Drug Interaction Report

Disulfiram and Chlordiazepoxide: Interaction Details

A pharmacist-reviewed analysis of the Disulfiram and Chlordiazepoxide interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Chlordiazepoxide

No brand names on record
+

Disulfiram

Antabuse Antabuse®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Minor
Usually limited clinical impact.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 45 documented Disulfiram interactions, 3 are rated minor — including this one.
Onset
delayed
Evidence
theoretical
Severity
Minor

What happens

An increased risk of chlordiazepoxide toxicity (CNS depression)

Interaction Deep Dive

The potential exists for increased chlordiazepoxide serum concentrations when disulfiram is given concurrently. Inhibition of hepatic metabolism of benzodiazepines that undergo oxidative metabolism is thought to be the mechanism of action12.

Why it happens (mechanism)

Decreased hepatic metabolism

Literature reports

1 report — tap to read

a) Concomitant disulfiram and benzodiazepine therapy may potentiate the sedative effects of the benzodiazepine. The metabolic clearance of various benzodiazepines when given concurrently with disulfiram was studied. Determinations of plasma chlordiazepoxide concentrations showed that the parent compound and desmethyl metabolite had a decreased plasma clearance in both healthy and alcoholic patients. The plasma clearance of diazepam decreased in both healthy and alcoholic patients by 41%. There was a corresponding decrease in the active N-desmethyl metabolites of both drugs. Disulfiram increased the half-life of chlordiazepoxide by 84% and diazepam by 37%. The disposition of oxazepam was not altered significantly by disulfiram, but the half-life was increased by 17%. Oxazepam may be the drug of choice in patients on disulfiram who require benzodiazepine therapy 1.

Common questions

Can I take Disulfiram and Chlordiazepoxide together?

An increased risk of chlordiazepoxide toxicity (CNS depression) Always confirm with your pharmacist or prescriber before making any change.

How serious is the Disulfiram and Chlordiazepoxide interaction?

It is rated minor. Usually limited clinical impact.

How quickly could this interaction happen?

The documented onset is "delayed". Effects tend to build up gradually over days to weeks.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Disulfiram or Chlordiazepoxide need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there anything you'd monitor while I'm on both?

References (2)

  1. MacLeod SM, Sellers EM, Giles HG, et al: Interaction of disulfiram with benzodiazepines. Clin Pharmacol Ther 1978; 24:583-589. PubMed
  2. Sellers EM, Giles HG, Greenblatt DJ, et al: Differential effects of benzodiazepine disposition by disulfiram and ethanol. Arzneimittelforschung 1980; 30:882-886.
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Chlordiazepoxide

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Disulfiram

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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Chlordiazepoxide + 1,4-butanediol Activated Charcoal Beer Gamma-hydroxybutyrate (ghb) Grapefruit Henbane Kava L-tryptophan + 180 more
Disulfiram + Activated Charcoal Bach Flower Remedies Beer Wine Biofeedback Black Tea Caffeine Cannabinol (cbn) + 37 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.