disulfiram at a glance
Medicine class
Alcohol-deterrent treatment
Usual role
Supporting abstinence in carefully selected people receiving supportive treatment
Key safety point
Avoid alcohol during treatment and for up to 14 days after stopping
Administration
Oral tablet swallowed with water
What is disulfiram used for?
Disulfiram is licensed as an alcohol-deterrent adjunct for carefully selected, cooperative people with drinking problems.
It helps maintain abstinence from alcohol.
It must accompany appropriate psychological, social or other supportive treatment.
How does disulfiram work?
Disulfiram irreversibly blocks aldehyde dehydrogenase, an enzyme involved in breaking down alcohol. Alcohol then causes acetaldehyde to accumulate, producing flushing, nausea, headache and palpitations, with potentially severe cardiovascular or neurological effects. The anticipated reaction acts as a deterrent.
disulfiram preparations and strengths
Tablet
Route: Oral
Strengths: 200 mg
How to take disulfiram
Take disulfiram exactly as prescribed and swallow the tablet with water. It must not be started during a drinking episode. Avoid alcoholic drinks and check foods, liquid medicines, remedies, mouthwashes, toiletries, perfumes and sprays for alcohol. Even low-alcohol or alcohol-free products may sometimes trigger a reaction.
Do not deliberately test the reaction by drinking alcohol.
Make sure family or supporters understand the alcohol restriction.
Avoid alcohol for up to 14 days after treatment stops.
disulfiram side effects
Common or expected effects
- Drowsiness or fatigue, particularly early in treatment; frequency is not known.
- Nausea, vomiting, unpleasant breath, rash or allergic dermatitis; frequency is not known.
Get urgent medical advice
- Liver injury, with jaundice, fever or feeling unexpectedly unwell.
- Alcohol reaction causing marked flushing, sweating, vomiting, breathlessness, palpitations, low blood pressure or collapse.
- New visual disturbance, severe confusion, weakness, numbness or other possible nerve or brain effects.
- New psychosis, mania, severe depression or suicidal thoughts.
disulfiram in pregnancy
Disulfiram is usually avoided during pregnancy, particularly during the first trimester. Evidence is limited, and alcohol exposure while taking it could harm both the pregnant person and baby. Exceptional use requires specialist assessment.
disulfiram while breastfeeding
Disulfiram should not normally be used while breastfeeding because transfer into milk and effects on the baby are unknown. Specialist alcohol-treatment and breastfeeding advice is needed if it is being considered.
disulfiram interactions
Check all prescribed, over-the-counter and liquid products because disulfiram can alter hepatic drug metabolism.
Alcohol and alcohol-containing products
May cause an unpredictable, potentially life-threatening disulfiram–alcohol reaction.
Warfarin and similar anticoagulants
Their anticoagulant effect may increase, requiring closer monitoring and possible adjustment.
Phenytoin or theophylline
Reduced metabolism may increase effects and toxicity, so monitoring and adjustment may be needed.
Common questions about disulfiram
Answers are fully visible for fast scanning and source review.
Does disulfiram reduce alcohol cravings?
Not directly. It mainly deters drinking by making alcohol exposure unpleasant and potentially dangerous.
Can I drink alcohol while taking disulfiram?
No. Even a small amount can trigger a severe reaction.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.