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Antabuse is a brand name for the active drug disulfiram. It is prescribed as part of a broader treatment plan for people with alcohol use disorder to discourage drinking by causing an aversive response if alcohol is consumed. It is intended to be used together with counseling, metric monitoring, and other support services.
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Quick facts sheet
- Bioactive ingredient in this product: disulfiram.
- Main use: support for people trying to maintain alcohol abstinence.
- Typical tablet strengths available: 250 mg and 500 mg tablets.
- Route: oral. Tablets can be crushed and mixed with drink for people who have trouble swallowing.
- Deterrent effect: can begin within hours and sensitivity to alcohol may last up to 14 days after stopping.
For more on the the governing mechanism, see The the way this operates by which this medicine works. For safety measures, see Important safety notices and alerts of potential danger.
How this drug operates
Disulfiram inhibits the enzyme aldehyde dehydrogenase. When someone taking disulfiram drinks alcohol, acetaldehyde accumulates and causes an unpleasant reaction. Symptoms may include flushing, throbbing head pain sensation, nausea, vomiting, chest discomfort, shortness of breath, and weakness. In rare or severe cases, cardiac rhythm disturbances, seizures, or death have been reported.
Because the heightened sensitivity to alcohol can continue for as long as two weeks after the last dose, patients must avoid alcoholic beverages and products that contain alcohol during treatment and for at least 14 days after stopping.
Disulfiram is most effective for those who are firmly committed to abstinence and who are followed closely by a clinician or support team.
Dosage and administration
Follow the prescriber's directions with precision. Typical directions include:
- Take orally with a full glass of water at the time of day recommended by your clinician.
- Do not ingest any alcohol within 12 hours before taking a dose.
- Keep dosing on a regular schedule; do not self-adjust frequency without consulting your prescriber.
- Tablets can be crushed and mixed with a suitable liquid if swallowing whole is difficult.
- Do not discontinue the medication abruptly without medical advice.
- For children or adolescents, dosing requires pediatric expertise and special caution.
See Operational warnings and standard safety precautions for important everyday safety necessary safeguards to take into account related to dosing and alcohol avoidance.
General warnings and precautionary measures
Do not take disulfiram if you have consumed alcohol recently or plan to drink. Even tiny amounts of alcohol while on treatment can produce severe reactions.
Make sure household members and caregivers know you are taking disulfiram and understand emergency steps if a reaction occurs. Call emergency services for severe symptoms such as respiratory trouble, chest pain, fainting, or seizures.
Watch out for hidden alcohol in everyday items. Examples include:
- Mouth rinses, breath sprays, and some toothpastes.
- Aftershave lotions, perfumes, and colognes.
- Certain cough syrups, cold remedies, tonics, and liquid pain relievers.
- Cooking wines, vinegars, sauces, and some fermented foods or extracts.
- Herbal preparations or topical liniments that contain ethanol.
If you are unsure whether a product contains alcohol, consult a pharmacist. Kindly take a look as well foreseen a mutual exchange of ideass span conversations, gestures, and feedback. listed at Drug the process of people engaging potential and conditions under Medical when treatment is forbidden.
Who should not take disulfiram
Disulfiram is contraindicated when any of the following apply:
- Recently consuming alcohol or coming into contact with alcohol-containing products.
- Use of metronidazole or paraldehyde at the same time.
- Current psychotic episode or a history of psychotic disorders.
- Severe cardiovascular disease, including advanced coronary disease.
- Substantial liver impairment.
- Allergy to disulfiram or to thiuram derivatives (for example, some rubber accelerators).
- Pregnancy, planning to conceive, or breastfeeding.
Exercise caution and discuss risks with your clinician if you have kidney disease, diabetes, hypothyroidism, seizure disorders, or other significant medical problems.
Possible effects to watch for
Seek medical attention promptly if you notice anything abnormal. any of these serious signs:
- Jaundice, dark urine, or pain in the right upper abdomen
- Severe mental changes such as confusion, disorientation, or loss of touch with reality
- Swelling of the face, lips, tongue; rash or severe itching
- Marked weakness, fever, or flu-like symptoms
- New neurological symptoms, such as numbness, tingling, or vision changes
- Persistent loss of appetite accompanied by vomiting
Common, generally milder effects that often subside over time include ache in the head, fatigue, drowsiness, a metallic or garlic-like taste, nausea, and sexual dysfunction. Notify your prescriber if these persist or worsen.
If an alcohol-disulfiram reaction occurs, stop drinking immediately and seek emergency care for severe reactions.
Drug the act of connecting with others effects
Avoid all forms of alcohol. Disulfiram can also interact with a number of medicines; some core the study maps how interplay between partiess evolve over time. include:
- Medications to avoid entirely: metronidazole, paraldehyde.
