Disulfiram
About Disulfiram
Disulfiram is an oral prescription medication used to help treat chronic alcohol dependence. It acts as a physical deterrent by causing highly unpleasant reactions if even small amounts of alcohol are consumed. This medication is designed to support individuals who are fully committed to maintaining sobriety as part of a structured recovery plan.
For the best results, you must take Disulfiram consistently every single day exactly as your doctor directs. You can take this medication with or without food, though taking it with food or at bedtime may help if you experience mild stomach upset or drowsiness. Alongside taking this medicine, participating in behavioural counselling, attending support groups, and making strict lifestyle changes to avoid all sources of alcohol are essential for your long-term success.
While using Disulfiram, some people may experience mild side effects, such as a metallic taste in the mouth, mild headaches, or drowsiness. However, you must contact your doctor immediately if you experience any serious side effects, particularly signs of liver damage, such as dark urine, severe stomach pain, or yellowing of your skin or eyes.
Do not take this if you have consumed alcohol in the past 12 hours, have severe heart disease, or have had a severe allergic reaction to this medication in the past. It is also important to talk to your doctor before starting this medicine if you have a history of liver disease, kidney problems, diabetes, an underactive thyroid, or mental health conditions like depression.
This medication can interact with other substances, such as blood thinners, certain seizure medications, and some antibiotics, potentially increasing the risk of side effects. If you are pregnant, planning to become pregnant, breastfeeding, or are an older adult, talk to your doctor or pharmacist to discuss if this treatment is appropriate for you.
Uses of Disulfiram
• Alcohol dependence treatment: Disulfiram helps people stop drinking by causing an unpleasant reaction when they consume alcohol.
• Behavioral therapy support: Often used alongside counseling and therapy to reinforce sobriety.
Medicinal Benefits
By creating a strong deterrent to alcohol consumption and supporting ongoing recovery efforts, Disulfiram offers several important benefits, including:
- Supports Long-Term Sobriety: Helps reduce the likelihood of drinking by causing an unpleasant reaction when alcohol is consumed.
- Encourages Accountability: Acts as a physical reminder of recovery goals, helping resist impulsive or unplanned alcohol use.
- Strengthens Behavioural Therapy Efforts: Complements counselling, support groups, and other recovery strategies by reinforcing abstinence.
- Provides Psychological Reassurance: Offers added confidence to both patients and their support network by creating a clear barrier against alcohol consumption.
- Promotes Focus on Recovery: Helps individuals concentrate on lifestyle changes, emotional well-being, and long-term behavioural improvements without the temptation of casual drinking.
Directions for Use
- Disulfiram can be taken with or without food as advised by your doctor.
- It should be taken once a day or as directed by the doctor.
- Swallow Disulfiram as a whole with a glass of water.
- If you have difficulty swallowing, crush them and mix with a liquid like water, milk, or juice.
Storage
Side Effects of Disulfiram
Common Side Effects (Usually mild):
- A temporary metallic or garlic-like taste in your mouth
- Mild drowsiness or daytime tiredness
- Headache
- Mild skin rash or acne
Serious Side Effects (Call a doctor right away):
- Signs of liver damage (such as yellowing of your skin or eyes, dark urine, severe upper stomach pain, or persistent nausea)
- Numbness, tingling, burning pain, or weakness in your hands or feet
- Sudden changes in vision or pain in your eyes
- Severe mental or mood changes, including confusion or extreme irritability
- Signs of a severe allergic reaction (such as hives, difficulty breathing, or swelling of your face, lips, tongue, or throat)
Medicines Containing this Salt
View AllDrug Warnings
- The 12-hour rule: Never take your first dose of Disulfiram unless you are 100% sure you have not consumed any alcohol for at least 12 hours.
- Carry medical identification: Always carry an emergency medical card or wear a medical alert bracelet stating that you are taking this medicine, as this is crucial information for emergency medical staff.
