disulfiram, Antabuse

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Prescription Drug Abuse Statistics

PREPARATIONS: Tablets: 250 and 500 mg

DRUG INTERACTIONS: Disulfiram may increase the effect of warfarin (Coumadin) and increase the risk of bleeding. The dose of warfarin may require adjustment.

Patients taking isoniazid and disulfiram may develop unsteady gait or significant changes in mental status. Disulfiram should be stopped if such symptoms appear.

Disulfiram may increase blood levels of phenytoin (Dilantin), leading to high blood levels of phenytoin. Blood levels of phenytoin should be monitored and the dose of phenytoin should be adjusted as needed.

PREGNANCY AND BREASTFEEDING SAFETY: Safe use of disulfiram by pregnant women has not been established. It is not known whether disulfiram is excreted in human milk

STORAGE: Disulfuram should be storec at room temperature, 20 C to 25 C (68 F to 77 F).

DOSING: Disulfiram should not be started unless a patient has stopped ingesting alcohol for at least 12 hours.

  • The initial dose is 500 mg every day for 1 to 2 weeks.
  • After two weeks a maintenance dose of 125 to 500 mg is given daily.
  • The average maintenance dose is 250 mg daily.
  • Treatment is continued until the patient develops self control.
  • Maintenance therapy may be required for months or even years.

DRUG CLASS AND MECHANISM: Disulfiram is an oral drug used for treating alcoholism. Alcohol is converted in the body into acetaldehyde by an enzyme called alcohol dehydrogenase. Another enzyme called acetaldehyde dehydrogenase then converts acetaldehyde into acetic acid. Disulfiram prevents acetaldehyde dehydrogenase from converting acetaldehyde into acetic acid, leading to a buildup of acetaldehyde levels in the blood.

High acetaldehyde levels cause unpleasant symptoms after drinking alcohol such as:

These unpleasant side effects dissuade alcoholics from drinking. The FDA approved disulfiram in August, 1951.

Medically reviewed by Omudhome Ogbru, PharmD

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 1/19/2016

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