Disulfiram Reaction and Side Effects

Medically Reviewed

It’s no secret that the United States is a place where a vast majority of its citizens struggle with alcohol abuse and addiction. The sheer prevalence of alcohol use and addiction require medications like disulfiram. 

 The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that an estimated 86.4 percent of adults 18 years or older reported consuming alcohol at some point in their lives.

The NIAAA reported that another 70 percent said they had a drink within the past 12 months, and 56 percent said they drank alcohol within the past 30 days. Another 26.9 percent of all adults in the U.S. reported engaging in binge drinking in the past 30 days, and seven percent admitted to heavy drinking in the past month. 

Due to alcohol’s easy accessibility and cheap price tag, it is no wonder that it remains one of the most widely abused substances. From a global standpoint, alcohol is the leading cause of death and disease worldwide.

Alcohol use is one of the leading risk factors for death and disability and is a leading risk factor for global disease burden that causes substantial health loss.

The World Health Organization (WHO) reports that alcohol consumption helps cause about three million deaths each year globally and to the disabilities and poor health of millions.

Quitting drinking on your own is not only tricky, but it can be deadly. 

Alcohol withdrawal can be fatal because of how it interacts with gamma-Aminobutyric Acid (GABA). Fortunately, disulfiram is prescribed for alcohol use disorders and is currently used by more than 200,000 people in the U.S.

Disulfiram and Alcohol Reaction

Disulfiram works by interfering with the body’s digestion and absorption of alcohol. It creates a series of highly unpleasant reactions throughout the process. This medication is marketed under the brand name Antabuse. 

Disulfiram is not meant to be consumed with alcohol. According to the Mayo Clinic, when someone takes the medication and drinks alcohol, they can get reactions such as:

  • Chest pain
  • Trouble breathing
  • Confusion
  • Throbbing headache
  • Flushing
  • Dizziness or fainting
  • Fast or pounding heartbeat
  • Blurred vision
  • Nausea and vomiting
  • Increased sweating
  • Weakness

The effects make it rather unpleasant for someone who is taking Disulfiram to drink alcohol. While drugs like Methadone or Suboxone have the power to reduce cravings for opioids, disulfiram cannot reduce cravings for alcohol. Despite this, however, user’s are still discouraged from drinking due to the unpleasant side effects that result from mixing the two.

Disulfiram’s method of action is to block the functioning of alcohol dehydrogenase which is an enzyme that breaks down ethanol in the liver. 

It will lead to an increased concentration of acetaldehyde, which causes discomfort. The reaction disulfiram causes can be severe, and in some cases, fatal. Today, the doses that are distributed to patients are much lower than doses from years past, which has made severe reactions a much rarer phenomenon.

How is Disulfiram Used?

Disulfiram is a prescription medication that is only to be used under the supervision of a medical doctor. 

The drug should only be administered when the person has gone through the initial period of withdrawal and detox and has remained entirely abstinent from alcohol for at least 12 hours. 

These instructions are crucial to follow because the drug can begin working in as little as 10 to 30 minutes after ingestion. 

The initial dose is 250 milligrams once a day for one to two weeks, with the average maintenance dose of 250 milligrams a day after that. Depending on the severity of the case, though, the daily dosage can range anywhere from 125 to 500 milligrams per day.

The drug should only be consumed after the person has been educated about potential impacts. 

Disulfiram should only be administered after the doctor has performed an extensive physical exam, baseline liver, and kidney function tests, pregnancy tests (for women), and electrocardiogram if the individual has had cardiovascular disease in the past.

White pills in a pile

Those that are committed to their sobriety will find that taking Disulfiram under the supervision of a doctor will be a sufficient means of treating their alcoholism.

If a dose is missed, states RxList.com, take the missed dose as soon as you remember.

You should also take the rest of the day’s doses at evenly spaced intervals unless otherwise directed by a doctor.

While the drug is effective at preventing someone from drinking, disulfiram alone is not sufficient to treat alcoholism.

It is only a component of reputable and effective alcohol treatment, which includes the continuum of care services such as medical detoxification, residential treatment, therapy, counseling, and 12-step programs.

Side Effects of Disulfiram

Disulfiram has been used in treatment settings for nearly 65 years, and it has been regarded as effective when incorporated as part of a full treatment plan.

It is an established medication for alcohol abuse treatment that has relatively minor side effects. 

Side effects will diminish or disappear within a few weeks. Unfortunately, there is a risk when you are consuming any medication, and it is essential to be aware of the potential side effects. 

These include:

  • Metallic taste
  • Headaches
  • Drowsiness
  • Sexual dysfunction
  • Acne

There are some other less common side effects of disulfiram, such as:

  • Hepatitis
  • Liver toxicity
  • Optic neuritis
  • Peripheral neuritis and neuropathy
  • Psychosis
  • Delirium
  • Hypersensitivity to the drug
  • Reactions with other medications

While side effects are less common, they do occur, and if you experience any of the above symptoms, you must immediately contact your doctor to discuss your options. 

Remember, you should only consume disulfiram if you are serious about your sobriety.

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