Uses
What is disulfiram used for?
Disulfiram is commonly used to help people with an alcohol use disorder who have already stopped drinking maintain their ability to no longer drink alcohol.
Disulfiram may also be used for other conditions as determined by your healthcare provider.
How does disulfiram work (mechanism of action)?
Disulfiram works by causing people a high amount of discomfort when taken with any amount of alcohol.
How is disulfiram supplied (dosage forms)?
Disulfiram is available in the following dosage forms that are taken by mouth.
- 250 mg oral tablets
- 500 mg oral tablets
How should I store disulfiram?
Disulfiram should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of disulfiram?
The most common side effects of disulfiram are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Tiredness
- Headache
- Acne
- Change in how things taste
There may be other side effects of disulfiram that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of disulfiram?
While less common, the most serious side effects of disulfiram are described below, along with what to do if they happen.
Severe Allergic Reactions. Disulfiram may cause allergic reactions, which can be serious. Stop taking disulfiram and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking disulfiram. Keep all appointments you have to get your blood checked. Call your healthcare provider right away if you have any of the following symptoms of liver damage.
- Nausea or vomiting
- Stomach or belly pain
- Fever
- Weakness or unusual tiredness
- Itching
- Loss of appetite
- Light-colored poop
- Dark-colored urine (pee)
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Nerve Damage. Nerves are the fibers that carry sensations from your body to the brain. Damage to nerves, such as peripheral neuropathy and optic neuritis, can happen in people who are taking disulfiram. Stop taking disulfiram and call your healthcare provider if you develop any of the following symptoms.
- Vision changes or vision loss
- Pain when you move your eyes
- Burning, tingling, numbness, or weakness in your arms, hands, legs and/or feet
Warnings & Precautions
Who should not use disulfiram?
Allergies to Ingredients. People who are allergic to any of the following should not take disulfiram.
- Disulfiram
- Antabuse
- Rubber
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific disulfiram products they stock.
Drug Interactions. Disulfiram should not be taken while you are using certain other medicines. Before taking disulfiram, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Alcohol. Disulfiram should not be taken with alcohol. See the Interactions section for more details.
Heart Disease. People with severe heart disease should not take disulfiram.
False Thoughts or Senses (Psychosis). People who see, hear or believe things that are not real should not take disulfiram.
What should I know about disulfiram before using it?
Do not take disulfiram unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share disulfiram with other people, even if they have the same condition as you. It may harm them.
Keep disulfiram out of the reach of children and pets.
Disulfiram leaves the body slowly. People can still possibly have discomfort if alcohol is consumed up to two weeks after disulfiram is stopped.
People who take disulfiram will not develop a tolerance to it. The longer a person takes disulfiram, the easier it will be for any amount of alcohol consumed to cause discomfort.
Disulfiram is not likely to have a strong effect on a person who no longer wants to drink alcohol unless it is combined with motivation and supportive therapy. Disulfiram will help you not drink alcohol, especially if you get counseling and support. Attend all therapy or support groups that may have been recommended to you.
People who take disulfiram should be aware of the presence of alcohol in common foods and products, such as sauces, vinegars, cough products, toothpaste, mouthwash, shave lotions and massage oils.
Disulfiram can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how disulfiram affects you.
People taking disulfiram should carry an identification card stating that they are taking disulfiram, the symptoms that may occur when disulfiram is combined with alcohol, and the contact information for their healthcare provider in the event of an emergency.
It is very important for you to not consume alcohol while taking this medicine. At least 12 hours must pass between the last time you consumed alcohol and when you take disulfiram. If you consume alcohol while taking disulfiram, you may have the following severe side effects.
- Flushing
- Severe headache
- Breathing problems
- Nausea, vomiting
- Sweating
- Chest pain/heart attack
- Feeling skipped or fast heart beats
- Heart failure
- Fainting
- Seizures
- Death
Disulfiram is not a cure for alcohol use disorder. Disulfiram can be used for as long as you feel it is helping. Should you wish to stop disulfiram, call your healthcare provider.
It is possible that people with an alcohol use disorder may begin to use other substances of misuse such as narcotics or opioids. Should you or your loved one begin to use substances other than alcohol, call your healthcare provider.
What should I tell my healthcare provider before using disulfiram?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if disulfiram is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider about any of the following.
- Diabetes
- Hypothyroidism
- Epilepsy
- Brain damage
- Nephritis
- Liver problems
- Heart disease, including heart attack
Pregnancy. It is not known if or how disulfiram could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take disulfiram while you are pregnant or trying to get pregnant.
Breastfeeding. It is not known if disulfiram passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take disulfiram while breastfeeding.
Interactions
Does disulfiram interact with foods or drinks?
There are no known interactions between disulfiram and foods or drinks.
Do not consume alcohol while taking disulfiram and for at least two weeks after stopping this medicine. You can get serious side effects if disulfiram is combined with even a small amount of alcohol. Be sure to check the labels of commonly used products like foods/sauces, mouthwash/toothpaste, lotions/rubs and cough syrups to see if they contain alcohol.
Does disulfiram interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using
In particular, make sure that you discuss if you are using any of the following before taking disulfiram.
- Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
- Warfarin, which is a blood thinner
- Isoniazid, which is an antibiotic commonly used to treat tuberculosis
- Metronidazole (Flagyl and others), which is a medicine commonly used to treat bacterial and other infections
This may not be a complete list of medicines that can interact with disulfiram. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much disulfiram?
If you or someone else has used too much disulfiram, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of disulfiram?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
Are you currently using Disulfiram?
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