Disulfiram is a treatment option for alcohol dependency. It acts as a deterrent.
You must not drink ANY alcohol with disulfiram. It will make you feel very unwell and is potentially dangerous.
Keep your appointments with your doctor and counsellor so that your progress can be monitored.
|Type of medicine||Aldehyde dehydrogenase inhibitor|
|Used for||Support treatment for alcohol dependency|
Disulfiram is used alongside other treatments and counselling for alcohol dependency. It is only suitable for people who have been through detoxification ('detox') and have stopped drinking alcohol. It acts as a deterrent to drinking further alcohol.
Disulfiram works by interfering with the way your body breaks down alcohol. Usually when you drink alcohol, your body breaks the alcohol down into a substance called acetaldehyde. This is then broken down further so that it can be removed from your body. Disulfiram blocks the enzyme which breaks down the acetaldehyde. This leads to high levels of acetaldehyde in your blood and causes an unpleasant effect.
If you drink even a small amount of alcohol with disulfiram, it will produce an extremely unpleasant reaction. It will give you a throbbing headache, a flushed face, and the sensation of having a 'thumping heart' (palpitations), and it will make you feel very sick. This reaction starts within about 10 minutes of drinking alcohol and can last for several hours. Knowing this will happen will help stop you from drinking alcohol. Because drinking larger amounts of alcohol can cause potentially dangerous reactions, disulfiram is only prescribed by specialists to people who are determined to stay off alcohol.
Before taking disulfiram
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking disulfiram it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you have a problem with your heart, or if you have high blood pressure.
- If you have had a mental health problem called psychosis, or if you have ever had a personality disorder.
- If you have had a stroke or a transient ischaemic attack (TIA).
- If you have any problems with the way your liver works, or the way your kidneys work.
- If you have diabetes.
- If you have epilepsy.
- If you have problems with your breathing.
- If you have a rare inherited condition called porphyria.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take disulfiram
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The manufacturer's leaflet will give you more information about disulfiram and a full list of the side-effects which you may experience from taking it.
- It is important that you have not drunk any alcohol for at least 24 hours before you take your first dose of disulfiram.
- Take disulfiram exactly as your doctor tells you to. You may be asked to take several tablets a day during the first few days of treatment, but after this your dose will be reduced. As a guide, the usual recommended daily dose is one 200 mg tablet, although your dose may be different to this.
- If you forget to take a dose, take it as soon as you remember, if it is still within 12 hours of when the dose was due. If you do not remember until more than 12 hours later, skip the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Disulfiram will be started in hospital or in a clinic, and then it is supervised by a specialist. Keep your regular appointments with your doctor and counsellor. This is so your progress can be checked on a regular basis.
- Make sure your family and friends know how important it is that you do not drink any alcohol, so that they can be a support to you. Even low alcohol, 'non-alcohol' or 'alcohol-free' beers and wines may cause a reaction.
- Even relatively small amounts of alcohol with disulfiram can produce severe reactions. Many liquid medicines, toiletries and mouthwashes contain sufficient alcohol to produce an effect. Always read the contents on the label and avoid any product which contains alcohol. If you buy any medicines, check with a pharmacist that they are safe for you to take.
Can disulfiram cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with disulfiram. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Disulfiram side-effects||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting)||Stick to simple meals - avoid rich or spicy foods|
|Feeling tired or sleepy (especially at the start)||Do not drive and do not use tools or machines until you feel better|
|Tingling feelings in your hands, bad breath, itchy red skin reactions, reduced interest in sex, mood changes||If any of these become troublesome, speak with your doctor|
If you experience any other symptoms which you think may be due to this medicine, discuss them with your doctor or pharmacist.
How to store disulfiram
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Disulfiram 200 mg tablets; Brown and Burk UK Ltd, The electronic Medicines Compendium. Dated October 2019.
British National Formulary, 79th Edition (Mar 2020); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.