disulfiram
Brand names: Antabuse
Disulfiram is a medicine that helps people with long-term alcohol problems stay sober. It is meant to be used with counseling and support.
Drug Pricing (NADAC)
Generic Price
$1.55/unit
Generic Available
Yes (3 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Disulfiram helps manage chronic alcohol problems.
Common side effects
Mild drowsiness, Tiredness, Headache
Key warnings
If you take disulfiram and drink alcohol, you may have a very bad reaction.
How It Works
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.
How to Take It
You should not take disulfiram until you have avoided alcohol for at least 12 hours. The starting dose is usually 500 mg daily for 1 to 2 weeks. After that, the usual dose is 250 mg daily, but it can range from 125 mg to 500 mg. Take it in the morning, but if it makes you sleepy, take it at bedtime.
Pregnancy & Breastfeeding
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.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store at room temperature, away from light and moisture.
Side Effects (from patient reports)
Based on 672 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 1,076 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
1,076
Death-Related Reports
111
Hospitalization Reports
504
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | OFF LABEL USE | 123 |
| 2 | DRUG INTERACTION | 120 |
| 3 | FATIGUE | 82 |
| 4 | TOXICITY TO VARIOUS AGENTS | 63 |
| 5 | DRUG INEFFECTIVE | 61 |
| 6 | NAUSEA | 48 |
| 7 | CONFUSIONAL STATE | 47 |
| 8 | PSYCHIATRIC SYMPTOM | 44 |
| 9 | OVERDOSE | 43 |
| 10 | DRUG ABUSE | 41 |
| 11 | DRUG-INDUCED LIVER INJURY | 40 |
| 12 | ANXIETY | 37 |
| 13 | CONDITION AGGRAVATED | 36 |
| 14 | TOXIC ENCEPHALOPATHY | 36 |
| 15 | SOMNOLENCE | 35 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
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.
Known Drug Interactions
DISULFIRAM SHOULD BE USED WITH CAUTION IN THOSE PATIENTS RECEIVING PHENYTOIN AND ITS CONGENERS, SINCE THE CONCOMITANT ADMINISTRATION OF THESE TWO DRUGS CAN LEAD TO PHENYTOIN INTOXICATION. PRIOR TO ADMINISTERING DISULFIRAM TO A PATIENT ON PHENYTOIN THERAPY, A BASELINE PHENYTOIN SERUM LEVEL SHOULD BE OBTAINED. SUBSEQUENT TO INITIATION OF DISULFIRAM THERAPY, SERUM LEVELS OF PHENYTOIN SHOULD BE DETERMINED ON DIFFERENT DAYS FOR EVIDENCE OF AN INCREASE OR FOR A CONTINUING RISE IN LEVELS.
Mechanism: Disulfiram interferes with how your body processes phenytoin, which can cause the phenytoin to build up to toxic levels.
What to do: Your doctor should monitor your phenytoin blood levels closely before and after you start taking disulfiram.
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) ].
Mechanism: Disulfiram does not change the way your body breaks down or uses acamprosate.
What to do: No special changes are usually needed when taking these two drugs at the same time.
Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section.
Mechanism: Disulfiram can interfere with how your liver breaks down amitriptyline. This can lead to higher levels of the medication in your system.
What to do: Use this combination with caution and follow your doctor's instructions for monitoring your symptoms.
Drug Interactions Disulfiram Psychotic reactions have been reported in alcoholic patients who are using metronidazole and disulfiram concurrently. Metronidazole should not be given to patients who have taken disulfiram within the last two weeks (see CONTRAINDICATIONS ).
Mechanism: Combining these two medicines can cause serious mental health problems, such as confusion or psychotic reactions.
What to do: Do not take metronidazole if you have taken disulfiram within the last two weeks.
CONCOMITANT DRUG CLINICAL EFFECT(S) Amphetamines, cocaine, other sympathomimetic agents Additive hypertension, tachycardia, possibly cardiotoxicity Atropine, scopolamine, antihistamines, other anticholinergic agents Additive or super-additive tachycardia, drowsiness Amitriptyline, amoxapine, desipramine, other tricyclic antidepressants Additive tachycardia, hypertension, drowsiness Barbiturates, benzodiazepines, ethanol, lithium, opioids, buspirone, antihistamines, muscle relaxants, other CNS depressants Additive drowsiness and CNS depression Disulfiram A reversible hypomanic reaction was r...
Mechanism: Using these two drugs together can cause a mood reaction that makes you feel unusually excited, restless, or energetic.
What to do: Watch for sudden signs of mood changes or high energy and contact your doctor immediately if they occur.
Common Questions
Can I drink alcohol while taking disulfiram?
How long do I need to take disulfiram?
What should I do if I have a reaction to alcohol while taking disulfiram?
Can disulfiram cure my alcoholism?
Are there any foods or drinks I should avoid while taking disulfiram?
Can I take other medicines with disulfiram?
What are the serious side effects of disulfiram?
Can I stop taking disulfiram on my own?
Does disulfiram have any effect on my driving?
How soon after taking disulfiram can I expect it to work?
What are the common side effects of disulfiram?
Does disulfiram interact with other medications?
What drug class is disulfiram?
Is disulfiram safe during pregnancy?
Related Medications in Aldehyde Dehydrogenase Inhibitor
Other drugs grouped near disulfiram — same-class peers and common alternatives.
acamprosate
Campral
Acamprosate is a medicine that can help you stay away from alcohol if you are alcohol-dependent and have already stopped drinking.
Compare with disulfiram →
alprazolam
Xanax
Alprazolam (Xanax) is a medication that can help you with anxiety and panic disorders.
Compare with disulfiram →
amitriptyline
Elavil
Amitriptyline is a medicine used to treat depression.
Compare with disulfiram →
amphetamine/dextroamphetamine
Adderall, Adderall XR
Adderall XR is a stimulant medicine.
Compare with disulfiram →
aripiprazole
Abilify
Aripiprazole (Abilify) is a medicine used to treat certain mental disorders and mood problems.
Compare with disulfiram →
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What the FDA Data Shows for disulfiram
The FDA label for disulfiram (sold under brand names such as Antabuse) classifies it as a prescription-only medication in the Aldehyde Dehydrogenase Inhibitor class. Disulfiram helps manage chronic alcohol problems. Official labeling lists 6 commonly reported side effects, including Mild drowsiness, Tiredness, Headache.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 672 voluntary reports. The database also lists 8 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $1.55.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: October 5, 2023
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages