Antabuse (Disulfiram) for Alcohol Use Disorder

Antabuse Side Effects

Many of the side effects of Antabuse are more apparent while the body is adjusting to the new medication. However, if the symptoms persist, or if they become more extreme, it is important to speak with a doctor or other medical professional as soon as possible.

Some of the most common side effects of Antabuse include:

• Drowsiness
• Headache
• Acne
• Metallic Taste in Mouth
• Change in Vision
• Decrease in Sexual Ability

In rare cases disulfiram can cause serious liver injury, including hepatitis and liver failure, even after many months of treatment. The FDA label suggests liver blood tests before you start and again 10 to 14 days later. Call your provider right away if you notice tiredness, weakness, loss of appetite, nausea, vomiting, yellow skin or eyes, or dark urine.

How Does Antabuse Work?

How a drug works is called its method of action. Antabuse’s method of action is that it keeps the body from converting acetaldehyde into acetic acid during the regular metabolic process. After someone drinks, the acetaldehyde levels build up in the blood, causing the drinker to experience several unpleasant symptoms.

Once the acetaldehyde levels build up in the blood, the user begins to experience some or all of these symptoms:

• Palpitations, or a fast, strong heartbeat
• Chest pain
• Nausea and perhaps vomiting
• Throbbing headache
• Blurred vision or dizziness

These are just some of the kinds of discomfort someone might feel if consuming alcohol while taking Antabuse.

It is vital that anyone trying to quit drinking with Antabuse have other supports in place. Antabuse itself only works as a deterrent, so it’s more like having a crutch while healing from a broken leg. The point of dealing with addiction by using a deterrent is to help a person with alcohol use disorder develop the coping skills to deal with life on a daily basis without alcohol.

Anyone who is ready to start taking Antabuse should wait at least 12 hours after the last drink and then keep taking it for as long as the doctor says. Someone who is recovering from the physical addiction to alcohol may decide to stop taking Antabuse because he or she feels better, but this can lead to relapse. Missing doses can also be dangerous, leading to an unplanned relapse. Users can experience the benefits of Antabuse for an additional week or two after taking the last dose.

How Long Does Antabuse Stay in Your System?

The amount of time a drug stays in the system can be measured with laboratory tests. Antabuse is absorbed slowly into the body, and it is eliminated just as slowly. It can take effect in just an hour or two. Only about 80% to 90% of the drug makes it into the system while the rest is eliminated without effect.

As with many other drugs, Antabuse is metabolized in the liver and then excreted through the kidneys, where it can be detected with lab tests. A smaller amount of the metabolites are exhaled harmlessly as carbon disulfide. The half life is the time a drug takes to reduce to half its original amount within the body; the half life of Antabuse is between 60 and 120 hours, so about a fifth of the original drug can stay in the body for up to a week.

Even after stopping the drug entirely, once the doctor says it’s okay, there is normally enough of the drug left in the body to continue to experience a reaction to alcohol for up to two weeks. Anyone who has been taking Antabuse for an extended period of time should continue to be aware of this for at least a few weeks after the treatment is stopped.

Antabuse (disulfiram) is one of three FDA-approved medications for alcohol use disorder, along with naltrexone and Campral (acamprosate). See medication for alcohol use disorder for how they compare.