What Antabuse Is

Antabuse is the trade name historically associated with disulfiram, a prescription medicine used to support recovery from alcohol dependence. It is usually provided as oral tablets in 250 mg and 500 mg strengths. While Antabuse can be an important tool, it is most effective when combined with counseling, support programs, and regular medical follow up.

Looking for safety details first? Jump to precautions or see who should not take it in contraindications.

How It Works and Common Use

Disulfiram helps discourage drinking by blocking the enzyme that metabolizes acetaldehyde, a breakdown product of alcohol. If a person drinks alcohol while on disulfiram, acetaldehyde rapidly builds up and triggers a strong aversive reaction that can include flushing, pounding headache, nausea, vomiting, chest discomfort, shortness of breath, and palpitations.

Because even small amounts of alcohol can provoke a severe reaction, people taking Antabuse must avoid all sources of alcohol, including some over-the-counter products and toiletries. For specific examples, see Key Precautions.

Dosage and Directions

Always follow your prescriber’s instructions on the label. Typical administration is by mouth with water. Tablets may be crushed and mixed with liquid if needed. Start only after you have avoided alcohol for at least 12 hours.

  • Take at the same time each day to build a routine.
  • Do not take more often than prescribed or stop without your clinician’s guidance.
  • Disulfiram can interact with alcohol for up to 14 days after the last dose. Continue to avoid alcohol during this period.
  • Pediatric use is not routinely recommended; discuss with a pediatric specialist if ever considered.

If you have questions about administration or timing, ask your pharmacist or clinician. For what to do if you forget a dose, see Missed Dose.

Key Precautions

Never take Antabuse if you have consumed alcohol recently, and make sure close contacts know you are taking disulfiram in case of an emergency. Even small alcohol exposures may lead to a dangerous reaction. Severe events such as breathing problems, arrhythmias, seizures, or rarely death can occur.

Alcohol can hide in many everyday products. Read labels carefully and avoid items that contain alcohol, including but not limited to:

  • Aftershave, cologne, or body sprays
  • Mouthwash and breath fresheners
  • Cough, cold, or liquid pain medications
  • Cooking wines, some sauces, and vinegars
  • Tinctures or elixirs, and certain tonics
  • Some sanitizers and liniments

If you are unsure whether a product contains alcohol, ask a pharmacist. For conditions where use is unsafe, go to Who Should Not Take It.

Who Should Not Take It

Disulfiram is not appropriate for everyone. Tell your prescriber about your full medical history. Avoid Antabuse if any of the following apply:

  • Psychotic disorder or history of psychosis
  • Recent alcohol intake or exposure to products containing alcohol
  • Liver disease or abnormal liver tests
  • Allergy to disulfiram or thiuram derivatives found in some pesticides or rubber products
  • Pregnancy, plans to become pregnant, or breast-feeding
  • Heart disease
  • Seizure disorders
  • Taking metronidazole or paraldehyde
  • Brain injury or brain damage
  • Underactive thyroid
  • Kidney disease
  • Diabetes

Some conditions may require special monitoring rather than absolute avoidance. Discuss risks and benefits with your clinician.

Possible Side Effects

Seek medical help right away if you notice:

  • Yellowing of eyes or skin, dark urine, or right upper belly pain
  • Rash, hives, itching, or swelling of face, lips, or tongue
  • Confusion, irritability, disorientation, or loss of contact with reality
  • Numbness, pain, or tingling in hands or feet
  • Severe fatigue or flu-like feeling
  • Changes in vision
  • Marked loss of appetite or persistent nausea

More common and usually mild effects:

  • Headache
  • Dizziness or drowsiness
  • Nausea or vomiting
  • Metallic or garlic-like taste
  • Changes in sex drive or performance
  • Tiredness

Mild effects often improve as your body adjusts. If symptoms persist or bother you, contact your healthcare professional.

Drug and Alcohol Interactions

Never combine Antabuse with alcohol or alcohol-containing products. Important interaction examples include:

  • Metronidazole or paraldehyde
  • Ritonavir oral solution or sertraline oral solution
  • Paclitaxel
  • Phenytoin
  • Isoniazid
  • Warfarin and other anticoagulants
  • Lopinavir and ritonavir combinations
  • Amprenavir
  • Cocaine
  • Tranylcypromine

This is not a complete list. Provide your clinician with a full inventory of prescription drugs, OTC medicines, vitamins, and herbs. Tell them if you smoke, drink alcohol, or use recreational drugs. Some items may interact with your medicine or increase risks.

Missed Dose

If you miss a dose, take it when you remember unless it is close to the next scheduled dose. If it is almost time, skip the missed dose and resume your regular schedule. Do not double up.

Overdose

If you think you or someone else may have taken too much disulfiram, call your local emergency number or contact Poison Control in the USA at 1-800-222-1222 immediately.

Storage

  • Store at 20 to 25 degrees C (68 to 77 degrees F).
  • Keep tablets in a tightly closed, light-resistant container.
  • Keep out of reach of children and pets.
  • Discard any remaining medication after the expiration date.

Alternatives and Similar Medicines

Several other medications can help treat alcohol use disorder. Choice depends on drinking patterns, medical conditions, and personal preferences. Discuss options with your prescriber.

  • Naltrexone (oral 50 mg; extended-release injectable 380 mg monthly, brand Vivitrol). Helps reduce rewarding effects of alcohol and cravings. Avoid in acute hepatitis or liver failure and in people needing opioid therapy.
  • Acamprosate (Campral; 333 mg tablets, typically 666 mg three times daily). Supports abstinence by modulating glutamate and GABA. Preferred when liver disease is present; adjust for kidney function.
  • Topiramate (off-label). May decrease heavy drinking days and cravings. Can cause paresthesias, cognitive slowing, and weight loss.
  • Gabapentin (off-label). Can reduce cravings and help with sleep or anxiety in early recovery. Dose adjust for renal function; watch for sedation.

Some people use disulfiram as a deterrent while also engaging in therapy or support groups. Others prefer craving-focused options like naltrexone. Combined behavioral supports generally improve outcomes regardless of medication choice.

Typical Prices in USD

Cash prices vary by pharmacy, strength, and quantity. Insurance, manufacturer programs, and discount cards can reduce costs. The ranges below are approximate monthly totals in the United States as of recent market data.

  • Disulfiram 250 mg once daily: roughly 15 to 60 USD for 30 tablets; 500 mg once daily: about 25 to 90 USD for 30 tablets.
  • Oral naltrexone 50 mg daily: about 20 to 70 USD for 30 tablets (generic).
  • Vivitrol injection 380 mg monthly: often 1500 to 2000+ USD per dose before insurance.
  • Acamprosate 333 mg (typical total 6 tablets daily): about 50 to 150 USD for a 1 month supply (generic).
  • Topiramate or gabapentin (generic, off-label): frequently 5 to 30 USD per month depending on dose.

Ask your pharmacist to compare prices and check for generic options or discount programs in your area.