- Solutions that contain alcohol, such as some formulations of ritonavir or sertraline oral solutions.
- Antivirals and related agents: amprenavir, lopinavir, ritonavir (formulation-specific issues).
- Certain chemotherapy agents such as paclitaxel.
- Recent cocaine use may increase risk of unfavorable health effects.
- Monoamine oxidase inhibitors, for example tranylcypromine.
Medications that may require continuous monitoring or dose adjustment include:
- Warfarin is listed as an anticoagulant. (risk of altered bleeding tendency).
- Phenytoin sodium (possible elevation of levels).
- Isoniazid can be referred to as INH in medical records. (added risk of liver injury and central nervous system effects).
The list provides only partial coverage. Always provide a full list of prescription drugs, over-the-counter medicines, supplements, and herbal products to your clinician, and mention tobacco or recreational substance use.
Treatment guidance for i skipped the doses
If you skip a dose, take it as soon as you remember, but only if the next dose is not near. When you are almost due for your next pill, skip the missed pill and continue as usual. Do not double up on medication to substitute for a i did not take a dose.
What you should do if there is an overdose
If you suspect an overdose on pills of disulfiram, contact your local poison control center or jump to the nearest emergency department without delay. Bring the medication container and any remaining tablets if possible.
Memory storage management helps organize and track items. care instructions
- Store out of the reach of children.
- Keep at room temperature, ideally between 20 and 25 degrees C (68 to 77 degrees F).
- Protect from light and moisture in a tightly closed container.
- Throw away expired or unused tablets per local ordinances or pharmacy take-back services.
Comparable drugs and herbal medicines
There are several other medications and strategies that may be considered depending on the clinical situation and patient preferences:
- Naltrexone (oral 50 mg): reduces the rewarding effects of alcohol and can lower the frequency of heavy drinking days. Usually taken once daily.
- Naltrexone extended-release injection (Vivitrol): administered once every 4 weeks; helps adherence but has higher out-of-pocket cost before insurance.
- Acamprosate (standard drug dosage involves multiple tablets per day): supports maintenance of abstinence by modulating glutamate and GABA pathways.
- Off-label options for some patients: topiramate and gabapentin. Evidence and tolerability vary; these are chosen selectively.
How they compare with disulfiram:
- Disulfiram produces a deterrent by creating an unpleasant reaction if alcohol is consumed; it is best suited to patients committed to complete abstinence.
- Naltrexone lowers craving and can reduce the rewarding effects of alcohol, which may help even if occasional lapses occur.
- Acamprosate is primarily used to maintain abstinence after detoxification and craving control has started.
Refer to the appendix the cost comparison table. Price estimates for the US market (USD). For access and prescribing rules, see The legal framework for prescription practices in the US..
Price ranges in the United States (USD)
Retail prices vary by pharmacy, geographic region, discounts, and insurance coverage. The ranges below are estimates and subject to change.
- Disulfiram generic 250 mg: roughly $10 to $60 for a 30-tablet supply; 100 tablets may cost about $20 to $120.
- Disulfiram generic 500 mg: approximately $15 to $90 for 30 tablets.
- Antabuse brand product: less commonly stocked; when available, retail cost for a 30-tablet supply may exceed $150 to $300.
Nearby different substitutes in conjunction with their approximate costs before insurance:
- Naltrexone 50 mg tablets (generic): about $15 to $70 per month.
- Naltrexone XR injection (Vivitrol): approximately $1500 to $2000 per 4-week dose.
- Acamprosate 333 mg: often ranges $60 to $180 per month depending on dose and supplier.
Tip: Prices can differ widely between brick-and-mortar pharmacies and online retailers. Ask about generic options, manufacturer coupons, or pharmacy discount programs to reduce out-of-pocket costs.
US guidelines and laws on prescribing medicines.
- Regulatory status: disulfiram is approved by the U.S. Food and Drug Administration and is prescription-only.
- Prescription requirement: a valid prescription from a clinician licensed in the United States is required for dispensing.
- Telemedicine: electronic prescribing is permitted when the prescriber follows federal and state regulations and holds a valid license in the patient's state.
- Online pharmacies: legitimate U.S. pharmacies require a prescription. Avoid vendors that offer to ship prescription drugs without one.
- Importation rules: bringing prescription drugs into the U.S. from abroad is restricted and may result in seizure or legal consequences without proper authorization.
- Controlled substance status: disulfiram is not classified as a controlled substance, though standard prescription rules apply.
- Extra information: disulfiram implants are not FDA-approved in the United States. Insurance coverage varies by plan; many insurers cover the generic product.
For state-specific rules consult your state board of pharmacy or speak with your prescriber or pharmacist.
