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Disulfiram Coupon - Disulfiram 250mg tablet

disulfiram

Generic Antabuse
Used for Alcohol Dependence
Used for Alcohol Dependence

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.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Kristianne Hannemann, PharmD
Last reviewed on January 8, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Disulfiram?

What is Disulfiram used for?

  • Alcohol use disorder

How Disulfiram works

Disulfiram is an alcohol antagonist. It works by stopping a protein in your liver from breaking down a by-product of alcohol after you consume something with alcohol in it. This causes your body to clear alcohol from your system slower.

As a result, the medication causes you to experience unpleasant effects, like sweating, a racing heart, flushing, nausea, and dizziness, when you drink any alcohol. These effects are meant to discourage you from drinking alcohol.

Drug Facts

Common BrandsAntabuse (brand no longer available)
Drug ClassAlcohol use treatment
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only

More on Disulfiram essentials

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What are the side effects of Disulfiram?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Other Side Effects

  • Rash
  • Itching
  • Acne
  • Liver problems
  • Trouble getting or maintaining an erection

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Worsening liver problems or liver failure: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine

Source: DailyMed

More on Disulfiram side effects

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The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common

Eye pain or tenderness or any change in vision

mood or mental changes

numbness, tingling, pain, or weakness in hands or feet

Rare

Darkening of urine

light gray-colored stools

severe stomach pain

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Drowsiness

Less common or rare

Decreased sexual ability in males

headache

metallic or garlic-like taste in mouth

skin rash

unusual tiredness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Disulfiram

thumbs-up

Pros

Works well to manage alcohol use disorder

Only need to take once a day

Available as a lower-cost generic

thumbs-down

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

pharmacist-tips

Pharmacist tips for Disulfiram

pharmacist

  • You should be alcohol-free for at least 12 hours before you take disulfiram to avoid having a disulfiram-alcohol reaction.

    • Avoid eating any food or drinking anything that contains alcohol while you're taking disulfiram and for 2 weeks after you stop the medication. Some foods that contain alcohol include certain sauces and condiments, vinegar, kombucha, and vanilla extract. Check the food label to see whether there's alcohol in it.

      • Also, avoid products containing alcohol, like mouthwashes, cold medications, and alcohol-based hand-sanitizers. Always check the ingredient list on the back of the package. Ask a provider or pharmacist if you're not sure if something has alcohol in it.

        • Your care team might give you an identification card for you to carry. This card lets people know that you're taking disulfiram. It also lists symptoms of the disulfiram-alcohol reaction to look out for, such as sweating, racing heart, dizziness, vomiting, trouble breathing, and chest pain. The card will also include your provider's contact information for emergencies.

          • Take disulfiram with or without food at any time of the day. But if the medication makes you tired, you can take it before you go to sleep.

            • Side effects, like sleepiness, fatigue, headache, and changes in taste, can happen within the first 2 weeks of starting disulfiram. These side effects should get better with time as you continue to take the medication. Talk to your provider if they don't and if they get too bothersome because you might need your dosage lowered.

              • Make sure your providers and pharmacists know about all the medications you take or have recently taken to avoid dangerous drug interactions with disulfiram. You shouldn't take an antibiotic called metronidazole (Flagyl) if you've taken disulfiram within the past 2 weeks. This combination can lead to psychosis, like changes in your mood and seeing or hearing things that aren't real.

                • There isn't a set amount of time that you'll need to be treated with disulfiram. You should work closely with your care team to determine how long you should continue treatment.

