Disulfiram
Disulfiram is a prescription tablet used as an aid in managing chronic alcoholism by creating a strong physical deterrent to drinking.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 5 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾
Disulfiram must never be given to someone who is currently intoxicated (drunk) or who does not know they are taking it. Giving this medication without a person's full knowledge and consent is dangerous and is strictly prohibited. Family members should be informed of this rule by the prescribing doctor. The patient must understand what this medication does and agree to take it willingly.
📖 Disulfiram: Patient Information Guide
A plain-language walkthrough of Disulfiram — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Disulfiram is approved for use as an aid in the management of chronic alcoholism.
- Used to help motivated patients with chronic alcohol dependence maintain sobriety
- Intended to be part of a broader treatment plan that includes counseling and psychotherapy
- Not a cure for alcoholism — its effect depends heavily on the patient's motivation and engagement with supportive treatment
⚙️How it works▾
When you drink alcohol, your body normally breaks it down in two steps. Disulfiram blocks the second step, causing a substance called acetaldehyde to pile up in your bloodstream at levels 5 to 10 times higher than normal. That buildup produces a powerful and unpleasant physical reaction — making drinking feel genuinely awful — which reinforces the decision not to drink. Over time, continued use actually increases your sensitivity to alcohol rather than reducing it, so the deterrent effect doesn't wear off with long-term use.
💊How it's taken▾
Disulfiram is taken as an oral tablet once a day. It is typically taken in the morning, but can be taken at bedtime if drowsiness is a problem. Your first dose cannot be taken until you have been completely free of alcohol for at least 12 hours. Treatment continues daily without interruption — often for months or even years — until your doctor determines you have established lasting self-control.
- Take it at the same time each day to stay consistent
- If you suspect you are not absorbing it properly, your doctor may recommend crushing the tablet and mixing it into a liquid
- Do not stop taking it on your own — always talk to your prescriber first
🤒Side effects — in detail▾
Most early side effects of disulfiram are mild and tend to ease up after the first couple of weeks.
- Drowsiness or fatigue
- Headache
- Metallic or garlic-like aftertaste
- Acne-like skin eruptions
- Allergic skin reactions
- Impotence (difficulty with erections)
More serious reactions — including liver damage (hepatitis or liver failure), nerve damage (peripheral neuropathy or optic neuritis affecting the limbs or eyes), and psychotic episodes — have been reported and require immediate medical attention.
⚠️Warnings & precautions▾
- Alcohol reaction: Drinking any alcohol — even a tiny amount hidden in food, sauces, or personal care products — while on disulfiram can trigger flushing, severe headache, chest pain, vomiting, rapid heartbeat, difficulty breathing, low blood pressure, fainting, convulsions, heart attack, or death. This risk lasts up to 14 days after your last dose.
- Liver damage: Serious liver injury, including liver failure requiring transplant or causing death, has been reported. Watch for yellowing of the skin or eyes, dark urine, or severe abdominal pain.
- Nerve damage: Optic neuritis (nerve damage affecting vision), peripheral neuritis and neuropathy (nerve damage in the limbs) may occur.
- Psychotic reactions: Mental health changes including psychosis have been reported, especially at higher doses or when combined with certain other medications.
- Never given without consent: Disulfiram must never be given to someone who is intoxicated or unaware they are taking it.
🔀What it interacts with▾
Disulfiram interacts with several common drugs and substances — always give your pharmacist and doctor a full list of everything you take.
- Alcohol (any form): Even small amounts in food, drink, medicines, or personal care products can cause a serious, potentially fatal reaction.
- Metronidazole (antibiotic): Combination is contraindicated — serious toxic reactions can occur.
- Paraldehyde: Must not be combined with disulfiram.
- Phenytoin (seizure medication): Disulfiram raises phenytoin blood levels, risking toxicity; careful monitoring and possible dose adjustment required.
- Oral anticoagulants (blood thinners like warfarin): Disulfiram can increase their blood-thinning effect; dose adjustments may be needed.
- Isoniazid (TB medication): Can cause unsteady walking or serious mental status changes when combined with disulfiram.
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Do not take if you have consumed any alcohol or alcohol-containing products within the past 12 hours
- Do not take if you are currently using metronidazole or paraldehyde
- Do not take if you have severe heart disease or blocked coronary arteries
- Do not take if you currently have psychosis
- Do not take if you are allergic to disulfiram or to thiuram compounds (used in some pesticides and rubber products)
- Use with great caution — and inform your doctor — if you have diabetes, thyroid problems, epilepsy, brain damage, kidney disease, or liver disease
- Pregnancy: safety is not established; use only if your doctor concludes the benefit outweighs the risk
- Breastfeeding: do not use — it is unknown whether disulfiram passes into breast milk
- Children: safety and effectiveness have not been established in pediatric patients
- Older adults: lower starting doses are recommended due to the greater likelihood of reduced organ function and other medical conditions
🚑If you take too much▾
There is no specific treatment protocol established for a disulfiram overdose. If you suspect an overdose, contact your local Poison Control Center immediately or seek emergency medical care. Do not wait for symptoms to develop.
📡Pharmacodynamics — effects in the body▾
Disulfiram blocks a key enzyme in alcohol metabolism, causing acetaldehyde — a toxic breakdown product of alcohol — to accumulate in the blood at levels far above normal. This buildup produces a wide range of unpleasant and potentially dangerous physical symptoms whenever alcohol is consumed. The severity of the reaction is proportional to both the dose of disulfiram and the amount of alcohol ingested. With prolonged use, sensitivity to alcohol actually increases rather than decreasing — the drug does not produce tolerance.
