top of page

Antabuse Injection & Pills - Medication for Alcoholism

Medication alone cannot overcome an alcohol addiction. But medication in combination with other treatment such as counselling, self-help groups, developing recovery skills and relapse prevention techniques has be proven to increase the chances of overcoming alcoholism.

What is Antabuse / Disulfiram?

Disulfiram is a treatment that is used as an alcohol-aversion therapy: the treatment stops individuals from drinking alcohol. It is commonly referred to by the brand name, Antabuse. Disulfiram is sometimes administered in the form of an Antabuse injection, but more commonly as an oral tablet. Disulfiram works by blocking an enzyme which breaks down acetaldehyde (what alcohol turns to inside the body). This effectively stops acetaldehyde from converting into acetic acid. As a result, an increased amount of acetaldehyde in the blood remains, producing unpleasant physical effects. 


The above is what happens when an individual drinks alcohol while taking Disulfiram (in the form of an Antabuse injection or other). It is used as an alcohol antagonist drug, deterring individuals from relapsing and from following their cravings.

How Medication Helps Alcoholism Treatment and Recovery

Numerous studies have proven that Antabuse is effective in the treatment of alcoholism and alcohol abuse. Antabuse has been used since 1951. (The generic name of Antabuse is Disulfiram.) Antabuse is not only effective in treating alcoholism, it is also helpful in treating drug addiction. If you have a drug problem, anything that helps you stop drinking will also help you stop using drugs, because alcohol usually leads to drugs.

Antabuse works by making you sick to your stomach if you have a drink. It works - because if you know you can't drink, then you won't think about drinking as much. Antabuse reduces cravings for alcohol. One study of over 250 people showed that Antabuse significantly reduces cravings for alcohol. Antabuse reduces the risk of relapse. A review of 13 clinical trials for alcoholism treatment confirmed that Antabuse in combination with treatments such as counselling, self-help groups and alcohol rehab significantly reduces the risk of relapse. (2, 3) Antabuse also reduces the risk of relapse in adolescent addicts.

People who use Antabuse feel liberated. That internal struggle that goes on every day, "Will I drink? Won't I drink?" is silenced when you're on Antabuse. Because drinking is not an option you don't waste your time thinking about drinking, and instead you focus more on your recovery. Antabuse is effective, because you have to wait for one to two weeks before you can have a drink after you stop Antabuse. You can't stop Antabuse one day and have a drink the next. It gives you plenty of time to reconsider, restart your Antabuse, and ask for help.

The Antabuse Reaction

It takes one drink to produce a reaction. It takes one bottle of beer, one glass of wine, or one shot of liquor to become sick.

The normal sequence of the Antabuse reaction is:

  • Flushing of the face

  • Headache

  • Low blood pressure

  • Racing heart

  • Dizziness

  • Nausea and vomiting

 

If you have one drink, you will vomit about as much as if you had food poisoning. A few people are very sensitive to Antabuse and get a stronger reaction. A quick test of whether you're sensitive to Antabuse is to see if your skin flushes when you put alcohol on your skin. If you're sensitive you may still decide to use Antabuse, but you'll have to be a little more careful about avoiding alcohol. Most people just need to show some common sense when they're on Antabuse.

The Do's and Don'ts of Antabuse

Wait at least 24 hrs after drinking before starting Antabuse. Consider the following arithmetic. If you had 10 drinks and weighed only 100 lbs (45kg), the alcohol would be completely eliminated from your system in 24 hrs. If you weighed more than 100 lbs (45kg) it would take less than 24 hrs. http://bloodalcoholcalculator.org

Do not start Antabuse if you have recently taken other medications such as metronidazole or paraldehyde. Avoid any alcoholic beverages, as well as specific foods and drinks. Examples include certain sauces, Kombucha, and others which may contain alcohol. Non-alcoholic beverages may still contain traces of alcohol. Over-the-counter cough syrups, cold and flu products might also contain as much as 40% alcohol. Be mindful that anti-histamines and perfume also contain alcohol and some individuals may experience nausea if using these. 


To prevent an unwanted reaction, refrain from consuming such substances for at least 12 hours before your first Antabuse dose and for several weeks after your last. 

