WARNING

Antabuse (Generic Disulfiram) is a medication used to help people with alcohol use disorder avoid drinking alcohol by causing unpleasant effects when alcohol is consumed. However, taking Antabuse comes with certain risks:

• Severe Reactions to Alcohol: Consuming alcohol while taking Antabuse can cause severe reactions, including nausea, vomiting, headache, chest pain, difficulty breathing, rapid heartbeat, and low blood pressure. In extreme cases, it can lead to seizures, heart attacks, or death.
• Liver Toxicity: Antabuse may cause liver damage, which can be serious or life-threatening. Symptoms of liver problems include yellowing of the skin or eyes (jaundice), dark urine, severe stomach pain, and persistent nausea or fatigue.
• Neurological Effects: Potential side effects include drowsiness, fatigue, headache, and in rare cases, neuropathy (nerve damage), which can cause numbness, tingling, or pain in the hands or feet.
• Psychiatric Symptoms: It can cause mood changes, confusion, depression, or psychosis, particularly in people with a history of mental health disorders.
• Allergic Reactions: Some people may experience allergic reactions, such as skin rashes, itching, or swelling. In rare cases, severe reactions like anaphylaxis can occur.
• Drug Interactions: Antabuse can interact with other medications, including certain antidepressants, anticoagulants, and medications for diabetes, which may increase the risk of side effects.

Before starting Antabuse, it’s important to discuss any existing health conditions and medications with a healthcare provider to manage these risks effectively.

Why is this medication prescribed?

Antabuse (Generic Disulfiram) is prescribed to help people with alcohol use disorder maintain abstinence from alcohol. It is part of a comprehensive treatment program that includes counseling and support to help individuals quit drinking. Antabuse is primarily prescribed for people who want to stop drinking alcohol but have difficulty doing so. The medication discourages alcohol consumption by causing unpleasant reactions (such as nausea, vomiting, headache, and flushing) when even small amounts of alcohol are consumed. These reactions create a strong deterrent effect. It is used as a long-term treatment to help prevent relapse in people recovering from alcoholism. Antabuse supports patients’ commitment to sobriety by reinforcing the negative consequences of drinking.

How should this medicine be used?

Here’s how you should use it:

• Dosage: Antabuse is taken orally, usually once a day. The dosage is determined by a healthcare provider, typically starting with a higher dose (500 mg daily) and then reducing it to a maintenance dose (usually between 125 mg to 500 mg daily, depending on the patient’s response and tolerability).
• Timing: It is usually taken in the morning, but for patients who experience drowsiness, it may be taken at bedtime.
• Alcohol Abstinence: It is crucial to avoid alcohol for at least 12 hours before taking the first dose of Antabuse. Alcohol must be avoided throughout treatment and for at least 14 days after stopping the medication to prevent a disulfiram-alcohol reaction.
• Monitoring: Regular follow-ups with a healthcare provider are necessary to monitor for side effects, liver function, and overall progress in abstaining from alcohol.
• Avoiding Alcohol in Other Products: Patients should avoid all sources of alcohol, including over-the-counter medications (like some cough syrups), mouthwashes, cooking sauces, vinegars, and certain personal care products that may contain alcohol.
• Consistent Use: It’s essential to take Antabuse exactly as prescribed, without skipping doses, to maintain its deterrent effect.

Patients should always follow their healthcare provider’s instructions and notify them of any side effects or concerns while taking Antabuse.

Other uses for this medicine

• Social and Behavioral Conditioning: While Antabuse is primarily used for alcohol use disorder, it may sometimes be used in a clinical setting to explore its effects on behavioral conditioning or to support various behavioral therapies.
• Support for Abstinence: It may be used as part of a comprehensive treatment program that includes therapy and counseling, to help reinforce the commitment to abstaining from alcohol.

What special precautions should I follow?

Special Precautions for Antabuse:

• Avoid Alcohol: Ensure complete abstinence from alcohol, including in foods, drinks, medications, and personal care products, to avoid serious reactions. This includes avoiding alcohol-based mouthwashes, cough syrups, and even some foods cooked with alcohol.
• Liver Function: Regular liver function tests are necessary as Antabuse can cause liver damage. Report any symptoms of liver problems such as yellowing of the skin or eyes, dark urine, severe stomach pain, or persistent nausea to your healthcare provider immediately.
• Medical History: Inform your healthcare provider about any history of liver disease, kidney disease, heart disease, psychiatric disorders, or any other significant health conditions before starting Antabuse.
• Drug Interactions: Be aware of potential drug interactions. Inform your healthcare provider about all other medications you are taking, including prescription, over-the-counter drugs, and supplements, to avoid adverse interactions.
• Mental Health: Monitor for any changes in mood, behavior, or psychiatric symptoms. Antabuse can sometimes exacerbate mood disorders or cause new symptoms.
• Adherence to Treatment: Follow your healthcare provider’s instructions carefully regarding dosage and timing. Do not start, stop, or change the dose of Antabuse without consulting your healthcare provider.
• Emergency Plan: Have a plan for emergencies. If you experience severe reactions or symptoms of a disulfiram-alcohol reaction (such as severe nausea, vomiting, or difficulty breathing), seek medical help immediately.
• Pregnancy and Breastfeeding: Inform your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. The safety of Antabuse in these conditions has not been well-studied, and it should only be used if clearly needed.

