Taking disulfiram for alcohol use disorder means drinking can trigger a reaction. You may feel flushed, nauseous, or get a headache. In serious cases, your blood pressure can fall too low. Heart issues are possible. You could even have a seizure.
If you have these severe signs, call 911 right away. Or go to the nearest emergency room. Do not hold off until you see a doctor. Skip waiting for a quiz outcome. If you are unsure about a recent drink, call Poison Control for help.
Our guide holds more details on medications for alcohol use disorder. We post a directory of treatment centers. We do not serve as a treatment provider. General facts are shared in this guide. It is not personal medical advice. Speak with your prescriber regarding your care plan.
What to Do If You Had a Drink While on Disulfiram
If you had a drink while using disulfiram, seek help right away. Do not keep it to yourself. Do not try to manage a bad reaction by yourself. The reaction can be very serious.[1]
- Stop drinking. Make sure no more alcohol is taken. If you drink heavily or regularly, contact a clinician or emergency service promptly for a withdrawal assessment rather than trying to manage withdrawal alone. Keep the pill bottle and alcohol packaging ready for doctors.
- Check for severe signs. Look for trouble breathing, fainting, seizures, or passing out.
- Call 911 or go to the ER. Go now if you see severe signs.
- Call Poison Control. If there are no severe signs, call Poison Control first.[2] Then tell your prescriber or pharmacist what happened.
What Is the Safest Next Step?
This self-check is for information only and isn't a diagnosis.
Understanding how to handle drinking on disulfiram keeps you safe. To learn about slips with other drugs like naltrexone or acamprosate, see our guide on steps after drinking on medication.
Drinking Alcohol on Disulfiram: What Can Happen
Disulfiram blocks alcohol breakdown at the acetaldehyde stage, causing acetaldehyde to build up when alcohol is consumed.[4] Common signs of a disulfiram-alcohol reaction include flushing, headache, nausea, vomiting, and sweating.[5] You may also feel your heart beat fast or hard.[5] Breathing can change too.[5]
How strong the reaction is varies from person to person.[1] Severe cases can lead to breathing depression, heart rhythm problems, heart attacks, cardiovascular collapse, unconsciousness, seizures, or death.[1]
30 minutes to several hours
is how long symptoms may last[6]
Never test the drug to check if it still works. Also, do not let bad symptoms get worse. If you have severe symptoms or danger signs, call 911 or go to the nearest emergency room now. If you drank alcohol while taking disulfiram and have no danger signs, call Poison Control at 1-800-222-1222 for free, confidential guidance,[2] and contact your prescriber or pharmacist for advice.
Finding Hidden Alcohol and Waiting Times
Alcohol can be in places you do not expect. Certain medicines and personal-care items may have it. This covers muscle rubs, cough syrups, tonics, elixirs, and cold and flu products.[7] You cannot tell if something is safe just by its type. Read the ingredient list closely every time.
The maker's FDA-approved label says disulfiram should never be given until someone has been alcohol-free for at least 12 hours.[8] This is a general rule. Ask your prescriber or pharmacist about your exact start or restart plan. They can tell you the right timing for you. If you stop taking disulfiram, do not think it is safe to drink right away. Check the current label and talk to your care team before having any alcohol.
Check for Possible Alcohol Sources
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Key Safety Precautions for Disulfiram
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If you have reactions or other problems on this medication, see our guide on that topic to learn more about managing medication side effects.
How Does Disulfiram for Alcohol Use Disorder Work?
Disulfiram stops a key step in how your body breaks down alcohol. This causes a chemical called acetaldehyde to pile up in your blood.[4] If you drink, that buildup makes you feel very sick.
Disulfiram does not directly lower your cravings.[13] Instead, the reaction it causes acts as a deterrent. This effect works to discourage you from drinking.
Your goals decide which medicine is right for you. Your health history and preferences matter too. There is no single best option for everyone. Doctors may suggest disulfiram for those with moderate to severe alcohol dependence who aim for full abstinence. This is true if they did not respond to acamprosate or naltrexone and know the risks.[14] It is not for acute alcohol withdrawal. Start it only after detoxification or when abstinence is set.[11]
In the U.S., the FDA has approved disulfiram, naltrexone, and acamprosate for alcohol use disorder.[15] Each acts in a unique way. Use the table below to prep for your doctor visit. If naltrexone is on your list, our guide to naltrexone injection vs oral compares the two delivery methods. For a broader look at how these drugs fit into a full plan, see our guide to mat for alcohol use disorder.
| Medication | General Approach | Key Considerations |
|---|---|---|
| Disulfiram | A deterrent that causes an unpleasant physical reaction if you drink. | Requires a goal of complete abstinence. Can cause serious liver injury, so liver function is monitored. Not suitable if you cannot guarantee abstinence or have certain medical conditions.[14][9][10] |
| Naltrexone | Helps reduce cravings and the rewarding effects of alcohol. | May be an option for those who want to cut down or stop. Discuss potential interactions with other medications. Read our guide on naltrexone for alcohol cravings. |
Research on how well disulfiram works is mixed. Another review noted that while double-blind studies showed no difference from controls, open-label trials suggested disulfiram was better than controls on alcohol-related outcomes.[16] Your doctor can help you weigh this information against your personal health needs.
