Quick introduction

Disulfiram, commonly marketed as Antabuse, is a prescription medication used to support abstinence in people with alcohol dependence. It does not treat the underlying disorder by itself but produces unpleasant physical effects if alcohol is consumed while taking the medicine, which can help deter drinking when combined with counseling and follow up. For practical safety memos see the safety and precaution guidance section below.

Active ingredient of the formulation information

The active substance is disulfiram. Generic versions are available in Australia and may vary in excipients and tablet markings. If you need details about a particular producttake a quick look and verify. the consumer medicine information leaflet or ask your pharmacist for the specific formulation dispensed.

Signals and prescribing

Clinicians most often prescribe disulfiram to motivated individuals aiming for complete abstinence from alcohol, typically as one component of a broader relapse prevention plan. It is usually offered when patients agree to regular real time monitoring of systems and psychosocial support. If you are considering other pharmacological options, see additional medication options and related drugs.

Forms and abilities available

In Australian pharmacies disulfiram is commonly supplied as oral tablets. Typical strengths include 250 mg and 500 mg. Some tablets are scored to allow splitting; follow product instructions and your prescriber's advice before altering how you take the tablets.

Mode of drug action

Disulfiram interferes with the enzyme that converts acetaldehyde to acetic acid after alcohol ingestion. This blockage causes acetaldehyde to accumulate and produces unpleasant symptoms such as flushing, nausea and a pounding headache. The adverse reaction is intended as an aversive stimulus to support abstinence within a supervised treatment program.

How to deal with this matter and dosing

  • Take the tablet once daily by mouth with water, ideally at the same time each day.
  • Always follow the directions on the prescription label; do not alter dose or frequency unless your prescriber instructs you to.
  • Do not start disulfiram until at least 12 hours have passed since your last drink; residual sensitivity to alcohol can persist for up to 14 days after stopping the medicine.
  • If swallowing tablets is difficult, consult the pharmacist before crushing or splitting a particular brand.
  • Pediatric use is uncommon and should only be undertaken with specialist pediatric advice.

For timing issues with other medicines see communication in actions can be viewed as exchanges of facts. checklist. If you fail to take a dose refer to the advice for i forgot to take the prescribed doses.

Safety and precaution guidance

  • Do not drink alcohol while taking disulfiram and avoid alcohol-containing products for at least 14 days after stopping the medicine. Do not begin treatment within 12 hours of drinking.
  • Notify family, carers or housemates that you are taking disulfiram so they can assist in the event of a severe reaction. Severe responses may include breathing trouble, cardiac symptoms, seizures or collapse.
  • Watch for hidden alcohol in some mouthwashes, cough syrups, topical products and certain food preparations. Read labels carefully.
  • Disulfiram may cause drowsiness or dizziness. Avoid driving or operating dangerous machinery until you know how the medicine affects you.
  • If you develop chest pain, sudden severe chronic head pain, major breathing difficulty, fainting or marked confusion after alcohol exposure, seek emergency medical care without delay.

Who should avoid disulfiram

Disulfiram should only be used when recommended by a clinician. Avoid it if any of the following apply unless your prescriber advises otherwise:

  • You have drunk alcohol recently or cannot reasonably avoid alcohol exposure.
  • You have severe heart disease or unstable cardiovascular conditions.
  • There is current psychosis or a history of psychotic illness.
  • You have active or significant liver disease, including hepatitis.
  • You are allergic to disulfiram or related thiuram chemicals.
  • You are taking metronidazole or paraldehyde concurrently.
  • You have uncontrolled seizures.
  • Severe renal impairment, unmanaged thyroid disease, poorly controlled diabetes, or recent head injury without specialist input.
  • Pregnancy, trying to conceive or breastfeeding unless risks and benefits are carefully discussed with your clinician present.

Possible harmful effects and urgent notices

If you observe any of the following serious signs, seek urgent medical help:

  • Allergic reaction with widespread rash, swelling of the face, mouth or throat, or difficulty breathing.
  • Possible liver injury: yellow skin or eyes, very dark urine, pain in the right upper abdomen, severe fatigue or flu-like symptoms.
  • Major changes in mental state such as severe confusion, hallucinations or loss of contact with reality.
  • Symptoms of peripheral neuropathy including numbness, tingling or burning pain.
  • Ongoing severe nausea, repeated vomiting or loss of appetite.