By adhering to these precautions, you can help ensure the safe and effective use of Antabuse as part of your treatment plan.

What special dietary instructions should I follow?

• Avoid Alcohol: Be meticulous about avoiding all sources of alcohol, including foods and drinks. Check labels on products to ensure they do not contain alcohol.
• Read Ingredients: Be cautious with foods that might contain alcohol-based ingredients, like certain sauces or desserts.
• Check Medications: Ensure that over-the-counter medications and herbal supplements do not contain alcohol.

What should I do if I forget a dose?

• Take It When Remembered: If you miss a dose and remember it later, take it as soon as possible unless it’s almost time for your next dose.
• Skip the Missed Dose: If it’s close to your next dose, skip the missed dose; do not double up to make up for a missed dose.
• Follow Regular Schedule: Resume your regular dosing schedule.

What side effects can this medication cause?

Antabuse (Generic Disulfiram) can cause various side effects. Some are more common and manageable, while others can be more serious. Here’s a breakdown:

Common Side Effects:

• Drowsiness: Feeling sleepy or tired.
• Fatigue: General weakness or feeling easily fatigued.
• Headache: Mild to moderate headaches.
• Metallic or Garlic-like Taste: Altered taste sensation.
• Skin Rash: Mild rash or itching.

Serious Side Effects:

• Liver Damage: Symptoms of liver problems include jaundice (yellowing of the skin or eyes), dark urine, severe abdominal pain, and persistent nausea. Liver function tests are needed to monitor this risk.
• Severe Reactions to Alcohol: Symptoms such as severe nausea, vomiting, flushing, headache, chest pain, difficulty breathing, and rapid heartbeat occur if alcohol is consumed. This can be severe or life-threatening.
• Neuropathy: Numbness, tingling, or pain in the hands or feet, which could be signs of nerve damage.
• Mental Health Changes: Mood swings, depression, confusion, or psychosis in some cases.
• Allergic Reactions: Severe allergic reactions like swelling of the face, lips, or throat, and difficulty breathing.
• Seizures: In rare cases, seizures may occur, particularly if high doses are taken or if there are other underlying conditions.
• Cardiac Issues: Rarely, Antabuse can lead to heart problems, including rapid heartbeat or chest pain.

If you experience any severe or unusual symptoms while taking Antabuse, it’s important to seek medical attention immediately. Regular follow-ups with your healthcare provider are also essential to monitor for any potential side effects and ensure the medication is working as intended.

What should I know about storage and disposal of this medication?

Storage of Antabuse:

• Store Antabuse at room temperature, away from excessive heat, moisture, and light.
• Do not store in the bathroom or other humid areas.
• Ensure the medication is kept out of reach of children and pets.
• Regularly check the expiration date and discard any expired medication properly.

Disposal of Antabuse:

• Do not flush Antabuse down the toilet or pour it into a drain unless instructed to do so by your pharmacist or local waste disposal regulations.
• Use a drug take-back program or pharmacy return service if available. These programs safely dispose of unused or expired medications.
• If no take-back programs are available, mix the medication with an undesirable substance (like used coffee grounds) and place it in a sealed container before throwing it in the trash.

In case of emergency/overdose

• Seek Immediate Medical Help: If you suspect an overdose or experience severe symptoms, seek emergency medical help immediately. Overdose symptoms may include extreme drowsiness, confusion, or severe reactions due to alcohol.
• Emergency Contact: Call your local poison control center or emergency services for guidance.

What other information should I know?

• Consistent Use: Adhere strictly to your prescribed regimen to avoid disrupting your treatment plan.
• Avoid Alcohol: Even small amounts of alcohol, including those found in certain foods or medications, can trigger a severe reaction.
• Inform Healthcare Providers: Always inform your healthcare providers, including dentists or surgeons, that you are taking Antabuse, as it can affect certain treatments or procedures.
• Behavioral Support: Antabuse is most effective when used in conjunction with behavioral therapy and counseling. Ensure you are participating in a comprehensive treatment plan for alcohol use disorder.
• Review Regularly: Regular follow-up appointments with your healthcare provider are important to monitor your progress and adjust treatment as needed.

By following these guidelines, you can safely manage your use of Antabuse and handle any issues that may arise.