Disulfiram (brand name Antabuse) is a medication that works by making people physically sick when they drink alcohol. It achieves this by interfering with the normal breakdown of alcohol by the liver.
Normally, when one drinks alcohol, it is broken down first into acetaldehyde, which is then broken down by an enzyme in the liver called acetaldehyde dehydrogenase. But disulfiram blocks this enzyme, which then causes a build up of acetaldehyde, which leads to many unpleasant and hangover like symptoms. So the ultimate message is do not even try to drink on this medication. I have had clients take this medicine and even 4 days later when they had one drink of alcohol, they felt bad.
Common side effects include:
1. flushing (warmth, redness, or tingly feeling);
2. sweating, increased thirst, swelling, rapid weight gain;
3. nausea, severe vomiting;
4. neck pain, throbbing headache, blurred vision;
5. chest pain, shortness of breath (even with mild exertion);
6. fast or pounding heartbeats or fluttering in your chest;
7. confusion, weakness, spinning sensation, feeling unsteady; or
8. a light-headed feeling, like you might pass out.
If you drink large amounts of alcohol while on this medicine, you will HAVE to go to the hospital because you’d be at risk of seizures or even death.
Disulfiram is dosed at 500mg/day for the 1st 2 weeks but then can go down to 250mg/day thereon, as it has built up in the system. If you are to use alcohol again after taking the medication, give it at least 5 days off of it before consuming any alcohol.
Remember alcohol is also an ingredient in mouthwash and certain dessert/food recipes.
A patients should wait a full 2 weeks from their last dose of disulfiram if they wish to have a drink of alcohol.
Posted by David Danish MD