For most people, it takes one drink to produce an Antabuse reaction. You can have foods that have been cooked in wine, as long as they've been cooked and the alcohol evaporates quickly. You have to be careful of some deserts that have a lot of uncooked alcohol in them. 

Most people prefer to use non-alcoholic mouthwashes to be on the safe side. The amount of alcohol you absorb from mouthwash doesn't equal one drink, assuming you don't drink your mouthwash. You can use perfumes, colognes, or aftershaves. The amount of alcohol you absorb through your skin is minimal. The standard patient information sheet on Antabuse states that you should avoid all of these: mouthwash, perfumes, colognes, even vinegar. However, we have treated thousands of patients, and have only rarely treated patients who have got a reaction from anything other than drinking. Antabuse liberates you, if you use a little common sense.

Is Antabuse Bad for the Liver?

Before taking Antabuse, make sure to tell your clinician if you have liver disease. Antabuse has been associated with acute liver injury, but this is not common. Severe liver problems might occur if Antabuse is taken in conjunction with significant amounts of alcohol. Throughout the Antabuse treatment, you will likely need to attend regular liver function tests to ensure that your liver is in good condition.

How Long Should I Wait to Drink Alcohol After Antabuse?

 

Do not drink while taking Antabuse. Avoid drinking alcohol for at least up to 14 days after stopping Antabuse treatment.

Antabuse Side Effects

The side effects of Antabuse are less common than the side effects of relapse. During the first week or two that you take Antabuse, you'll probably feel a little more tired. It usually lasts for a week or two and then it goes away. During the first two months that people take Antabuse, about 20% develop a funny taste in their mouth. It's usually described as a metallic taste. 80% of people don't get it, and if you do get that taste, it often goes away after a few weeks or months. That's it for the minor side effects of Antabuse.

The major side effects of Antabuse are rare. The most common but still rare side effect of Antabuse is liver damage. Any drug that you take over a long-term has the potential to cause liver damage. With Antabuse, it happens in roughly one out of 30,000 people. Your doctor can do a simple blood test to check the state of your liver before you start. After you've been on Antabuse for a month you should have your liver tests repeated. Your doctor should periodically check your liver enzymes while you're on Antabuse.

Any drug can have any possible side effect. You can never say never in medicine. Every year people die from taking Tylenol (acetaminophen). But that doesn't mean we should stop using Tylenol. The benefits far outweigh the risks. And the benefits of Antabuse outweigh the risks of drinking.

 

What to Know Before Taking Antabuse 

Before taking Antabuse, you should give your doctor your entire medical history. You may not be a able to take Antabuse if you have a significant medical history of heart or blood vessel disease, diabetes, an underactive thyroid, brain disorders (e.g., seizures, brain damage), kidney disease, liver disease, a history of severe depression, a history of psychosis, or a history of suicide attempts. 

Do not take Antabuse or any Antabuse generic if you are allergic to disulfiram. Remember that Antabuse should also not be used if you have:

  • Recently taken metronidazole or paraldehyde

  • Consumed products or food that contain alcohol, even in small amounts - i.e. mouthwash, ‘non-alcoholic’ beverages, cough syrup, vinegar, etc. 

  • Have been diagnosed with psychosis or severe heart disease

 

Do NOT take Antabuse if you are pregnant, or trying to become pregnant, breastfeeding or planning on breastfeeding. If you become pregnant while taking Antabuse, consult with your doctor. 
Tell your doctor prior to treatment if you have:

  • Diabetes

  • Epilepsy or seizures

  • Heart disease

  • History of stroke or heart attack

  • High blood pressure

  • Liver or kidney disease

  • Mental illness

  • Rubber allergy

  • Under-active thyroid

  • Brain damage or head injury

Speak with your doctor if you are currently taking phenytoin, a blood thinner, or tuberculosis medicine. Your doctor will be able to provide more information about whether Antabuse is suitable for you. 

The Link between Antabuse and metabolism

Antabuse can alter the metabolism and blood levels of certain drugs, especially tricyclic antidepressants, Dilantin (phenytoin), coumadin, isoniazid, and theophylline.

Serious Warning Signs

If you notice any of the following rare but serious warning signs, stop using Antabuse and tell your doctor immediately: dark urine, severe abdominal pain, persistent nausea or vomiting, yellowing of the eyes or skin.

