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How It Works
Disulfiram changes the way your body breaks down (metabolizes) alcohol. If you drink alcohol while you are taking disulfiram, you will experience uncomfortable symptoms, including severe nausea, vomiting, and headache. These symptoms discourage you from drinking alcohol by making it unpleasant.
Why It Is Used
Disulfiram is used to treat alcohol dependence. It is most helpful if you are motivated to stop drinking and are willing to take the medicine under supervision. Medicines are not typically used alone to treat alcohol abuse or dependence. The best treatment is a combination of medicine and counseling.
How Well It Works
The effectiveness of disulfiram varies. When taken as directed, it can help you completely stop drinking by increasing the number of days you go without a drink.1 It works best if you are motivated to stop drinking and you take the medicine as directed. Disulfiram is used less often than some of the newer medicines (naltrexone, acamprosate), because it might damage the liver.
The effects from disulfiram are intentionally unpleasant to help encourage you to remain sober. Disulfiram causes the following effects when you drink alcohol, with effects lasting from 30 minutes to 2 hours.
- Face and body flushing
- Throbbing in your head and neck, severe headache
- Blurred vision
- Fast heartbeat
- Dry mouth
- Nausea, vomiting
- Breathing difficulty
- Severe low blood pressure
When you take disulfiram and do not drink, the main effect is drowsiness. Use caution when you drive or operate machinery while taking this medicine.
In rare cases, disulfiram can cause abnormal liver function and numbness or tingling in your hands or feet.
You should not take disulfiram if you:
- Are pregnant.
- Have severe heart, lung, kidney, or liver disease.
- Have serious psychological illnesses (such as psychosis).
- Take certain medicines that interact with disulfiram or those that contain alcohol, such as cough medicine.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
You take this medicine every day for a period of weeks or longer, until you overcome your craving for alcohol. Disulfiram should not be taken within 24 hours of drinking alcohol. Disulfiram stays in the bloodstream for up to 2 weeks after the last dose. Uncomfortable symptoms will develop during this time if you drink alcohol.
While taking disulfiram, you cannot take medicines or use substances that contain alcohol (such as cough syrups, liquid medicines containing alcohol, mouthwashes, and wine vinegars). This will cause the same effects that occur when you take alcohol.
Several medicines, including seizure medicines, interact poorly with disulfiram. Be sure your doctor knows all the medicines you are taking before you try disulfiram.
You might want to ask friends or family to help you take disulfiram as directed until you feel confident about taking it on your own.
You might need liver function tests before and during the time you take disulfiram.
You will need to carry an identification card or wear a medical alert bracelet while taking disulfiram.
- Department of Health and Human Services (2009). Incorporating alcohol pharmacotherapies into medical practice. Treatment Improvement Protocol (TIP), Series 49 (HHS Publication No. SMA 09-4380). Available online: http://store.samhsa.gov/product/TIP-49-Incorporating-Alcohol-Pharmacotherapies-Into-Medical-Practice/SMA09-4380.
Last Revised: January 18, 2012
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