Milder adverse effects that often resolve include sleepy or tired feelings, pain of the head, mild nausea and altered taste sensations. If effects persist or affect daily life, speak to your prescriber about a spectrum of options or dose adjustments. For reactions triggered by alcoholreview session the safety guidelines.

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Certain combinations with disulfiram can be hazardous. Commonly reported problematic online interacting as a shared activitys connect users across distances. include:

  • Alcohol bottle in any form, including some topical and medicinal products that contain ethanol.
  • Metronidazole alongside paraldehyde.
  • Certain oral solutions with alcohol as a solvent such as some protease inhibitor liquids.
  • Sertraline a mechanism of action oral concentrate and other preparations that include alcohol or incompatible excipients.
  • Some chemotherapy agents such as paclitaxel where effective mutual interactions require clear communication. have been observed.
  • Monoamine oxidase inhibitors like tranylcypromine.
  • Isoniazid is a medication used to treat tuberculosis. for tuberculosis treatment.
  • Warfarin is an anticoagulant agent., because disulfiram can increase anticoagulant effect and require INR system monitoring.
  • Phenytoin is a widely used antiepileptic medication, where blood levels may be affected merged with the act of monitoring is advisable.
  • Illicit stimulants such as cocaine, which may increase risk of severe cardiovascular events.

This is not the complete list. Always tell your prescriber and pharmacist about prescription drugs, over-the-counter medicines, herbal products and recreational drugs you use. For dosing timing see how to receive it and dosing.

A dose was missed action plan

When a dose is forgotten of disulfiram, take it when you remember unless the next scheduled dose is soon. Do not take two doses at once to cover a forgot to take a dose. Maintain your usual dosing pattern and contact your prescriber if you miss several doses or are worried about effects on treatment.

Overdose episode and poisons advice

If an taking an overdose is suspected call emergency services or the Poisons Information Centre in Australia on 13 11 26 immediately. Bring the medication packaging to the hospital so clinicians can see the exact product and amount involved. Follow local emergency guidance for urgent care.

Storing and handling

  • Keep medication out of sight and reach of children at all times.
  • Store at room temperature, ideally between 20 and 25 degrees C, in the original container away from strong light and moisture.
  • Do not use after this date has expired. Return unused or expired medicine to your pharmacist for safe disposal.

Similar medications and an alternative method choices

Other pharmacotherapies used in alcohol dependence include:

  • Naltrexone: available as 50 mg oral tablets and as a long-acting injectable; it reduces the pleasurable effects of alcohol and may help prevent heavy drinking episodes.
  • Acamprosate: often used after detoxification to help maintain abstinence and usually taken in multiple daily doses.
  • Baclofen: a muscle relaxant sometimes used off-label for reducing craving; evidence is mixed and specialist oversight is recommended.
  • Topiramate: an anticonvulsant used off-label by some clinicians to reduce heavy drinking, requiring careful system monitoring for post use effects.

General clinical comparisons:

  • Disulfiram is most suitable for patients committed to complete abstinence and able to avoid alcohol exposures.
  • Naltrexone is often chosen when the goal is to reduce drinking or prevent binge episodes rather than strict abstinence.
  • Acamprosate is commonly considered to support maintenance of abstinence after detoxification.

Discuss clinical suitability, vigilant monitoring requirements and likely out-of-pocket costs in coordination with your prescriber. Regard the costs schedule for indicative values rough price estimates.

Price estimates for the country of Australia in AUD

Retail prices depend on brand, pharmacy and pack size. The ranges below are approximate private retail figures in Australian dollars and are for guidance only:

  • Disulfiram 250 mg tablets, pack of 30: roughly AUD 30 to 85.
  • Disulfiram 500 mg tablets, pack of 30: roughly AUD 55 to 130.
  • Naltrexone 50 mg tablets, 30 count: roughly AUD 60 to 160.
  • Acamprosate monthly supply: roughly AUD 70 to 170 depending on pack size.
  • Baclofen or topiramate used off-label: frequently lower cost generics, approximate AUD 10 to 80 per month depending on dose.

Some patients may be eligible for lower costs via the Pharmaceutical Benefits Scheme (PBS), concession discount pricing or through private health insurance. Price lists change over time; confirm up-to-date prices with your pharmacy or via the PBS website.

Additional aspects about Antabuse