How Antabuse Should be Taken

Antabuse is commonly taken orally as a 200 mg tablet. Some individuals might need to take more than one dose each day. Follow your clinician's instructions when it comes to taking Antabuse. 
 

The Antabuse tablet can also be crushed and dissolved in water, juice, or other beverage for easier consumption. If you experience an upset stomach while taking Antabuse, try taking the medication with food. 


Your doctor may change your dosage throughout the course of your treatment - do not take less or more than what is stated on your prescription label.


Make sure to carry a health card or tag that states that you take Antabuse, complete with your healthcare provider’s emergency contact details. 

Overcoming Psychological Resistance to Trying Antabuse

There are three main reasons why you may be reluctant to try Antabuse. First, because you're worried about the side effects. Although the side effects of Antabuse can be serious, they are rare. The side effects of relapsing on alcohol are common and serious. The second reason is because you want to do your recovery on your own. You've always been self-reliant and you want to be self-reliant in your recovery. But recovery involves learning to ask for help. Doing it on your own is overrated. You need to ask for help from your doctor, treatment program, 12 step group, and sponsor. Antabuse is just one more thing you can use. It is not an alternative to your supports. It complements them.

The third and final reason why you may be reluctant to try Antabuse is because you want to leave the door open to having a drink. Just in case you want to relapse there won't be anything in your way. Of course, if you leave that door open then it's guaranteed you'll relapse eventually. It's just a matter of time. If you've decided that you want to change your life. If you've decided that you have suffered enough negative consequences, then I encourage you to talk to your doctor about Antabuse.

FAQs

I missed a dose - what should I do?

If you miss a dose, take the missed dose as soon as possible if it was within 12 hours of when it was due. Skip the missed dose if it has been more than 12 hours or if you cannot remember. If you are taking more than one tablet a day, make sure to take the rest of the doses at even intervals. Consult with your clinician if you are unsure.

What should I do if I overdose?

Seek urgent medical assistance by dialling 999 for the ambulance service.

What do I need to avoid while taking Antabuse?

Avoid drinking alcohol while on Antabuse. This can include avoiding situations that may tempt you and avoiding the use of products that may contain alcohol. Always check the labels of foods, beverages, or medicines to check whether they contain alcohol. Non-consumable products, manufacturing and industrial fumes may also contain traces of alcohol, so it is recommended to avoid these if possible. 

Can you drink non-alcoholic beer and such beverages while taking Antabuse?

No. Non-alcoholic beverages, including beers and ciders, may still contain traces of alcohol. Consuming low or no-alcohol beverages can cause a reaction if you are taking Antabuse. 

Who is not suitable for Antabuse?

Antabuse is not recommended for individuals who:

  • Have severe heart disease

  • Have psychosis 

  • Have an allergy to Disulfiram

  • Are pregnant or intend on becoming pregnant

  • Are breastfeeding

  • Take certain medications

  • Adhere to the treatment regime, showing willingness to change

Contact us if you would like to learn more about your suitability for Antabuse. This medication is intended for individuals who are ready to stop drinking and have consented to this treatment.

What are the limitations of Antabuse?

Antabuse cannot alleviate alcohol withdrawal symptoms or reduce an individual’s cravings. While it is not a cure for alcoholism, it acts as a deterrent to follow cravings by causing unpleasant side effects when they start drinking alcohol to help individuals stop drinking. 

Can I take food with Antabuse?

You can take Antabuse after eating food - make sure to swallow the tablet(s) with water.

What medications should I avoid when taking Antabuse?

Medications to avoid are those that contain alcohol, which can include over-the-counter products like cough syrups. Make sure to tell your doctor if you are taking other medicines alongside your Antabuse, especially if you take:

  • Blood thinners (warfarin)

  • Phenytoin and paraldehyde

  • Benzodiazepines (Diazepam, Chlordiazepoxide)

  • Painkillers (morphine)

  • Stimulants (amphetamines)

  • Pimozide and Chlorpromazine 

  • Amitriptyline 

  • Isoniazid, metronidazole

Can I take Antabuse if I am pregnant and/or breastfeeding?

Antabuse should only be taken during pregnancy if this has been cleared by your clinician. Consult your clinician before taking Antabuse while breastfeeding - it is unknown that this medication passes into breast milk.

bottom of page