Antabuse (disulfiram) for Treating Alcoholism

  • 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

What is Antabuse, and how does it work (mechanism of action)?

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.

Is Antabuse available as a generic drug?

Yes, this drug is available in generic form.

Do I need a prescription for this drug?

Yes, you need a prescription from your doctor or other health care professional for this medication.

What are the uses for Anabuse?

Antabuse is used of treating alcoholism. It is used in combination with supportive care and psychotherapy.

Antabuse BLACK BOX WARNING and side effects

When alcohol is consumed by a patient taking disulfiram, effects include:

Common side effects of include:

Possible serious side effects  include:

Antabuse should never be given to a patient who is intoxicated, or without his or her full knowledge. Relatives of patients should be advised about this warning also.
Patients should be fully informed about the Antabuse-alcohol reaction and must be strongly warned about drinking while taking Antabuse. Patients should avoid alcohol in all forms, including alcohol in sauces, vinegars, cough mixtures, mouth wash, aftershave lotions, and back rubs.

Antabuse may cause a reaction with alcohol up to 14 days after ingestion.

Antabuse should be used cautiously in patients with diabetes, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic impairment.

Antabuse should not be given to people with severe heart disease, people allergic to Antabuse, and people with psychosis.

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What is the dosage for Antabuse, and how should it be taken?

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.

Which drugs or supplements interact with this medication?

  • Disulfiram may increase the effect of warfarin (Coumadin, Jantoven) 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.
  • The liquid form of ritonavir (Norvir) contains alcohol which can cause a severe reaction in people taking disulfiram.

Is this drug safe to take if I'm pregnant or breastfeeding?

  • Safe use of disulfiram by pregnant women has not been established.
  • It is not known whether disulfiram is excreted in human milk

What else should I know about this drug?

What preparations of are available?

  • This medication is available as tablets of 250 mg and 500 mg.

How should I keep this medication stored?

  • This drug should be stored at room temperature, 20 C to 25 C (68 F to 77 F).

When was it approved by the FDA?

  • The FDA approved disulfiram in August, 1951.

Reference: FDA Prescribing Information

Summary

Antabuse (disulfiram) is an drug used to treat alcoholism by interfering with how the body breaks down the alcohol. If a patient drinks alcohol on the drug, he or she will experience a range of unpleasant and even dangerous side effects like vomiting, seating, throbbing headache, confusion, and shortness of breath; removing the urge to drink. Read about side effects, drug interactions, and pregnancy safety information.

Treatment & Diagnosis

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Reviewed on 5/9/2017
References
Reference: FDA Prescribing Information

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