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Antabuse (Disulfiram) Side Effects

July 6, 2022

Table of Contents

Disulfiram (Antabuse) works by causing unpleasant side effects if you drink alcohol while taking it. In this way it serves to help people abstain from alcohol use. 

Antabuse for Alcohol Misuse

If you have a history of alcohol misuse, your doctor may offer you one of three medications that are approved to help abstain from alcohol. One is called Antabuse.

Antabuse (sold under the generic name “disulfiram”) can break the cycle of alcohol dependence. But this medication comes with significant side effects everyone should know about. 

Nowadays, Naltrexone and Acamprosate are newer medications and more commonly prescribed for AUD. However, for some individuals who have had good success with Disulfiram (Antabuse) in the past, or who cannot have Naltrexone or Acamprosate for other reasons, Antabuse might be a good choice for AUD. 

How Is Antabuse Used?

If your doctor adds Antabuse to your alcohol treatment plan, you'll take the medication on a set schedule, whether you think you face the risk of relapse or not. It is ideally given daily even before you drink so that if you do drink, you experience unpleasant side effects. In this way, you are disincentivized to drink again.

In addition to medication, you'll use therapy and support group work to help you stop drinking. Antabuse can't block alcohol cravings, so you'll need to work in therapy on coping strategies. 

Common Antabuse Side Effects

Antabuse blocks alcohol digestion, so your body fills with toxins that can cause unpleasant side effects. These side effects generally include head pounding, fast heart rate, and skin flushing, along with nausea and even vomiting. Th can make your head pound, your heart race, and your skin flush.[1]

These are a few side effects researchers have identified:

Allergic Reactions

Rarely, some people are allergic to Antabuse ingredients. After you take your first dose, you might notice that it's hard to breathe, and your throat or face may be swollen. You may also have a thick and red rash on your face or arms.

This is a medical emergency. Get help immediately. 

Cross Contamination

Antabuse should make you feel sick if you drink alcohol, but the medication can also interact with household substances like these:[2]

  • Liquid medications
  • Toiletries
  • Perfumes
  • Alcohol-free wine and beer

Read labels carefully, and don't use anything that contains alcohol. 

Fatigue

You may seem tired and weak while taking Antabuse. If the feeling persists and doesn't get better with rest, talk with your doctor.

Headache

Some people have a mild and transient headache that develops while taking Antabuse. Talk with your doctor about this before treating it with an over-the-counter medication like aspirin.

Mood Changes

Antabuse can spark some troublesome mental health concerns in some people. You might feel the following:

  • Paranoid
  • Confused
  • Excited 
  • Energetic 
  • Overly sexual

Bring these symptoms to your doctor immediately. A different medication might be right for you. 

Nerve Changes

Some people develop a tingling sensation in their hands and feet. Talk with your doctor about this issue before trying an over-the-counter medication to ease them. 

Strange Aftertaste

Antabuse pills shouldn't taste like anything, but some people taste garlic or metal in their pills. Drinking plenty of water may help.

Vision Changes

Blurred or jumpy vision could be a sign of nerve problems caused by Antabuse. Talk to your doctor about these symptoms immediately.

Who Is a Candidate for Disulfiram Treatment? Why choose it over Naltrexone or Acamprosate?

Nowadays, Doctors tend to use two other medications - Naltrexone and Acamprosate - more commonly than Disulfiram to treat alcohol use disorder, because of greater efficacy and tolerability of these medications. These two medications actually decrease cravings for alcohol before drinking, whereas disulfiram mostly just causes unpleasant side effects when a person does drink on the medication.[3]

For this reason, Disulfiram has fallen out of favor as a first line treatment for AUD. However, some patients have been on Disulfiram in the past and find it helpful. Other patients may not be able to have medications like Naltrexone because of liver disease. These are a few situations in which you and your doctor might choose Disulfiram instead of the other medications for AUD.

You've finished your detoxification program, and you're committed to getting sober, but you don't think you can make it without help. Antabuse could be just right for you.

The medication isn't right for you if you have a history of heart disease.[4] If you've ever been diagnosed with heart or vascular problems, talk to your doctor before filling your prescription.

Disulfiram may not be right for you if you've ever had any of the following:[5]

  • Brain damage
  • Diabetes
  • Epilepsy
  • Kidney disease 
  • Liver disease 
  • Thyroid disease

Don't let these side effects scare you. Remember that alcohol use disorder can be a fatal disease, especially if you are experiencing liver damage and continue to drink.

Your doctor can help you decide if medications could be helpful as you work on fighting your alcohol misuse issues. With the right medication and support, you can leave alcohol misuse in your past.

Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. Disulfiram. Prescribers' Digital Reference. https://www.pdr.net/drug-summary/Antabuse-disulfiram-681. Accessed June 2022.
  2. Antabuse. New Zealand Consumer Medicine Information. https://www.medsafe.govt.nz/Consumers/cmi/a/Antabusetab.pdf. May 2017. Accessed June 2022.
  3. Incorporating Alcohol Pharmacotherapies Into Medical Practice. Substance Abuse and Mental Health Services Administration. https://www.ncbi.nlm.nih.gov/books/NBK64036/. 2009. Accessed June 2022.
  4. Disulfiram (Antabuse). National Alliance on Mental Illness. https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Disulfiram-(Antabuse). January 2021. Accessed June 2022. 
  5. Disulfiram. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a682602.html. August 2017. Accessed June 2022.

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