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                  faqs

                  Frequently asked questions about Disulfiram

                  How long does disulfiram stay in your system?
                  The effects of disulfiram can last in the body for up to 2 weeks. This medication works by blocking a protein in your liver from breaking down the toxic by-products of alcohol. And it takes your body a few weeks to make new versions of this protein (to replace the protein that the medication has blocked). For this reason, you shouldn't drink any alcohol for at least 2 weeks after your last disulfiram dose. Otherwise, you might have a disulfiram reaction.
                  What is a disulfiram reaction?
                  The disulfiram-alcohol reaction, or simply the disulfiram reaction, is an unpleasant reaction that happens if you drink alcohol after you take disulfiram and when the medication is in your system. Disulfiram makes you sensitive to alcohol. So if you drink alcohol with disulfiram in your system, you'll experience side effects like sweating, racing heart, dizziness, nausea, vomiting, trouble breathing, and chest pain. In severe cases (like when a person drinks an excessive amount of alcohol), it's possible that a heart attack, seizure, or even death can happen.
                  How long does the disulfiram reaction last?
                  The disulfiram reaction can happen about 10 to 30 minutes after you drink alcohol with disulfiram in your system. The reaction can last for about 30 to 60 minutes, but it can also last for several hours for more severe cases.
                  Can disulfiram cure alcohol use disorder?
                  No, disulfiram isn't a cure for alcohol use disorder. The medication should be used together with motivation from your healthcare provider and loved ones, behavioral therapy, and support groups to get the best results.
                  Does disulfiram lessen alcohol cravings?
                  No, disulfiram doesn't lessen alcohol cravings. It only works by making you more sensitive to the effects of alcohol. So if you drink alcohol while you're taking disulfiram, you'll feel unpleasant effects (like nausea, a racing heart, and chest pain), which will discourage you from drinking alcohol. Speak with your healthcare provider for resources and tips on how to control your alcohol cravings.
                  Does disulfiram cause weight gain?
                  Disulfiram doesn't appear to directly affect your weight. However, it's important to consider the effects alcohol has on your metabolism. Alcohol can lead to weight gain, especially if you drink excessive amounts or if you drink alcohol that's high in sugar. Keep in mind that when you stop drinking alcohol, weight gain is still possible if you're not careful with your dietary choices. So when you stop drinking alcohol and start treatment with disulfiram, it's important that you follow a balanced diet and exercise plan.
                  Can disulfiram cause liver damage?
                  It's possible for disulfiram to cause liver damage, but it's rare. It's also important to keep in mind that alcohol can cause liver damage too. To make sure disulfiram isn't harming your liver, your provider might regularly order blood tests to check your liver health. Get medical attention right away if you notice signs of liver damage, such as stomach pain; yellowing of your skin or the whites of your eyes; stool changes (black, tarry, or bloody stools); dark or brown urine; nausea; vomiting; or confusion.
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                  What are the risks and warnings for Disulfiram?

                  Disulfiram can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                  risk-warning

                  Reaction with alcohol

                  • Risk factors: Drinking alcohol while taking disulfiram or within 12 hours before a disulfiram dose

                    Even in small amounts, drinking alcohol or consuming any products with alcohol (e.g., vinegars, cough syrups) while you're taking disulfiram will cause an unpleasant reaction called the disulfiram-alcohol reaction. Symptoms include flushing, head and neck throbbing, difficulty breathing, nausea, vomiting, fast heartbeat, and chest pain.

                    This reaction to alcohol can happen up to 14 days after you take disulfiram. It can last for 30 to 60 minutes, but can even last several hours in severe cases. It's recommended to seek medical help if you're experiencing symptoms that suggest you're having a disulfiram reaction.

                    risk-warning

                    Worsening liver problems and liver failure

                    • Risk factors: History of liver problems | Taking other medications that cause liver problems

                      Though rare, some people who took disulfiram have had serious liver problems that can lead to liver failure. You might need to get blood tests to check your liver health before and during treatment to make sure your liver is working properly. Get medical attention right away if you notice stomach pain; yellowing of your skin or the whites of your eyes; stool changes (black, tarry, or bloody stools); dark or brown urine; nausea; vomiting; or confusion. You might need to stop using the medication to prevent further liver damage.

                      risk-warning

                      Severe allergic reactions

                      • Risk factors: Rubber allergy

                        Severe allergic reactions to disulfiram are possible. Let your provider know if you have an allergy to rubber. A chemical that's in rubber called thiuram is similar to disulfiram. So, it's possible that you might be allergic to disulfiram if you're allergic to rubber. Seek medical attention right away if you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after you take disulfiram.

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                        dosage

                        Disulfiram dosage forms

                        The average cost for 30 tablets of 250mg of Disulfiram is $33.59 with a free GoodRx coupon. This is 74.83% off the average retail price of $133.43.
                        tablet
                        Tablet
                        DosageQuantityPrice as low asPrice per unit
                        250mg30 tablets$33.59$1.12
                        500mg30 tablets$94.28$3.14

                        Typical dosing for Disulfiram

                        The typical starting dose is up to 500 mg by mouth once a day for 1 to 2 weeks. Then, your provider will work with you to adjust your dose based on your response to the medication. The typical dose ranges from 125 mg to 500 mg once daily.

