Disulfiram
Pronunciation: (dye-SUL-fi-ram).
- Generic name
- Disulfiram
- Brand names
- Disulfiram Sandoz, Cronotol, Antabuse, Esperal, Disulfiram
- Drug class
- Alcohol Deterrent
Availability and supply rules vary by country
Trade names by country: India
Australia: · Full directory
What Disulfiram is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Disulfiram works
Disulfiram is classified as Alcohol Deterrent. See the how-to-take, warnings, and interactions sections for the redistributed clinician-authored dosing and safety detail formerly held in this field. (2)
What Disulfiram is used for
Alcohol dependence
Substance use disorders
Before taking Disulfiram
Do not take / not appropriate for
- Do not take disulfiram if you have drunk alcohol in any form in the last 12 hours, or if you are intoxicated. Disulfiram must never be started until you have been completely alcohol-free for at least 12 hours, and it must never be given to anyone without their full knowledge and consent. (all countries) (1)
- Do not take disulfiram if you are using anything that contains alcohol, including cough syrups and tonics. Alcohol is also hidden in sauces, vinegars, aftershave lotions and back rubs, and these must be avoided as well. Even a small amount of alcohol can trigger the disulfiram-alcohol reaction (flushing, throbbing headache, breathing difficulty, vomiting, chest pain, collapse), which can be severe and has been fatal, and a reaction can still occur for up to 14 days after the last dose. (all countries) (1) (2)
- Do not take disulfiram if you are taking, or have recently taken, metronidazole or paraldehyde. (all countries)
- Do not take disulfiram if you have severe heart muscle disease (severe myocardial disease) or coronary occlusion. (all countries)
- Do not take disulfiram if you have a psychosis. (all countries)
- Do not take disulfiram if you are hypersensitive (allergic) to disulfiram or to other thiuram derivatives, which are used in pesticides and in rubber manufacture. If you have ever reacted to rubber on contact, you should be assessed for thiuram hypersensitivity before disulfiram is started. (all countries)
Tell your clinician about
- Every alcohol-containing product you use, including cough and cold medicines, mouthwashes, tonics, sauces, vinegars, aftershave lotions and back rubs.
- Diabetes, an underactive thyroid, epilepsy, or any brain injury — disulfiram is used with extreme caution in these conditions because of the risk of an accidental disulfiram-alcohol reaction.
- Any kidney inflammation (acute or chronic nephritis), or liver cirrhosis or liver failure — the same extreme caution applies.
- Any history of liver problems, and report fatigue, weakness, loss of appetite, nausea, vomiting, yellowing of the skin or eyes, or dark urine at once, because severe and sometimes fatal hepatitis has occurred even after many months of treatment.
- Any past reaction to rubber gloves or other rubber contact (rubber contact dermatitis).
- Pregnancy, plans for pregnancy, or breastfeeding — safe use in pregnancy has not been established, and it is not known whether disulfiram passes into human milk.
