Disulfiram

Disulfiram is a prescription medication used to treat Alcoholism. 

• Disulfiram is available under the following different brand names: Antabuse.

Adult dosage

Tablet

• 250mg
• 500mg

Alcoholism

Adult dosage

• Only administer after the patient has abstained from ethanol for at least 12 hours
• 500 mg orally once daily initially for 1-2 weeks; not to exceed 500 mg/day
• Maintenance: 250 mg orally once daily (125-500 mg range); continue therapy until a basis for self-control has been established; patient may continue to take drug therapy for months or even years.

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”.

Common side effects of Disulfiram include:

• skin rash, 
• acne, 
• mild headache, 
• tiredness, 
• impotence, 
• loss of interest in sex, and 
• metallic or garlic-like taste in the mouth

Serious side effects of Disulfiram include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• flushing (warmth, redness, or tingly feeling), 
• sweating, 
• increased thirst, 
• swelling, 
• rapid weight gain, 
• nausea, 
• severe vomiting, 
• neck pain, 
• throbbing headache, 
• blurred vision, 
• chest pain, 
• shortness of breath, 
• fast, slow, or pounding heartbeats, 
• fluttering in the chest, 
• confusion, 
• weakness, 
• spinning sensation, 
• feeling unsteady, 
• lightheadedness, 
• severe chest pain spreading to the jaw or shoulder, 
• weak pulse, 
• seizure, 
• fainting, 
• weak or shallow breathing, 
• slow breathing or breathing that stops, 
• eye pain, 
• sudden vision loss, 
• unusual thoughts or behavior, 
• upper stomach pain, 
• itching, 
• tiredness, 
• loss of appetite, 
• dark urine, 
• clay-colored stools, and
• yellowing of the skin or eyes (jaundice)

Rare side effects of Disulfiram include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Disulfiram has severe interactions with the following drugs:
  • benznidazole
  • dronabinol
  • eliglustat
  • ritonavir
• Disulfiram has serious interactions with the following drugs:
  • carbamazepine
  • ethonal
  • lonafarnib
  • metronidazole
  • pexidartinib
  • Selinexor
  • tinidazole
  • tipranavir
• Disulfiram has moderate interactions with at least 30 other drugs.
• Disulfiram has minor interactions with at least 31 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Ethanol, metronidazole, paraldehyde, any alcohol-containing produced (eg, some mouthwashes)
• Severe cardiac disease
• Coronary occlusion
• Psychosis
• Hypersensitivity

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Disulfiram?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Disulfiram?”

Cautions

• When EtOH ingested by patient taking disulfiram: flushing, throbbing HA, N/V, diaphoresis, thirst, SOB, syncope, vertigo, blurred vision, confusion; respiratory depression, cardiac arrhythmias, MI or liver failure may occur
• Use caution in diabetes, hypothyroidism, seizures, nephritis, hepatic impairment
• Severe hepatitis and/or hepatic failure has been associated with therapy even in patients without prior history of abnormal hepatic function

Pregnancy and Lactation

• Use with caution if benefits outweigh risks during pregnancy. 
• Lactation: excretion in milk unknown/not recommended.