- Understand the lingering effect: Be aware that your body will remain highly sensitive to alcohol for up to 14 days after you stop taking Disulfiram. Do not drink alcohol during this two-week window.
- Keep up with blood tests: Attend all scheduled medical appointments. Your doctor will need to perform routine blood tests to monitor your liver function while you are on this medicine.
- Report nerve changes: Inform your doctor immediately if you notice any numbness, tingling, or 'pins and needles' sensations in your fingers or toes.
Drug Interactions
Drug-Drug Interactions
Disulfiram can interact with medicines that affect blood clotting, seizure control, or brain function, including:
- Blood thinners (like warfarin): Disulfiram can increase the effects of blood thinners, which may raise your risk of bleeding. Your doctor may need to adjust your blood thinner dose.
- Certain seizure medications (like phenytoin): This medication can slow down how your body clears seizure drugs, leading to toxic levels in your system.
- Certain antibiotics (like metronidazole): Taking these medications together can cause severe confusion, mental changes, or hallucinations.
Drug-Food Interactions
Alcohol can trigger a severe reaction while taking Disulfiram, including alcohol that may be hidden in foods, beverages, or other products:
- Alcohol-containing foods and beverages: Consuming even trace amounts of alcohol will trigger a highly dangerous physical reaction, including severe headache, rapid breathing, vomiting, chest pain, and a dangerous drop in blood pressure.
Drug-Disease Interactions
Disulfiram may require special caution in people with conditions affecting the liver, heart, or mental health, including:
- Liver disease: Because this medicine is processed by the liver and carries a risk of liver damage, it must be used with extreme caution if you have pre-existing liver problems.
- Heart disease: The physical strain of an accidental alcohol reaction can be dangerous to your cardiovascular system, making this medication risky for those with severe heart conditions.
- Mental health disorders: This medication can affect brain chemicals and may worsen symptoms of depression, psychoses, or other psychiatric conditions.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeNot recommended for alcoholism as Disulfiram and alcohol causes severe 'aldehyde reaction' causing life-threatening conditions.
Pregnancy
cautionNot enough data available but Disulfiram is not given in pregnant females unless recommended in a doctor.
Breast Feeding
unsafeNot recommended as such, as not enough data is available. Breastfeeding mothers should consult a doctor before taking the Disulfiram.
Driving
cautionNot recommended before driving. Disulfiram has been found to cause drowsiness in the patient. Hence, taking Disulfiram before driving or performing hazardous tasks is not recommended.
Liver
cautionNot recommended in liver patients. Disulfiram has been found to cause liver damage in patients & hence not recommended to be taken without doctors consultation.
Kidney
cautionNot recommended in kidney patients. Disulfiram should be taken by kidney patients only on doctors consultation.
Children
unsafeStrictly not recommended in children. it may result in neurological interactions resulting in harmful symptoms.
Habit Forming
Diet & Lifestyle Advise
- Avoid all forms of alcohol: You must completely avoid beer, wine, spirits, and non-alcoholic or low-alcohol beers, as even trace amounts of alcohol can trigger a severe reaction.
- Check food labels: Read ingredient lists carefully to ensure your food does not contain alcohol, wine vinegars, cooking wines, or spirits (often found in sauces, soups, and desserts).
- Screen personal care products: Many everyday items like mouthwashes, aftershaves, perfumes, colognes, and hand sanitizers contain alcohol that can be absorbed through the skin or inhaled. Opt for alcohol-free alternatives.
- Be cautious with over-the-counter medicines: Many liquid cough syrups, cold remedies, and tonics contain alcohol. Always read the labels or ask your pharmacist for alcohol-free choices.
Special Advise
Disulfiram may interfere with certain laboratory tests (including urine VMA/HVA tests), possibly causing false test results. It is a paramount priority for a patient to enlighten the laboratory personnel and all their doctors to know they use this drug.
Disulfiram should never be given to a patient when they are in a state of alcohol intoxication or without his full knowledge.
