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Disulfiram for Alcohol Addiction & Dependence

Medication can play an essential role in helping a patient overcome their addiction. When it comes to alcohol use disorder (AUD), one of the most effective medications is disulfiram. 

Disulfiram works by inducing unpleasant and uncomfortable symptoms in a patient who consumes alcohol while taking the medication. This effect makes disulfiram one of the top deterrents for alcohol currently available. 

What is Disulfiram (Antabuse)?

There are currently three medications approved by the Food and Drug Administration (FDA) to treat alcohol dependence.1 In 1949, disulfiram, which is also known by the brand name Antabuse®, was the first medication to receive FDA approval.2  

For the past 75 years, disulfiram has been an effective option to use in medication-assisted treatment (MAT). For patients with alcohol use disorder, MAT integrates specific medications into their treatment plan that will either deter or change the desired effects of drinking alcohol.3  

Disulfiram medication comes in the form of a tablet and is taken once a day.1 It can be crushed and mixed with a liquid like water or fruit juice if a patient cannot take pills. 

How Disulfiram Works for Alcohol Addiction

While alcohol abuse medications like naltrexone and acamprosate decrease cravings for alcohol, disulfiram serves another role: it creates extremely unpleasant symptoms if alcohol is ingested.

So, how does disulfiram work? Disulfiram’s drug class is called “alcohol antagonists.” This group of medications changes how the body responds to alcohol. In disulfiram’s case, it produces a sensitivity to alcohol.4 It does this by blocking the oxidation of alcohol at a specific stage, which results in a higher concentration of acetaldehyde in the blood than usual. Our bodies don’t cope well with high amounts of acetaldehyde, resulting in a host of unpleasant symptoms.4  

To avoid this uncomfortable disulfiram and alcohol reaction, the patient stops drinking alcohol, making disulfiram a strong deterrent of alcohol abuse.

Effects of Taking Disulfiram With Alcohol

Drinking alcohol while taking disulfiram will result in several severe symptoms. While the intensity of the effects will depend on how much alcohol was consumed, even small amounts of alcohol can cause unpleasant repercussions. This is why someone taking disulfiram is instructed to avoid foods, sauces, cough syrups, and products like mouthwash that contain alcohol to prevent any unwanted symptoms.5,6  

The effects of consuming alcohol while taking disulfiram are experienced quickly, within 10 minutes of drinking.5 The symptoms can last for one hour or more, depending on how much was ingested. 

Because of the intensity of the effects, patients are instructed to wait at least 12 hours after their last drink before they begin taking disulfiram. When a patient stops taking the medication, they may experience an adverse reaction to drinking for up to two weeks after their last dose.5

Effects of mixing alcohol and disulfiram (Antabuse) can include:5

  • Headache
  • Vomiting
  • Chest pain
  • Sweating
  • Nausea
  • Weakness
  • Blurred vision
  • Flushing of the face
  • Mental confusion
  • Breathing difficulty or feeling of choking
  • Anxiety

Is Disulfiram (Antabuse) Safe?

Yes, disulfiram is considered to be a very safe medication when taken as prescribed. Over the past 70 years, doctors have determined the optimal disulfiram uses and adjusted how they utilize the medication, now prescribing lower doses. This decrease in dosage, along with not allowing patients with heart issues to take disulfiram, has led to serious reactions to the medication being very rare.7  

However, like many medications, patients taking disulfiram for alcoholism may experience some side effects. These are typically mild unless the medication is misused.7   

Side Effects of Taking Disulfiram

Some patients may experience side effects of disulfiram (Antabuse), while others may experience none. While many believe the benefits of the medication outweigh disulfiram’s side effects, the prescribing doctor can answer any concerns about unwanted disulfiram reactions.. 

Common side effects of disulfiram can include:5,6

  • Mild headache
  • Drowsiness
  • Skin rash
  • Acne
  • Change in sex drive
  • Garlic or metallic taste in the mouth

Less common disulfiram side effects can include:5,6

  • Excessive lethargy
  • Loss of appetite
  • Upset stomach
  • Allergic reactions like hives
  • Confusion or disorientation
  • General flu-like feeling
  • Numbness
  • Dark urine

Drug Interactions With Disulfiram

Some medications that use the same enzyme system as disulfiram can interact with the drug when used at the same time. Medications that could cause a disulfiram reaction include:7

  • Benzodiazepines, including Chlordiazepoxide (Librium®) and Diazepam (Valium®): Could make the effects last longer or have stronger effects.
  • Tricyclic antidepressants, amitriptyline (Elavil®): May cause delirium.
  • Metronidazole (Flagyl®): Could lead to a higher risk of psychosis. 
  • Isoniazid: May cause unsteadiness or changes in mental health.
  • Oral anticoagulant (e.g., warfarin [Coumadin®]): Could become stronger than intended.
  • Oral hypoglycemic: Could cause symptoms similar to those experienced after consuming alcohol.

