Antabuse (Disulfiram): What It Does and How to Use It Safely

Antabuse, the brand name for disulfiram, is a medicine that helps people stop drinking by making alcohol cause an unpleasant reaction. It doesn’t reduce cravings. Instead, it creates a strong deterrent: if you drink while taking Antabuse you can get flushing, nausea, fast heartbeat, and other bad symptoms. That shock is the point—many people find it helps them stick to sobriety when combined with support or counseling.

How Antabuse works and when it's prescribed

Disulfiram blocks an enzyme that breaks down alcohol. That makes acetaldehyde build up in your body when you drink. Acetaldehyde is what causes the flushing, dizziness, and nausea. Doctors usually prescribe Antabuse for people who are motivated to stay sober and who can follow a clear plan—often as part of a broader treatment that includes therapy or support groups.

Typical dosing starts with a higher dose on day one (often 500 mg), then drops to a maintenance dose (often 250 mg daily). Some doctors use 100–200 mg daily for people who need a lower dose. Your prescriber will choose the right plan based on your health and needs.

Safety, side effects, and practical tips

Antabuse can be helpful, but it also has risks. The most common side effects are tiredness, a metallic or garlic-like taste, and skin rash. More serious issues include nerve problems and liver damage, so doctors usually check liver function before starting and monitor it during treatment. Stop the drug and call your doctor if you notice yellowing skin, dark urine, or severe stomach pain.

Never drink alcohol while on Antabuse. That includes obvious drinks and hidden sources: some cough syrups, sauces, vinegar-containing foods, and even aftershaves can contain alcohol. Ask your pharmacist about everyday products that might cause a reaction. Also tell your healthcare team about all medicines you take—Antabuse can interact with warfarin, phenytoin, metronidazole, and some diabetes drugs.

Antabuse isn’t safe for everyone. People with severe heart disease, uncontrolled high blood pressure, active liver disease, or acute psychosis usually shouldn’t take it. It’s also not recommended during pregnancy. Your doctor will run a health check and discuss alternatives like naltrexone or acamprosate if Antabuse isn’t right for you.

Practical tips that help: use supervised dosing if you worry about missing pills; carry a medical alert card stating you take disulfiram; set a plan with a counselor or support group to handle cravings; and make a list of foods and products that contain alcohol so you can avoid surprises.

Antabuse can be a powerful tool when used correctly. It works best with commitment, medical follow-up, and behavioral support. Talk openly with your prescriber about risks, alternatives, and a plan that fits your life.