Addiction Alcohol Use Antabuse (Disulfiram) Treatment for Alcohol Use Disorder What to know about this preventive medicine By Buddy T Buddy T Facebook Twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial process Updated on May 17, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Table of Contents View All Table of Contents How It Works Antabuse and Alcohol Side Effects Who Shouldn't Take It What You Need to Know What It Doesn't Do Effectiveness How to Use Antabuse (disulfiram) is a medicine used to treat alcohol abuse and alcohol dependence. It can be an effective deterrent because it causes an extremely unpleasant reaction if a person drinks alcohol while taking it. Antabuse was the first medicine approved by the Food and Drug Administration (FDA) to treat alcohol use disorder. How Antabuse Works When you consume alcohol, your body metabolizes it into acetaldehyde—a toxic substance that causes many of the hangover symptoms that occur after heavy drinking. Under normal circumstances, your body continues to oxidize acetaldehyde into acetic acid, which is harmless. How Alcoholic Metabolism Works Antabuse interferes with this metabolic process by preventing the oxidation of acetaldehyde into acetic acid. This causes a build-up of acetaldehyde in the body that is five to 10 times greater than what would normally be present after drinking alcohol. Effects of Drinking While on Antabuse The high concentration of acetaldehyde that occurs when someone drinks while taking Antabuse triggers a very unpleasant reaction. The severity of the reaction, which can range from mild to severe, depends on how much Antabuse and alcohol are consumed. Symptoms last as long as alcohol is in the body. The effects of Antabuse or disulfiram begin about 10 minutes after alcohol enters the body and can last for an hour or more. Someone who drinks alcohol while taking Antabuse may experience symptoms including: FlushingNauseaCopious vomitingSweatingThirstThrobbing in the head and neckHeadacheRespiratory difficultyChest painPalpitationsDyspnea (shortness of breath)Hyperventilation (rapid breathing)Tachycardia (rapid heartbeat)Hypotension (low blood pressure)Syncope (loss of consciousness)Marked uneasinessWeaknessVertigoBlurred visionConfusion Severe reactions can include respiratory depression, cardiovascular collapse, myocardial infarction (heart attack), acute congestive heart failure, unconsciousness, arrhythmias, convulsions, and even death. Antabuse Side Effects Even if you don't drink while taking Antabuse, it is still possible to experience some side effects. Some of the most common side effects of Antabuse include: AcneDrowsinessFatigueHeadacheMetallic aftertaste In rare cases, taking Antabuse can result in nerve pain or damage, psychosis, and skin rash. A few patients have had an acute liver injury as a result of taking disulfiram. Case studies have also associated disulfiram use with a single seizure episode. Does Antabuse Make You Lose Weight? At least one small-scale study found that taking disulfiram reduced binge-eating episodes, which could result in weight loss. However, out of the 12 subjects in the study, 11 reported having side effects, causing researchers to conclude that Antabuse is not a good solution for people with this eating disorder. Who Should Not Take Antabuse Only someone who wants to quit drinking and is fully aware of the consequences of drinking while on Antabuse should take this drug. Antabuse should never be given to someone without their knowledge and informed consent, nor should it be given to anyone who is intoxicated. Due to possible severe reactions, Antabuse should not be used by anyone with severe heart disease, psychosis, or an allergy to Antabuse. People who are pregnant should not take Antabuse or disulfiram unless their healthcare provider feels that the benefits outweigh the risks. Because disulfiram interactions can occur with other medications, someone taking Antabuse should also consult with their healthcare provider before taking other prescription or over-the-counter drugs. What to Know Before Using Antabuse If you are taking Antabuse, do not drink any alcoholic beverages, including wine and beer. Also stay away from other medications that contain alcohol while on Antabuse or disulfiram, such as cough syrup, elixirs, and some cold and flu products. Even