Disulfiram (Antabuse) for Alcohol

Someone handed you the name Antabuse, and you are trying to tell a deterrent pill from the medicine that keeps withdrawal from becoming a seizure. Disulfiram is the older of the three medicines the Food and Drug Administration has approved for alcohol use disorder. NIAAA's clinician article calls it the older medication and calls acamprosate and naltrexone the newer ones. NIAAA's treatment fact sheet describes it in one line: a pill that discourages drinking by causing unpleasant symptoms when alcohol is consumed. The other two are naltrexone and acamprosate. NIAAA says all three are nonaddictive and may be used alone or with behavioral treatment or mutual-help groups. What follows is only about disulfiram. It does not give a milligram, a start date you can copy, or permission to drink in order to test the reaction.

If someone has chest pain, trouble breathing, a seizure, or will not wake, call 911. For a mental health crisis, call or text 988. After a long run of heavy drinking, stopping all at once can be medically dangerous. Disulfiram is not the medicine used for that emergency.

The other two approved medicines are the acamprosate guide and the naltrexone guide. People who were handed the name Antabuse and want the alcohol-reaction medicine should stay here.

What the pill is supposed to do

NIAAA's clinician article says disulfiram interferes with alcohol metabolism by blocking the enzyme acetaldehyde dehydrogenase. Acetaldehyde then builds up. The article names flushing, nausea, and other unpleasant symptoms when alcohol is consumed. It calls disulfiram a pill taken once per day that helps patients maintain abstinence. Once a day is the schedule in that article. The amount is a prescriber's decision.

MedlinePlus, last revised August 15, 2026, uses the older clinical phrase "chronic alcoholism" and places the drug in a class called alcohol deterrents. It says the medicine causes unpleasant effects when even small amounts of alcohol are consumed. The list is longer than NIAAA's summary: flushing of the face, headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety. Those effects begin about 10 minutes after alcohol enters the body and last for 1 hour or more. "About" and "or more" are the limits of that sentence. They are not a timer you can set at the kitchen table.

The same page says disulfiram is not a cure. It discourages drinking. It controls the problem in the sense that the reaction is a deterrent, and it does not end the disorder. Do not stop the medicine without talking with the prescriber. NIAAA's consumer handout adds a different point that is easy to mix up with that instruction: the approved alcohol medicines are not addictive, and stopping the pills does not cause a withdrawal syndrome from the medicine itself. Those two sentences can both be true. The pill is not a drug you withdraw from, and you still tell the prescriber before you stop, because an alcohol reaction can outlast the last tablet.

MedlinePlus says a reaction may occur for up to 2 weeks after disulfiram has been stopped. NIAAA's clinician article says the medicine should never be administered until the patient has abstained from alcohol for at least 12 hours. MedlinePlus matches that window from the other direction: the patient should not take disulfiram for at least 12 hours after drinking. The handout's comparison chart is blunt about the goal. In the row for people who want to cut down, medication is marked "all except disulfiram." This medicine is for a plan of not drinking. It is a poor match for a plan of drinking less while staying on the pill.

It is not withdrawal care

The consumer handout is explicit. Naltrexone, acamprosate, and disulfiram do not help withdrawal symptoms. Other medicines can prevent dangerous withdrawal. The handout lists shakes, nausea, vomiting, headaches, sweating, and irritability as common withdrawal symptoms, and it says withdrawal can lead to seizures and confusion. Untreated severe withdrawal can kill. NIAAA's understanding-of-AUD fact sheet says people with severe alcohol use disorder may need medical help to avoid withdrawal if they stop after prolonged heavy drinking, and that withdrawal can be life-threatening.

Those warning signs are the symptoms guide and the timeline guide. Withdrawal medicines and the medicines used afterward are separated on the rehab guide. Waiting out a seizure because a deterrent pill exists on paper is not a plan.

MedlinePlus also says never give disulfiram to a patient who is intoxicated, and never give it without the patient's full knowledge. The reaction is the treatment's point. It is also the reason a family member does not crush it into a drink. Chest pain, confusion, and trouble breathing are on the effect list. Get emergency help if those are happening now.