How Long Do People Stay on Disulfiram?
How long you take disulfiram varies from person to person. There is no standard length of time that fits everyone.[11] Your prescriber makes the call on when to stop. They look at your past and how your body reacts to the drug.[11] To keep track of how the medication is affecting you, our guide to monitoring alcohol medication progress explains what to watch for.
Before starting
You and your prescriber talk about goals and health history.
During treatment
You keep follow-up appointments. Your clinician may check liver function before and during treatment to ensure safety.[10]
At follow-up visits
You review benefits and side effects. You can also talk about changing goals.
Later on
You and your prescriber decide together whether to continue or stop. There is no standard stop date.
Serious, potentially fatal liver injury can happen from disulfiram.[9] Let your prescriber know about any new signs you notice. Severe liver issues can appear even after you have been on the drug for many months.[9] Ask your doctor what to watch for to keep your liver safe during visits.
Helping With Cravings, Withdrawal, and More
A strong urge to drink has no fast cure. Reach out to your clinician or a trusted friend when a craving hits. Share what you are feeling with them. Inquire about treatment options for alcohol use disorder. Do not change your medicine on your own.
Your care plan may include counseling. It works well with medication.[17] These talks help you build skills. They help you manage stress and dodge triggers. Your team can locate a fitting therapist or group. If you want to see how those conversations unfold, our guide to motivational interviewing alcohol shows the techniques therapists use. For a look at another common approach, our guide to cognitive behavioral therapy for alcohol use disorder details the session flow.
If cravings remain high, your doctor may discuss other medicines. Acamprosate assists people in staying away from alcohol.[18] Consult your prescriber before changing or adding meds. Our guide to acamprosate for alcohol use disorder covers how it works and the side effects to watch for.
Disulfiram is not meant for managing withdrawal at home. It does not treat acute alcohol withdrawal.[11] A medical check is needed if you have drunk heavily. A doctor must oversee your withdrawal safely. Disulfiram begins only after detox and abstinence.[11]
Combine counseling, support, and medicine to lower the urge to drink alcohol. This blend often works best. Your doctor can help you create a complete plan for recovery.
What Is Alcohol Use Disorder and How to Get Help
People can get help for alcohol use disorder. Most who have this condition can gain from some kind of care.[19]
Talk to a professional if you worry about your drinking. Doctors advise looking for unhealthy alcohol use in primary care. They also point to brief counseling for those who drink at risky levels.[20]
You can read about the symptoms of alcohol use disorder to help you prepare.
What to Bring Up With a Clinician
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See more hints on talking to your doctor about meds.
Frequently Asked Questions
What should I do if I drank while taking disulfiram?
Call 911 or go to the emergency room now if you have severe symptoms. Do not wait for a quiz result. For other exposures, call Poison Control right away.[22] Also contact your prescriber or pharmacist. Do not test the reaction or change your dose on your own.
How long should someone be on disulfiram?
There is no one-size-fits-all time frame. Your prescriber will look at your goals and health needs. They will help you decide how long to stay on the medication. Talk with them before you stop or change anything.
How long after stopping disulfiram should someone avoid alcohol?
A reaction can happen for up to two weeks after the last dose.[12] Check with your prescriber or pharmacist for personal advice. Do not assume this time frame clears you for everyone.
What is the success rate of disulfiram?
What can help reduce the urge to drink alcohol?
There is no instant fix for cravings. Medications can help lower relapse risk and ease withdrawal symptoms like craving.[11] Naltrexone is one option to ask about. Behavioral support can also be part of your care plan. Talk with a clinician about what fits your goals.
What are the 11 symptoms of alcohol use disorder?
The DSM-5 lists 11 symptoms of problematic drinking.[23] These include drinking more than planned and failing to cut down. Other signs are spending time recovering and having strong cravings.[24] You might also miss work, ignore relationship issues, or build tolerance. Meeting two or more symptoms in 12 months meets the diagnostic threshold.[23] This list is not a diagnosis. Seek a professional evaluation if you are worried about your drinking.
What are the three medications used to treat alcohol use disorder?
Naltrexone, acamprosate, and disulfiram are FDA-approved for alcohol use disorder.[15] The right choice depends on your health history and goals. Discuss these options with a clinician to find the best fit. See the medication-comparison table above for more details.
What is the most effective treatment for alcohol use disorder?
No single treatment works best for everyone. Your goals and health history matter most.[15] A clinician can guide you through your options. Combining medication and behavioral support may be helpful for some people.