How Long Is Disulfiram Prescribed for? 

Each patient’s medical provider will decide the best time to begin a disulfiram protocol. The guiding principle is that the first dose should be at least 12 hours after the last drink.6  

Disulfiram is not addictive, and it does not have withdrawal symptoms upon stopping use of the medication.7 The length of disulfiram treatment will depend on the person, with some patients taking disulfiram for months, while others take it for years. Research has indicated that the psychological effects of the medication may be as beneficial as the pharmacological effects, which could be a factor in long-term use of disulfiram for alcohol use disorder.7

Will Insurance Cover Disulfiram Treatment?

Yes, medications like disulfiram (Antabuse) used in medication-assisted treatment are covered by insurance. This is due to The Mental Health Parity and Addiction Equity Act (MHPAEA), which requires health insurers to provide the same level of benefits for substance use treatment that they do for medical/surgical care.8

The exact amount of coverage will depend on your specific insurance policy. To find out what your plan’s coverage includes, contact your insurance company directly. Our rehab admissions team at Empowered Recovery Center in Kansas City is also happy to verify your benefits on your behalf. 

Alcohol Addiction Treatment in Kansas City 

Seeking treatment for an alcohol addiction can seem overwhelming, but MAT methods like disulfiram can make the process less daunting and more manageable. Our team of addiction professionals can put together a customized MAT plan that utilizes the most effective medications and innovative strategies to get you on the path to long-term sobriety.

At Empowered Recovery Center in Kansas City, we combine expertise with compassion throughout your treatment. Together, we’ll explore our different treatment options—medical detox, partial hospitalization, intensive outpatient, or standard outpatient—to determine the best fit for your specific needs. We’ll explain every step of the admissions process, including our different payment options and using insurance, so you feel confident on your first day of treatment. 

Give us a call or fill out our contact form to learn how medication-assisted treatment like disulfiram could make all the difference in overcoming your alcohol addiction.

References

  1. Stokes, M., Patel, P., & Abdijadid, S. (2024, September 10). Disulfiram. StatPearls – NCBI Bookshelf. Retrieved July 27, 2025, from  https://www.ncbi.nlm.nih.gov/books/NBK459340/ 
  2. Medications Development Program | (n.d.). National Institute on Alcohol Abuse and Alcoholism (NIAAA). Retrieved July 27, 2025, from https://www.niaaa.nih.gov/medications-development-program 
  3. Mullen, B., & Jackman, R. (n.d.). Medication Assisted Treatment (MAT) for Alcohol Use Disorder (AUD): an overview. Retrieved July 27, 2025, from https://medschool.cuanschutz.edu/docs/librariesprovider294/default-document-library/mat-overview-10-28-2020.pdf?sfvrsn=5b388db9_0 
  4. DailyMed – DISULFIRAM tablet. (n.d.). Retrieved July 27, 2025, from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b90f8ff4-4fb3-46ab-8149-cb55f24a4044 
  5. Disulfiram: MedlinePlus Drug Information. (n.d.). Retrieved July 27, 2025, from https://medlineplus.gov/druginfo/meds/a682602.html 
  6. Disulfiram tablets. (2024, December 26). Cleveland Clinic. Retrieved July 27, 2025, from https://my.clevelandclinic.org/health/drugs/18185-disulfiram-tablets 
  7. Treatment, C. F. S. A. (2009). Chapter 3—Disulfiram. Incorporating Alcohol Pharmacotherapies Into Medical Practice – NCBI Bookshelf. Retrieved July 27, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK64036/
  8. Division, D. C. (2023, May 30). Does insurance cover treatment for opioid addiction? HHS.gov. Retrieved July 27, 2025, from https://www.hhs.gov/opioids/treatment/insurance-coverage/index.html
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