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Antabuse vs. Vivitrol

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Disulfiram (formerly branded as Antabuse) and Vivitrol (naltrexone) are both used to treat alcohol use disorder, but they work in different ways and have different forms. Disulfiram is an oral tablet taken daily that makes you feel sick if you drink alcohol, while Vivitrol is a monthly injection that blocks the feel-good effects of alcohol and opioids. Disulfiram is available as a generic, but Vivitrol is only available as a brand-name medication. Disulfiram requires you to avoid all alcohol, even in small amounts, to prevent severe reactions, whereas Vivitrol helps reduce cravings for alcohol and opioids. Vivitrol also treats opioid use disorder, while disulfiram does not. Both medications should be used alongside therapy and support groups for the best results.

Disulfiram

 

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Vivitrol

 

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Summary for Antabuse

Prescription only

Disulfiram is an alcohol antagonist that's used to treat alcohol use disorder in adults. It's a tablet that's taken by mouth once a day. It's preferred that you take part in behavioral therapies and support groups along with disulfiram. Abstinence (not drinking alcohol) is also important while you're taking this medication. Otherwise, you can get a severe reaction called the disulfiram-alcohol reaction. Some side effects can include drowsiness and headache. While the brand name Antabuse has been discontinued, generic disulfiram is still available.

Indications for Antabuse

  • Alcohol use disorder

Pros and Cons for Antabuse

Pros

  • Works well to manage alcohol use disorder
  • Only need to take once a day
  • Available as a lower-cost generic

Cons

  • Even small amounts of alcohol (like in cough syrup) can cause a bad reaction
  • Not a cure for alcohol use disorder
  • Doesn't lessen cravings for alcohol
  • Should be used with caution in people with certain conditions like diabetes, thyroid problems, seizures, brain damage, and liver or kidney problems

Common Side Effects for Antabuse

Warnings for Antabuse

  • Reaction with alcohol
  • Worsening liver problems and liver failure
  • Severe allergic reactions

Summary for Vivitrol

Prescription only

Vivitrol is an extended-release naltrexone injection. It's an opioid antagonist that's used to treat opioid use disorder and alcohol use disorder in adults. Vivitrol is prescribed as part of a holistic treatment plan that also includes therapy and support groups. This medication is given as a deep gluteal injection into the muscle on the buttock, typically once a month by a healthcare professional. Some common side effects of Vivitrol include pain or tenderness at the injection site, nausea, and headache. Vivitrol is brand name only and not available as a generic medication.

Indications for Vivitrol

Pros and Cons for Vivitrol

Pros

  • Lowers opioid and alcohol cravings
  • Given once per month
  • Better option for people who don't want to take naltrexone tablets everyday

Cons

  • Need to go to clinic or HCP's office to receive the injections
  • Must be given by injection into the buttock muscle
  • Can cause bothersome injection site reactions, such as pain and swelling

Common Side Effects for Vivitrol

Alcohol use disorder

  • Tenderness, pain, swelling at injection site (up to 45%)
  • Nausea (33%)
  • Headache (25%)
  • Fatigue, tiredness (23%)
  • Low appetite (14%)
  • Trouble falling asleep (14%)
  • Vomiting (14%)
  • Diarrhea (13%)
  • Dizziness (13%)
  • Anxiety (12%)
  • Joint pain or stiffness (12%)
  • Stomach pain (11%)
  • Sore throat (11%)

Opioid use disorder

  • Higher liver enzymes (13%)
  • Common cold, flu (up to 7%)
  • Difficulty sleeping (6%)
  • High blood pressure (5%)
  • Injection site pain (5%)

Warnings for Vivitrol

  • More sensitive to opioids (risk of opioid overdose)
  • Opioid withdrawal
  • Liver injury
  • Risk of depression and suicidal thoughts
  • Injection site reactions
  • Severe allergic reactions

Prices with our coupons for Antabuse vs. Vivitrol

Price Card Drug Icon
Disulfiram30 tablets / 250mg
$31.97$78.89
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Vivitrol1 carton / 1 vial of 380mg/vial
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