How to take Disulfiram
- Take disulfiram exactly as prescribed by your healthcare provider. Do not take more or less than directed. Take the tablet with or without food, usually in the morning. If drowsiness is a problem, ask your prescriber or pharmacist whether the timing of your dose can be changed.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2) (1)
Missed dose
Per MedlinePlus (NIH/NLM): if you miss a dose, take it as soon as you remember it that same day. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Overdose
In case of overdose, seek emergency medical attention or contact a poison control center immediately. The clinician-authored database record for this medicine (not independently verified against a professional label in this research pass) notes symptoms may include nausea, vomiting, unsteady movements, seizures, or loss of consciousness, with supportive care and monitoring as the mainstay of treatment. (2) (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Headache
Incidence: Reported in the clinician-authored database; frequency not established
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Vomiting
Incidence: Reported in the clinician-authored database; frequency not established
Fatigue
Incidence: Reported in the clinician-authored database; frequency not established
Drowsiness
Incidence: Reported in the clinician-authored database; frequency not established
Metallic taste
Incidence: Reported in the clinician-authored database; frequency not established
Skin rash or acne
Incidence: Reported as a common side effect by MedlinePlus (NIH/NLM)
Impotence
Incidence: Reported as a common side effect by MedlinePlus (NIH/NLM)
Psychotic reactions (confusion, hallucinations, unusual behavior)
Incidence: Reported in the clinician-authored database; seek prompt medical attention if this occurs
Possible liver damage: excessive tiredness, weakness, lack of energy, loss of appetite, upset stomach, vomiting, or yellowing of skin/eyes with dark urine
Incidence: Reported in the clinician-authored database and corroborated by MedlinePlus; seek prompt medical attention if this occurs
Chest pain, shortness of breath, severe allergic reaction (swelling of the face, lips, tongue, or throat), or seizures
Incidence: Reported in the clinician-authored database; seek immediate medical attention if this occurs
Signs of a severe disulfiram-alcohol reaction: flushing, throbbing headache, nausea, vomiting, sweating, thirst, chest pain, palpitations, confusion, low blood pressure, or collapse
Incidence: Reported in the clinician-authored database; seek immediate emergency medical attention if this occurs
Serious warnings
Current alcohol intoxication, alcohol consumed within the last 12 hours, severe heart disease, psychosis, or known hypersensitivity to disulfiram or thiuram derivatives all need clinician assessment before disulfiram is started — the prescriber will confirm the required alcohol-free interval and whether disulfiram is appropriate — serious
Symptoms: Current alcohol intoxication, alcohol consumed within the last 12 hours, severe heart disease, psychosis, or known hypersensitivity to disulfiram or thiuram derivatives all need clinician assessment before disulfiram is started — the prescriber will confirm the required alcohol-free interval and whether disulfiram is appropriate.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (1)
Boxed warning — serious
Symptoms: Boxed warning: disulfiram should never be given to a person who is intoxicated, or without that person's full knowledge that they are taking it — the prescriber and care team are responsible for confirming this before any dose is given.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (1)
Severe, potentially life-threatening reactions can occur if alcohol is ingested during treatment, including with alcohol in some foods, medicines, or topical products — serious
Symptoms: Severe, potentially life-threatening reactions can occur if alcohol is ingested during treatment, including with alcohol in some foods, medicines, or topical products; check labels and ask a pharmacist if unsure.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (1)
Use with caution in patients with liver or kidney impairment — serious
Symptoms: Use with caution in patients with liver or kidney impairment.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (1)
May cause drowsiness or affect mental alertness — serious
Symptoms: May cause drowsiness or affect mental alertness.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (1)
Inform all healthcare providers and dentists that you are taking disulfiram — serious
Symptoms: Inform all healthcare providers and dentists that you are taking disulfiram.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| General | Clinician-authored database record (not independently verified against a professional label in this research pass): disulfiram can interact with many medications, including metronidazole (may cause psychotic reactions), warfarin (increased anticoagulant effect), phenytoin (increased toxicity), isoniazid, and certain antidepressants. Always inform your healthcare provider of all medications and supplements you are taking. | (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Tell your doctor if you are pregnant or planning pregnancy before starting disulfiram, and contact your doctor immediately if you become pregnant during treatment. (2) (1)
Breastfeeding
Tell your doctor if you are breastfeeding before starting disulfiram; discuss infant feeding plans with your prescriber. (2) (1)
Children
Safety and efficacy in children have not been established. Disulfiram is generally not recommended for pediatric use. (2) (1)
Renal_impairment
Per the FDA-approved label (DailyMed), disulfiram should be used with caution in patients with hepatic cirrhosis or hepatic insufficiency; liver function should be evaluated before starting and monitored periodically during treatment, given reported cases of hepatitis (including fulminant hepatitis) and hepatic failure. For renal impairment, the product labeling does not give a specific dose adjustment; use with caution, with cautious low-end initial dosing suggested in elderly patients, who more often have reduced hepatic, renal, or cardiac function. (2) (1)
Hepatic_impairment
Per the FDA-approved label (DailyMed), disulfiram should be used with caution in patients with hepatic cirrhosis or hepatic insufficiency; liver function should be evaluated before starting and monitored periodically during treatment, given reported cases of hepatitis (including fulminant hepatitis) and hepatic failure. For renal impairment, the product labeling does not give a specific dose adjustment; use with caution, with cautious low-end initial dosing suggested in elderly patients, who more often have reduced hepatic, renal, or cardiac function. (2) (1)
Monitoring
(2) (1)Storage
Store at room temperature, away from moisture, heat, and direct light. Keep out of reach of children.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Alcohol dependence
Dose summary: Typical starting dose is 500 mg once daily for 1–2 weeks, then maintenance dose of 250 mg once daily. Maximum recommended dose is 500 mg daily.
