Is Antabuse Dangerous?

October 10, 2022

Table of Contents

Antabuse is a safe and effective therapy for people struggling with an alcohol use disorder (AUD).

Antabuse (generic name “Disulfiram”) is a drug to help people abstain from alcohol use. It works by making people feel very sick when they drink alcohol. If they take this medication and then subsequently drink alcohol, they will experience symptoms like a racing heart, nausea and vomiting, headaches, and overall “flu like symptoms”.

Antabuse is really the oldest medication for addiction treatment (MAT) for AUD currently on the market. Nowadays, newer medications like Naltrexone and Acamprosate are more commonly prescribed for AUD because unlike Antabuse that simply makes you feel sick when you drink, these other medications actually work by reducing cravings to drink, making them more tolerable and potentially more effective than Antabuse.

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 Safe Is Antabuse for Regular People?

Most people can take Antabuse safely. The most common problems people report while taking the drug include headaches, fatigue, and anxiety.[1]

Antabuse blocks the breakdown of alcohol’s metabolites. However, it also blocks the breakdown of some other substances which may make you feel sick accidentally even if you don’t take any alcohol. People can experience reactions while taking these substances:[2]

  • Cough syrup
  • Tonics
  • Elixirs
  • Cold medication
  • Certain foods like cheeses

If you are using Antabuse, be careful to ask your doctor about any other medications, substances or foods you should avoid. 

Who Shouldn’t Take Antabuse?

While most people can take Antabuse safely there are exceptions.

People who shouldn't take Antabuse have the following:[3]

  • Cardiovascular disease: Some people with heart disease might want to avoid antabuse. 
  • Psychosis: People with mental health issues, including episodes of psychosis, have experienced breakthrough mental health symptoms while on Antabuse. 
  • Liver disease: Disulfiram is processed by the liver, and people with liver issues may not move the drug out of their bodies fast enough.

In addition, Antabuse does not address cravings for alcohol the way that some newer medications do. [4] Therefore it might be a viable option for some people, but it is certainly not the most tolerated or necessarily the first line for AUD medications anymore.  

What Can I Try Instead?

The U.S. Food and Drug Administration approved two other drugs for alcoholism treatment. Unlike Disulfiram, which simply causes unpleasant symptoms if someone drinks while on the medication, the following medications actually act to prevent cravings for alcohol and the overall urge to drink, making likely more effective medications for AUD.

Those two drugs include:[5]

  • Acamprosate: a medication that works to decrease your cravings for alcohol 
  • Naltrexone: a medication that works to decrease your cravings for alcohol

If you are interested in using either Antabuse, Acamprosate or Naltrexone for AUD, your doctor can work with you and find the pharmaceutical solution that's right for you and your lifestyle.

Medically Reviewed By 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. The Safety of Disulfiram for the Treatment of Alcohol and Cocaine Dependence in Randomized Clinical Trials: Guidance for Clinical Practice. Expert Opinion in Drug Safety. https://pubmed.ncbi.nlm.nih.gov/18613809/. July 2008. Accessed August 2022.
  2. Disulfiram (Antabuse). National Alliance on Mental Illness. https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Disulfiram-(Antabuse). January 2016. Accessed August 2022. 
  3. Disulfiram. StatPearls. https://www.statpearls.com/ArticleLibrary/viewarticle/20621. January 2021. Accessed August 2022. 
  4. The Relative Safety of Disulfiram. Addictive Disorders and Their Treatment. https://journals.lww.com/addictiondisorders/Abstract/2013/09000/The_Relative_Safety_of_Disulfiram.5.aspx. September 2013. Accessed August 2022. 
  5. Medications for Alcohol Use Disorder. American Family Physician. https://www.aafp.org/pubs/afp/issues/2016/0315/p457.html. 2016. Accessed August 2022.

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