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Disulfiram Tablets (250mg / 500mg)
Common Brand Names: Antabuse, DIZone, Esperal
Drug Summary
Disulfiram (or Antabuse) is a specific prescription drug used as an adjunct in the treatment of chronic alcoholism. Unlike craving reducers, Disulfiram acts as a deterrent.
How it works: The medicine blocks the enzyme (aldehyde dehydrogenase) required to break down alcohol in the bodies of those suffering from chronic alcohol use. If even a sip of an alcoholic beverage is consumed on this drug, it results in a severe physical reaction so that a motivated person can stay sober.
The Science of Aversion Therapy
Alcohol in the body is usually transformed into acetaldehyde and then further to acetic acid. However, alcohol stops this process at the acetaldehyde stage.
- Result: A build-up of toxic acetaldehyde in the blood.
- Reaction: Drinking will cause flushing, nausea, pounding headache, and palpitations, usually within 10–30 minutes of ingestion. Such therapy automatically creates a physical barrier to drinking.
Expert Consult for Patients
- 12-Hour Rule: Do not ingest your first dose of Disulfiram when you have been drinking until you are alcohol-free for at least 12 hours.
- Hidden Liquor: Be informed there could be alcohol in mouthwashes, cough remedies, vinegars, desserts, and aftershave lotions. All these could elicit a reaction.
- Regularity Is the Key: Take medication at the same time every day. Generally, it is recommended to take it at bedtime if it causes drowsiness.
- “Carry a Card” Rule: It is always good to carry a medical ID card stating that you are on Disulfiram so that emergency personnel are aware in case you have an accidental reaction.
Security and Side Effects
While the Disulfiram side-effect of an alcohol reaction is expected, other mild side effects could occur:
- Common: Metal or garlic taste in the mouth, mild headache, or drowsiness.
- Rare but Serious: Yellowing of the skin/eyes, dark urine, or persistent fatigue. Call your doctor immediately if you have any of these, as it can indicate hepatic stress.
Safety Checks of Disulfiram
| Safety Check | Status |
|---|---|
| Potential for a Reaction to Alcohol | Not recommended; reactions may occur for 14 days after stopping |
| Pregnancy | Consult your doctor for definitive advice. Avoid except when benefits exceed risks. |
| Driving | Use caution; may cause slight drowsiness in the beginning |
| Liver Health | Periodic liver enzyme testing is required |
FAQs (Frequently Asked Questions)
- How long does Disulfiram last in the system?
Its effects are long-lasting. Since it binds irreversibly to the enzyme, it may take about 1 week to build up new enzymes in your bloodstream, after which you may still react even up to 14 days after taking the last dose. - Can Disulfiram help stop the urge or craving to drink?
No emphasis can be placed on the “craving” or “urge” to drink in this case. Instead, it operates as an aversive reaction. The most effective use of the drug is in combination with supportive therapy such as AA or another group that helps manage the psychological aspects of addiction. - Can I use hand sanitizer or perfume while taking this?
In a few very sensitive people, inhalation of paint fumes or the application of colognes/alcoholic aftershaves can cause a mild reaction (redness or itching). Consider testing a small patch of skin or using non-alcoholic personal-care products. - What can I do if I accidentally have alcohol?
If it is a mild reaction such as slight flushing, the patient should rest and stay hydrated. In cases of intense chest pain, trouble breathing, or severe vomiting, seek immediate emergency care. - Can I break the tablets since I cannot swallow them?
Yes, the Disulfiram tablets may be crushed and mixed with water, juice, or milk. In their whole form, they may sometimes be difficult to swallow; in such cases, crushing is advised.
