acamprosate vs disulfiram

PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.

Side-by-side comparison of acamprosate and disulfiram. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

minor Known Drug Interaction

The pharmacokinetics of acamprosate are not affected by alcohol, diazepam, or disulfiram, and clinically important interactions between naltrexone and acamprosate were not observed [ see Clinical Pharmacology (12.3) ].

Drug Class
acamprosate GABA Analog (Alcohol Dependence)
disulfiram Aldehyde Dehydrogenase Inhibitor
Type
acamprosate Prescription
disulfiram Prescription
Summary
acamprosate

Acamprosate is a medicine that can help you stay away from alcohol if you are alcohol-dependent and have already stopped drinking. It should be used with counseling and support.

disulfiram

Disulfiram is a medicine that helps people with long-term alcohol problems stay sober. It is meant to be used with counseling and support.

What It Treats
acamprosate

Acamprosate helps people who are alcohol-dependent to not drink alcohol. You must have already stopped drinking before you start taking acamprosate. This medicine works best when it is part of a complete treatment plan that includes counseling and support.

disulfiram

Disulfiram helps manage chronic alcohol problems. It is for people who want to stop drinking. This medicine works best when combined with counseling and support to help you stay sober. It is not a cure for alcoholism.

How It Works
acamprosate

Acamprosate is similar to a natural substance in your brain. It is thought to work by helping to restore the normal balance of brain activity that is changed by long-term alcohol use. This can reduce your craving for alcohol.

disulfiram

Disulfiram blocks the body from breaking down alcohol. If you drink alcohol while taking this medicine, you will feel sick. This helps you avoid drinking alcohol.

Common Side Effects
acamprosate
  • Accidental injury
  • Weakness
  • Pain
  • Loss of appetite
  • Diarrhea
disulfiram
  • Mild drowsiness
  • Tiredness
  • Headache
  • Acne
  • Skin rash
FAERS Reports
acamprosate
  • Hypotension 14
  • Asthenia 13
  • Condition Aggravated 13
  • Acute Kidney Injury 12
  • Coma 12
disulfiram
  • Drug Interaction 120
  • Fatigue 82
  • Toxicity To Various Agents 63
  • Nausea 48
  • Confusional State 47
Serious Warnings
acamprosate

Acamprosate may increase the risk of suicidal thoughts or actions. Your doctor should watch you for depression or suicidal thoughts. Tell your doctor right away if you have any new or worsening symptoms of depression or suicidal thoughts.

disulfiram

If you take disulfiram and drink alcohol, you may have a very bad reaction. This can cause flushing, headache, nausea, vomiting, chest pain, weakness, blurred vision, confusion, and breathing problems. In severe cases, it can cause seizures, heart problems, and even death.

Pregnancy
acamprosate

Acamprosate may harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if acamprosate passes into breast milk. Talk to your doctor if you are breastfeeding.

disulfiram

It is not known if disulfiram is safe to use during pregnancy. Talk to your doctor about the risks and benefits if you are pregnant or plan to become pregnant. Do not take disulfiram if you are breastfeeding.

How to Read This acamprosate vs disulfiram Comparison

acamprosate is classified in the GABA Analog (Alcohol Dependence) drug class, while disulfiram sits within the Aldehyde Dehydrogenase Inhibitor class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, acamprosate has 64 submissions while disulfiram has 360. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to disulfiram does not change the way your body breaks down or uses acamprosate.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for acamprosate or disulfiram.

Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.