hand sanitizers, aftershave, rubbing alcohol, mouthwash, perfume, and hairspray can all cause a response. It's equally important that you avoid all foods and beverages containing alcohol. This includes: Certain flavorings Kombucha Sauces Vinegar Avoiding these substances while taking Antabuse can help prevent a reaction. You can also help stop a reaction by not using these substances during the 12-hour period before you take your first dose and for several weeks after stopping the drug. Can You Drink Non-Alcoholic Beer While on Antabuse? What Antabuse Doesn't Do Antabuse serves as a physical and psychological deterrent for someone trying to stop drinking. It does not reduce the person's alcohol cravings, nor does it treat any alcohol withdrawal symptoms. Antabuse is not a cure for alcoholism; it only discourages drinking. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. How Effective Is Antabuse? In Europe (where Antabuse is more widely used than in the United States), research has shown that long-term use of this drug is effective in helping people stop drinking, producing abstinence rates of 50%. This research also revealed that the longer a person takes Antabuse, the more effective it is, because they develop a habit of not drinking. Other studies have failed to show such positive results. But it's also important to keep in mind that the effectiveness of Antabuse in helping someone to quit drinking depends on continued use of medication. Because Antabuse or disulfiram is administered in a daily pill, people can simply stop taking the drug and begin drinking several weeks later. What is the Most Effective Treatment for Alcoholism? How to Use Antabuse Antabuse or disulfiram is generally given in tablet form. There are two dosage options: 250 milligrams or 500 milligrams. The smaller Antabuse dosage may be attempted first to make sure the drug will be well tolerated, only moving up to the higher dosage if it is. Antabuse can be taken in the morning or evening, although evening may be best if it makes you tired. If you experience an upset stomach when taking disulfiram or Antabuse, take it with food to reduce this feeling. The tablet can also be crushed and added to water, juice, or coffee if this makes it easier to take. If you miss taking a pill at the regular time, don't double up or take the missed dose too close to when the next one is due. Antabuse begins acting fairly quickly after taking the very first dose and can create a response up to two weeks after the medication has been stopped. It is also recommended that people taking Antabuse carry a card with them that describes what will happen if they consume alcohol. This card should contain the name and phone number of a healthcare provider in case they need to be contacted in the event of a reaction. 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Center for Substance Abuse Treatment. Chapter 3—Disulfiram. In: Incorporating Alcohol Pharmacotherapies Into Medical Practice. Substance Abuse and Mental Health Services Administration. Stokes M, Abdijadid S. Disulfiram. In: StatPearls [Internet]. StatPearls Publishing. National Alliance on Mental Illness. Disulfiram (Antabuse). National Institute of Diabetes and Digestive and Kidney Diseases. LiverTox: Clinical and research information on drug-induced liver injury [Internet]. Vrishabhendraiah SS, Das G, Jagadeesh MK, Mruthyunjaya N. Disulfiram-induced seizures with convulsions in a young male patient: A case study. Indian J Psychiat. 2015;57(3):309-310. doi:10.4103/0019-5545.166625 Farci AMG, Piras S, Murgia M, et al. Disulfiram for binge eating disorder: An open trial. Eating Behav. 2015;16:84-87. doi:10.1016/j.eatbeh.2014.10.008 Krampe H, Stawicki S, Wagner T, et al. Follow-up of 180 alcoholic patients for up to 7 years after outpatient treatment: impact of alcohol deterrents on outcome. Alcohol Clin Exp Res. 2006;30(1):86-95. doi:10.1111/j.1530-0277.2006.00013.x Winslow B, Onysko M, Hebert M. Medications for alcohol use disorder. Am Fam Physician. 2016;93(6):457-465. Additional Reading Goh ET, Morgan MY. Review article: Pharmacotherapy for alcohol dependence - the why, the what and the wherefore. Aliment Pharmacol Ther. 2017;45(7):865-882. doi:10.1111/apt.13965 U. S. National Library of Medicine. Disulfiram. By Buddy T Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.