Disulfiram: What It Is and How It Works

Disulfiram is a prescription medicine used to support people who want to stop drinking alcohol. It doesn't cure addiction, but it makes drinking unpleasant by blocking the enzyme that breaks down alcohol. If you drink while on disulfiram you can get flushing, nausea, headache, and fast heartbeat within minutes.

Doctors usually prescribe disulfiram as part of a wider plan that includes counseling and support. It works best when someone commits to staying sober and uses the drug as a safety measure. Many people find it helpful when cravings are strong or when they need extra deterrence during early recovery.

How to take disulfiram

Take disulfiram exactly as your doctor tells you. Common doses range from 250 mg to 500 mg once daily, often after a short trial of a lower dose. Expect to wait at least 12 hours after your last drink before starting disulfiram to avoid a severe reaction. Missed doses reduce protection quickly, so try to take it at the same time each day.

Side effects and safety

Minor side effects can include tiredness, drowsiness, metallic taste, and skin rash. Serious effects are rare but can happen: liver problems, severe allergic reactions, or mental changes like depression. Your doctor will usually check liver function before starting and during treatment. Avoid any products containing alcohol — mouthwash, cough syrups, some sauces — because they can trigger a reaction.

Disulfiram interacts with many medicines. Tell your doctor about all prescription drugs, over-the-counter meds, and herbal supplements you use. Certain antibiotics, antifungals, and heart medicines can cause problems when taken with disulfiram. If you plan surgery or dental work, remind the provider you take disulfiram so they avoid alcohol-based agents.

Who shouldn’t take disulfiram? People with severe heart disease, serious liver damage, or psychosis usually should not use it. Pregnant or breastfeeding people need to discuss risks and benefits with a clinician. Disulfiram is not a quick fix — it's a tool that works when combined with therapy, peer support, and a plan for relapse prevention.

Common questions: How long should I take it? That depends on your goals. Some stay on disulfiram for a few months, others longer under medical supervision. Can I stop anytime? You can, but stopping removes its protective effect. How effective is it? Studies show it helps some people avoid drinking, especially when supervised.

If you think disulfiram might help, talk to a doctor or addiction specialist. They can assess your health, explain risks, set a start date, and arrange follow-up. Using disulfiram alongside counseling and support groups gives you the best chance to stay alcohol-free.

Practical tips: set a daily reminder, store pills somewhere visible, carry an ID card that notes you're taking disulfiram, tell close friends or family so they can help, and plan sober activities for high-risk times like parties and holidays. If you notice unusual tiredness, yellow skin, or dark urine contact your doctor. Check-ins with your care team make the treatment safer and effective.