutes, including flushing, nausea, vomiting, headache, fast heartbeat, chest pain, breathing problems, fainting or seizures (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/li>\r\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Alcohol should be avoided while taking this drug and for up to 14 days after the last dose because symptoms can still occur after stopping it (<\/span><a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a682602.html\"><span style=\"font-weight: 400;\">MedlinePlus, 2017<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/li>\r\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Alcohol can be hidden in products like mouthwash, cough medicine, cooking wine, sauces, extracts, aftershave, lotions and some topical products. Ask a doctor or pharmacist what to avoid before starting treatment (<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\"><span style=\"font-weight: 400;\">Stokes et al., 2024<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/li>\r\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Effectiveness depends heavily on whether the drug is taken consistently. A Cochrane review found stronger benefit in open-label or supervised settings, while blinded studies showed less consistent benefit (<\/span><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6513584\/\"><span style=\"font-weight: 400;\">Pedersen et al., 2018<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/li>\r\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Disulfiram does not treat alcohol withdrawal. If you drink heavily or daily, stopping suddenly can cause dangerous symptoms, including seizures or delirium tremens, so medical detox may be needed before starting medication (<\/span><a href=\"https:\/\/www.aafp.org\/afp\/2021\/0900\/p253\"><span style=\"font-weight: 400;\">Tiglao et al., 2021<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/li>\r\n \t<li aria-level=\"1\">This treatment may not be safe for people with certain heart conditions, severe liver disease, psychosis, seizure disorders, pregnancy-related concerns or suicidal thoughts. Liver monitoring may be needed before and during care (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459340\/\">Stokes et al., 2024<\/a>).<\/li>\r\n<\/ul>","source":{"source_label":"View Sources","source_content":"The American Psychiatric Association. \u201c<a href=\"https:\/\/psychiatryonline.org\/doi\/pdf\/10.1176\/appi.books.9781615371969\" target=\"_blank\" rel=\"noopener\">Practice Guideline For The Pharmacological Treatment of Patients With Alcohol Use Disorder<\/a>.\u201d 2018. Accessed July 18, 2019.\r\n\r\nCenter for Substance Abuse Treatment. \u201c<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK64036\/\" target=\"_blank\" rel=\"noopener\">Incorporating Alcohol Pharmacotherapies Into Medical Practice: Chapter 3- Disulfuram<\/a>.\u201d 2009. Accessed July 18, 2019.\r\n\r\nMedlinePlus. \u201c<a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a682602.html\" target=\"_blank\" rel=\"noopener\">Disulfiram<\/a>.\u201d August 15, 2017. Accessed July 18, 2019.\r\n\r\nMoos, RH; Moos, BS. \u201c<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1976118\/\" target=\"_blank\" rel=\"noopener\">Rates and predictors of relapse after natural and treated remission from alcohol use disorders<\/a>.\u201d Addiction, September 11, 2007. Accessed July 19, 2019.\r\n\r\nThe National Institute on Alcohol Abuse and Alcoholism. \u201c<a href=\"https:\/\/www.niaaa.nih.gov\/alcohol-health\/overview-alcohol-consumption\/alcohol-facts-and-statistics\" target=\"_blank\" rel=\"noopener\">Alcohol Facts and Statistics<\/a>.\u201d August 2018. Accessed July 18, 2019.\r\n\r\nThe National Institute on Alcohol Abuse and Alcoholism. \u201c<a href=\"https:\/\/www.niaaa.nih.gov\/alcohol-health\/overview-alcohol-consumption\/alcohol-use-disorders\" target=\"_blank\" rel=\"noopener\">Alcohol Use Disorder<\/a>.\u201d Accessed July 18, 2019.\r\n\r\nPubChem. \u201c<a href=\"https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/Disulfiram\" target=\"_blank\" rel=\"noopener\">Disulfiram<\/a>.\u201d Accessed July 18, 2019.\r\n\r\nSubstance Abuse and Mental Health Services Administration. \u201c<a href=\"https:\/\/store.samhsa.gov\/system\/files\/sma15-4907.pdf\" target=\"_blank\" rel=\"noopener\">Medication for the Treatment of Alcohol Use Disorder: A Brief Guide<\/a>.\u201d 2015. Accessed July 18, 2019.\r\n\r\nWeathermon, R; Crabb, DW. \u201c<a href=\"https:\/\/pubs.niaaa.nih.gov\/publications\/arh23-1\/40-54.pdf\" target=\"_blank\" rel=\"noopener\">Alcohol and Medication Interactions<\/a>.\u201d Alcohol Research &amp; Health, 1999. Accessed July 19, 2019."},"staff_member_heading":"Authorship","staff_member":[{"staff_member_title":"Editor","select_staff_member":317},{"staff_member_title":"Medical Reviewer","select_staff_member":283}],"insurance_label":""},"_links":{"self":[{"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/blog\/10805","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/blog"}],"about":[{"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/types\/blog"}],"author":[{"embeddable":true,"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/comments?post=10805"}],"version-history":[{"count":0,"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/blog\/10805\/revisions"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/staff\/283"},{"embeddable":true,"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/staff\/317"}],"wp:attachment":[{"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/media?parent=10805"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/categories?post=10805"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.floridarehab.com\/wp-json\/wp\/v2\/tags?post=10805"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}