Cough Medicines Safe To Take With Disulfiram

In our latest question and answer, the pharamcist discusses cough medications that are safe to take with Antabuse (disulfiram).

Question

I’m currently taking Disulfiram to help stop drinking alcohol. However, I was told even trace amounts of alcohol could make me extremely sick while taking the medication. My question is what cough medicine is safe to take with disulfiram?

Asked by JPV On Jan 02, 2023

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Jan 03, 2023
Last updated Mar 25, 2024

Key points

  • It is recommended to completely avoid alcohol, and alcohol-containing products, while taking disulfiram as even small amounts of alcohol could cause a negative reaction.
  • There are several alcohol-free cough medications available that are safe to take with disulfiram, including Delsym and Father John's Alcohol-Free Cough Medicine.

Answer

You are correct that you want to avoid consuming any alcohol while you are taking Antabuse (disulfiram) to avoid the reactions the drug causes.

Symptoms that can occur by combining alcohol with disulfiram include:

  • Flushing
  • Throbbing in head and neck,
  • Difficulty breathing
  • Nausea
  • Vomiting
  • Sweating
  • Thirst
  • Chest pain
  • Trouble breathing
  • Increased heart rate
  • Low blood pressure

The symptoms that disulfiram causes will vary based on the amount of alcohol consumed. The more alcohol that is consumed, the more severe the side effects are.

How Much Alcohol Does It Take To Cause A Reaction To Disulfiram?

Disulfiram causes a reaction to alcohol consumption as the drug blocks one important step in its metabolism, which results in an increase in acetaldehyde concentrations in the blood. This increase in acetaldehyde is what causes the negative symptoms that are experienced.

Although there isn't a specific amount of alcohol that 100% causes a reaction in an individual, the amount needed is generally very little.

Per the prescribing information for Disulfiram:

Mild reactions may occur in the sensitive individual when the blood alcohol concentration is increased to as little as 5 to 10 mg per 100 mL. Symptoms are fully developed at 50 mg per 100 mL, and unconsciousness usually results when the blood alcohol level reaches 125 to 150 mg. The duration of the reaction varies from 30 to 60 minutes, to several hours in the more severe cases, or as long as there is alcohol in the blood.
Antabuse Prescribing Information

I want to emphasize that mild reactions can start when your blood alcohol concentration is as little as 5mg per 100 mL. We traditionally think of blood alcohol concentration (BAC) in regard to what is considered legally impaired, which is 0.08%. 5mg per 100mL, as the prescribing information states, translates to a BAC of 0.005%, which is certainly less than what you would typically even feel.

As it takes very little alcohol to experience a reaction, you really want to avoid it altogether if you are taking disulfiram. It is even recommended to avoid alcohol-containing products, such as mouthwash.

Safe Cough Medications

Your safest options for cough medication, if you are taking disulfiram, are alcohol-free ones. It is extremely important to check the labels of any medication you are looking at to see if they contain alcohol.

Some cough medication options that are alcohol-free include:

  • Delsym Adult Cough Suppressant Liquid
  • NyQuil Alcohol-Free Cough, Cold & Flu Nighttime Relief Liquid, Berry Flavor
  • Father John's Alcohol-Free Cough Medicine
  • Diabetic Tussin DM Liquid
  • Robitussin Cough & Allergy
  • Robitussin DM Liquid
  • Vicks Dayquil Multi-symptom cold/flu relief

As you can see, there are a variety of options available to you. However, I do caution you to inspect the product you are looking at carefully. Some of the ones I've listed above have multiple versions available, such as NyQuil (e.g., it comes in an alcohol and alcohol-free version).

Final Words

I hope this answer was helpful. Thanks for reaching out!

References

  • NyQuil Manufacturer Website, Vick's
  • Alcohol use disorder: Pharmacologic management, UpToDate
  • Antabuse Prescribing Information, DailyMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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