🔬Pharmacokinetics — how your body processes it▾
Disulfiram is absorbed slowly from the gastrointestinal tract after you swallow it. It is also eliminated from the body very slowly, which means its effects can persist for up to one to two weeks after the last dose. Because it lingers in the body, patients need to avoid all alcohol even after stopping the medication. The drug does not appear to speed up or slow down the actual rate at which alcohol leaves the body.
📦How to store it▾
Dispense in a tight, light-resistant container as defined in the USP. Store at 20° to 25°C (68° to 77°F) .
📄 Written from Disulfiram’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
Supplements & herbs that interact with Disulfiram
45 supplements and herbal products have documented interactions with Disulfiram in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 4
- Moderate · 30
- Minor · 11
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Nutrient depletion considerations
Disulfiram has been associated with lower levels of 1 nutrient in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.
Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Disulfiram — the kind of thing our pharmacy team would talk through with you at the counter.
What exactly does disulfiram do, and why would my doctor prescribe it? ▾
How long do I need to take it? ▾
Can I have even a little alcohol — like in food or mouthwash — while on disulfiram? ▾
What side effects should I expect, and what should make me call my doctor? ▾
Are there any medications or supplements I need to tell my doctor about before starting? ▾
Is it safe to take disulfiram if I'm pregnant or breastfeeding? ▾
Is Disulfiram available over the counter? ▾
When was Disulfiram first available? ▾
Who makes Disulfiram? ▾
💬 Answers drafted from Disulfiram’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Disulfiram comes
Disulfiram is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Tablet
How this form is used
- Disulfiram tablet is used as an aid in managing chronic alcoholism in patients who are motivated to remain sober
- Disulfiram tablet is intended to be used alongside counseling and psychotherapeutic support, not as a standalone treatment
- Disulfiram tablet is taken by mouth once daily — usually in the morning, or at bedtime if it causes drowsiness
- Disulfiram tablet must not be taken until the patient has been free of alcohol for at least 12 hours
- If a patient is suspected of not actually swallowing the tablet, Disulfiram may be crushed and mixed well into a liquid
- Disulfiram tablet should be taken every day without interruption for as long as the prescriber recommends — treatment may last months to years
📊 Disulfiram across the U.S. market
How Disulfiram appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
Also listed with the FDA, not a patient dose form: Powder (6) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
📈 How widely Disulfiram is used
A general measure of how commonly Disulfiram is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Disulfiram is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Disulfiram prescribed? Of the 1,594 medications we measure, Disulfiram ranks #682 by Medicaid prescriptions — more than 57% of them.
Utilization by Disulfiram product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
disulfiram 250 MG Oral Tablet Most dispensed
Summed across the 4 of 13 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 197623
disulfiram 500 MG Oral Tablet
Summed across the 3 of 9 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 197624
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Disulfiram, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 7 of 22 listed Disulfiram NDCs with Medicaid activity.
🔍 Compare Disulfiram products
A representative set of FDA-listed product records for Disulfiram — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Tablet | ||||
| 250 mg | Oral | Alvogen Inc. × 3 listings | ANDA | View NDC → |
| 250 mg | Oral | Bryant Ranch Prepack | ANDA | View NDC → |
| 250 mg | Oral | Chartwell RX, LLC × 2 listings | ANDA | View NDC → |
| 500 mg | Oral | Chartwell RX, LLC × 2 listings | ANDA | View NDC → |
| 250 mg | Oral | Golden State Medical Supply, Inc. × 3 listings | ANDA | View NDC → |
| 500 mg | Oral | Hikma Pharmaceuticals USA Inc. | ANDA | View NDC → |
| 250 mg | Oral | Rising Pharmaceuticals, Inc. | ANDA | View NDC → |
| 500 mg | Oral | Rising Pharmaceuticals, Inc. | ANDA | View NDC → |
| 250 mg | Oral | Sigmapharm Laboratories, LLC × 2 listings | ANDA | View NDC → |
| 500 mg | Oral | Sigmapharm Laboratories, LLC | ANDA | View NDC → |
| 250 mg | Oral | West-Ward Pharmaceuticals Corp. | ANDA | View NDC → |
| 500 mg | Oral | West-Ward Pharmaceuticals Corp. | ANDA | View NDC → |
| 💊Bulk drug substance | ||||
| 1 kg/kg | — | Apicore Pharmaceuticals Private Limited | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | Corden Pharma Bergamo S.p.A. × 2 listings | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | Matrix Pharmacorp Private Limited | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | PolyCarbon Industries, Inc. | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | Solara Active Pharma Sciences Limited | BULK INGREDIENT | View NDC → |
Showing 25 of 25 products — FDA National Drug Code Directory. See every product, package size and price: browse all 25 Disulfiram NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Disulfiram — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Disulfiram in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Disulfiram went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 3554 1 dose form · 3 strengths
-
Dose form (SCDF) Oral Tablet RxCUI 371940In current FDA listings
Look up RxCUI 3554 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Disulfiram is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Disulfiram belongs to the Aldehyde Dehydrogenase Inhibitor class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 5 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Sigmapharm Laboratories, LLC is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.