Alcohol that is easy to miss

MedlinePlus tells patients not to drink any alcoholic beverages, including wine, beer, and medications that contain alcohol such as cough syrup, while taking disulfiram, during the 12 hours before the first dose, and for several weeks after stopping. It also says to avoid sauces, vinegars, and all foods and beverages containing alcohol. "Several weeks" is the page's phrase for the period after the last dose. It lines up with the warning that a reaction may occur for up to 2 weeks after stopping. It is not a calendar you invent for a holiday.

The same page warns about products that are not drinks. Do not come in contact with or breathe the fumes of paint, paint thinner, varnish, shellac, and other products containing alcohol. Aftershave, cologne, and rubbing alcohol applied to the skin may cause headache, nausea, local redness, or itching. That is a reason to ask a clinician or pharmacist before using them. Do not test the warning on your own skin. A small reaction is still a reaction, and a large one needs medical care.

Mild effects that MedlinePlus says to tell the doctor about if they are severe or do not go away include skin rash, acne, mild headache, drowsiness, tiredness, impotence, and a metallic or garlic-like taste. The page also says the drug may make you drowsy, and not to drive or operate machinery until you know how it affects you. Drowsiness from the pill is separate from the alcohol reaction. Neither one is a reason to add alcohol to take the edge off.

Heart, liver, and what to tell the prescriber

MedlinePlus says to tell the doctor if you have severe heart disease. The doctor will probably tell you not to take disulfiram. Also tell the prescriber about diabetes, thyroid disease, epilepsy, brain damage, and kidney or liver disease, including any history of those conditions. Pregnancy, plans for pregnancy, and breastfeeding belong in the same conversation. If you become pregnant while taking it, call the doctor. Surgery, including dental surgery, is a time to say you take the medicine.

Some side effects are reasons to call the doctor immediately, in the MedlinePlus list: excessive tiredness, weakness, lack of energy, loss of appetite, lower abdominal pain, vomiting, yellowing of the skin or the whites of the eyes, dark urine, or clay-colored stools. Those can be signs of liver trouble. They are not a complete list of emergencies. Chest pain, trouble breathing, or collapse needs the emergency help already named above.

The page says the doctor will order lab tests to check the response to disulfiram, and that patients should keep those appointments. It also says to carry identification stating that you take disulfiram and naming the doctor or institution to contact in an emergency. Ask the pharmacist or doctor how to get a card if you need one. Bring a written list of every prescription, nonprescription medicine, vitamin, and supplement to each visit.

In an overdose, MedlinePlus says to call the poison control helpline at 1-800-222-1222. If the person has collapsed, had a seizure, has trouble breathing, or cannot be awakened, use the emergency number above.

NIAAA's clinician article notes that some patients find the newer medicines, acamprosate and naltrexone, more appealing than disulfiram because disulfiram makes people feel sick if they drink. That is a preference, not a ranking of who will do well. The article also says that if one medicine does not help, another is often worth a try, and that a prescriber does not need specialized addiction training or a separate addiction license to prescribe these medicines. How to ask whether counseling and a prescriber will work together is the therapist guide. The broader page on medicines in treatment is the medication guide.

What to ask

1. Has it been at least 12 hours since the last drink, and is anyone treating withdrawal first?
2. Is the goal abstinence? The handout does not put disulfiram in the "cut down" column.
3. Which heart, liver, kidney, pregnancy, and other-medicine facts does the prescriber already have?
4. Which cough syrups, sauces, and skin products should this person avoid, and for how long after the last dose?
5. Who is the clinician if a reaction or a liver symptom shows up after hours?

FindTreatment.gov can narrow a search for programs. Safety for one person is a prescriber's question. Call or text (800) 653-9376 if you want help finding a program or a prescriber who can talk through alcohol medicines.

Additional Resources

Sources cited on this page:

• NIAAA: Treatment for Alcohol Problems: Finding and Getting Help
• NIAAA Core Resource: Recommend Evidence-Based Treatment: Know the Options
• NIAAA: Options for people who are thinking about their drinking
• NIAAA: Understanding Alcohol Use Disorder
• MedlinePlus: Disulfiram (last revised August 15, 2026)
• SAMHSA FindTreatment.gov
• 988 Suicide & Crisis Lifeline

Common Questions