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                        interactions

                        Interactions between Disulfiram and other drugs

                        Disulfiram may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Disulfiram. Please note that only the generic name of each medication is listed below.

                        More on Disulfiram interactions

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                        Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                        Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                        Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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                        contraindications-icon

                        Disulfiram contraindications

                        Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Disulfiram will not be safe for you to take.

                        • Have recently taken metronidazole (Flagyl) or alcohol-containing products (e.g., certain cough syrups, tonics)

                        • Severe heart conditions

                        • History of psychoses (mental health problems)

                        • Allergy to thiuram derivatives in pesticides or rubber

                        alternatives

                        What are alternatives to Disulfiram?

                        There are a number of medications that your doctor can prescribe in place of Disulfiram. Compare a few possible alternatives below.
                        Disulfiram
                        Used for:

                        • Alcohol use disorder

                        $33.59 Lowest GoodRx priceView Prices
                        Acamprosate
                        Used for:
                        $67.82 Lowest GoodRx priceView Prices
                        Naltrexone (ReVia)
                        Used for:
                        $32.40 Lowest GoodRx priceView Prices
                        latest news

                        What is the latest news about Disulfiram?

                        Medication-assisted treatment (MAT) combines medication with counseling and therapy. See how MAT can be effective for substance use disorders.

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                        The recommended Antabuse (disulfiram) dosage is 500 mg once daily. Learn what to do if you miss an Antabuse dose, and get info on dose adjustments.

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                        Antabuse (disulfiram) isn’t recommended for most pregnant women unless the benefit outweighs the risk. Here's what the experts say about Antabuse and pregnancy.

                        Can You Take Antabuse During Pregnancy?

                        Antabuse (disulfiram) isn’t recommended for most pregnant women unless the benefit outweighs the risk. Here's what the experts say about Antabuse and pregnancy.
                        Antabuse (disulfiram) prevents your body from metabolizing alcohol, creating an adverse reaction when it’s consumed. Learn more about how Antabuse works here.

                        How Does Antabuse (Disulfiram) Work? And What To Avoid While Taking It

                        Antabuse (disulfiram) prevents your body from metabolizing alcohol, creating an adverse reaction when it’s consumed. Learn more about how Antabuse works here.
                        While we don’t know how long disulfiram (Antabuse) stays in your system, we know the effects can last for 2 weeks. Learn answers to more disulfiram FAQs, here.

                        How Long Does It Take Disulfiram to Work? Plus, 4 More Disulfiram FAQs

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                        Acamprosate and disulfiram both help treat alcohol use disorder. However, these medications work in different ways and have different side effects.

                        Acamprosate vs. Disulfiram for Alcohol Use Disorder: 5 Differences You Need to Know

                        Acamprosate and disulfiram both help treat alcohol use disorder. However, these medications work in different ways and have different side effects.
                        Disulfiram and naltrexone are medications used to treat alcohol use disorder. Your provider may recommend disulfiram or naltrexone based on your symptoms and health goals.

                        Disulfiram vs. Naltrexone for Alcohol Use Disorder: 5 Differences You Need to Know

                        Disulfiram and naltrexone are medications used to treat alcohol use disorder. Your provider may recommend disulfiram or naltrexone based on your symptoms and health goals.
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                        References

                        Best studies we found

                        Alvogen Inc. (2023). Disulfiram tablet [package insert]. DailyMed.

                        National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Disulfiram. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury.

                        Pak, V. M., et al. (2012). What is the role of thiurams in allergy to natural rubber latex products? Journal of Occupational and Environmental Medicine.

                        View All References (3)

                        Skinner, M. D., et al. (2014). Disulfiram efficacy in the treatment of alcohol dependence: A meta-analysis. Public Library of Science One.

                        Stokes, M., et al. (2024). Disulfiram. StatPearls.

                        Substance Abuse and Mental Health Services Administration. (2009). Chapter 3—Disulfiram. Incorporating Alcohol Pharmacotherapies Into Medical Practice.

                        GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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