After you stop taking Disulfiram, do not drink alcohol for at least seven days as your body needs to start making the enzyme 'acetaldehyde' again. In case, drinking alcohol earlier than this may trigger an 'aldehyde reaction'.
Patients Concern
Disease/Condition Glossary
Chronic alcoholism: Alcoholism is the addictive drinking of alcohol that results in physical & mental problems. A person can become an alcoholic out of stress, depression or just after developing a chronic habit. Excessive alcohol use can damage various organs like the brain, heart, kidneys and most importantly, the liver, which leads to liver cirrhosis (liver dysfunction). In most severe cases, there is an immediate need for liver transplantation. During pregnancy, drinking alcohol in large amounts affects the unborn baby and may lead to various birth complications.
FAQs
Disulfiram is used to treat alcohol dependence or chronic alcoholism.
Disulfiram contains 'Disulfiram', which belongs to 'Antabuse' used to treat alcohol dependence. It works by blocking an enzyme (acetaldehyde) that helps break alcohol in the body. Disulfiram helps alcohol-dependent people who have decided to quit alcohol drinking by deterring them from drinking again.
An asthmatic patient, if already on cough-suppressing medications like diphenhydramine, is not recommended to take Disulfiram. Disulfiram and diphenhydramine are contraindicated and may result in harmful implications.
Not recommended in patients taking blood thinners like warfarin to prevent blood clot formation inside heart/brain vessels. Warfarin (blood thinner) and Disulfiram are contraindicated and should not be taken together.
Yes, Disulfiram has been implicated in altering the results of tests done for adrenal tumours & hence not recommended to be taken before any diagnostic test is done.
The common side effects of Disulfiram are usually temporary, including headaches, nausea, a metallic taste in the mouth and feeling tired.
Take the missed dose as soon as you remember. Take the rest of the day's doses at evenly spaced intervals unless otherwise directed by your doctor.
Disulfiram is safe if taken in the dose and duration prescribed by the doctor.
Disulfiram is not an over-the-counter medicine. It can be taken only when prescribed by the doctor.
Disulfiram is not addictive. It does not have habit-forming tendencies.
Disulfiram will not work for everyone. It is used to help people with an alcohol addiction who have already stopped drinking and are maintaining their ability to no longer drink alcohol. Disulfiram is not recommended for people with heart failure or coronary artery disease.
Disulfiram takes 1-2 hours to start working. For the full benefits, keep taking Disulfiram for the prescribed duration.
No, you should avoid non-alcoholic or 'alcohol-free' beers and wines. Many of these products still contain trace amounts of alcohol, which can be enough to trigger a highly unpleasant physical reaction. Talk to your doctor or pharmacist if you have questions about specific beverages.
You must wait at least 14 days after your last dose of Disulfiram before consuming any alcohol. The medication remains active in your body for up to two weeks, and drinking during this time can still trigger a severe reaction.
If you experience a reaction, even a mild one, monitor your symptoms closely. If you experience severe symptoms like chest pain, severe shortness of breath, rapid heart rate, or extreme dizziness, seek emergency medical care immediately.
Some people can experience a mild skin reaction or headache from absorbing alcohol through the skin or inhaling strong vapours from aftershaves, perfumes, or hand sanitisers. It is safest to use alcohol-free personal care products while on this medication.
Disulfiram does not directly reduce or stop physical cravings for alcohol. Instead, it acts as a behavioural deterrent by making the physical consequences of drinking highly unpleasant. It is most effective when combined with counselling and support groups.
Disulfiram is generally not recommended during pregnancy unless your doctor decides the benefits heavily outweigh the risks. If you are pregnant or planning to become pregnant, talk to your doctor to discuss safer treatment alternatives for alcohol dependence.
Yes, experiencing a metallic or garlic-like taste in your mouth is a very common and usually harmless side effect of Disulfiram. This symptom typically fades as your body adjusts to the medication.
Yes, your doctor will likely order routine blood tests to check your liver function before you start taking this medicine and at regular intervals during your treatment. This helps ensure the medication is not causing any strain on your liver.
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