Renal context: The FDA-approved label reviewed for this page does not provide a specific renal-impairment dosage adjustment for disulfiram; it advises general caution and, for elderly patients (who more often have reduced renal function), starting at the low end of the dosing range. (2) (1)
Frequently asked questions
How does disulfiram help treat alcoholism?
Disulfiram works by blocking the breakdown of alcohol in the body, causing unpleasant symptoms if alcohol is consumed. This discourages drinking and supports abstinence.
How long should I avoid alcohol after stopping disulfiram?
You should avoid alcohol for at least 14 days after your last dose of disulfiram, as the effects can persist and cause a reaction.
Can I use products containing alcohol while on disulfiram?
No. Even small amounts of alcohol in foods, medicines, or topical products can trigger a reaction. Always check labels and consult your healthcare provider.
What should I do if I accidentally consume alcohol while on disulfiram?
Seek immediate medical attention, as the reaction can be severe and potentially life-threatening.
Is disulfiram safe during pregnancy or breastfeeding?
Tell your doctor before starting disulfiram if you are pregnant, planning pregnancy, or breastfeeding, and contact your doctor promptly if you become pregnant during treatment — this is a clinician-directed decision based on your specific situation.
Can disulfiram be used in children or adolescents?
Disulfiram is generally not recommended for use in children or adolescents due to limited safety and efficacy data.
How long does it take for disulfiram to start working?
According to the clinician-authored database record for this medicine (not independently verified in this research pass), disulfiram begins to work within 1-2 hours after the first dose. Alcohol should not be consumed for at least 12 hours before starting the medication, per MedlinePlus.
What is the mechanism of action of Disulfiram?
Disulfiram is classified as Alcohol Deterrent. See the how-to-take, warnings, and interactions sections for the redistributed clinician-authored dosing and safety detail formerly held in this field. (2)
What is the generic name of Disulfiram?
The generic name is Disulfiram. It is sold under brand names including Disulfiram Sandoz, Cronotol, Antabuse, Esperal, Disulfiram.
What class of drug is Disulfiram?
Disulfiram is classed as: Alcohol Deterrent.
References
- ANTABUSE (disulfiram) — prescribing informationU.S. Food and Drug Administration · United States · dated 2026-08-07 · accessed 2026-08-07 · source 1
- Disulfiram: MedlinePlus Drug InformationMedlinePlus, U.S. National Library of Medicine · United States · accessed 2026-08-07 · source 2
- DISULFIRAM TABLET [GOLDEN STATE MEDICAL SUPPLY, INC.] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Disulfiram — FDA approval record (Drugs@FDA ANDA091563)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- Disulfiram — RxNorm normalized drug concept (RXCUI 3554)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient Disulfiram names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
India
- Dizone250 mg · Ozone Pharmaceuticals Ltd
- Esperal250 mg · Torrent Pharmaceuticals Ltd
- Recopress250 mg · Leeford Healthcare Ltd
- Disulfree250 mg · Jagsam Pharma