Antabuse and alcohol don’t mix, by design. Drinking while taking Antabuse (disulfiram) sets off a harsh physical reaction. Within about 10 minutes, MedlinePlus says, you can get flushing in the face, a pounding headache, nausea, vomiting, chest pain, sweating, trouble breathing, weakness and confusion. It can last an hour or more.
That reaction is the whole point of the medication. Antabuse doesn’t make you want to drink less. It makes drinking miserable, and for some people that’s the wall they need between a craving and a bottle.
How Antabuse Works
Normally your body breaks alcohol down in two steps. First it turns ethanol into acetaldehyde, a toxic compound. Then an enzyme called aldehyde dehydrogenase (ALDH) clears the acetaldehyde away before it builds up.
Disulfiram blocks that second enzyme. So if you drink, acetaldehyde piles up in your blood with nowhere to go, and acetaldehyde is what makes you sick. The reaction isn’t an allergy or a side effect. It’s your body flooded with a poison it would normally clear in minutes.
A little history
Disulfiram started out in industry and was being studied as a treatment for intestinal parasites in the 1940s. Two Danish researchers, Erik Jacobsen and Jens Hald, tested it on themselves and discovered that even a small drink afterward made them violently ill. The FDA approved it for alcoholism in 1951, making it one of the oldest medications for alcohol use disorder.
The Physical Consequences of Combining Alcohol and Antabuse
The disulfiram-alcohol reaction can range from unpleasant to dangerous. Commonly reported effects include:
- Hot, red flushing of the face and neck
- Throbbing headache
- Nausea and vomiting
- Fast heartbeat and chest pain
- Sweating
- Shortness of breath
- Dizziness, confusion or weakness
- Anxiety
Severe reactions are less common but serious. Blood pressure can drop sharply, and people can faint or, rarely, go into circulatory collapse. How bad it gets depends partly on how much alcohol is involved, but even a small amount can set it off.
If someone on Antabuse has been drinking and has chest pain, trouble breathing, collapses, has a seizure or can’t be woken, call 911. For questions about a possible overdose or reaction, call Poison Control at 1-800-222-1222.
Hidden Sources of Alcohol
Avoiding beer, wine and liquor is the easy part. MedlinePlus also warns about:
- Medicines that contain alcohol, such as some cough syrups
- Cooking sauces and vinegars
- Fumes from paint, varnish and similar products
- Skin products with alcohol, like cologne or rubbing alcohol (use caution)
People are often caught off guard by these. Read labels, and ask your pharmacist before you start any new product, including over-the-counter medicine.
It lingers after you stop
Because disulfiram shuts that enzyme down rather than just pausing it, the effect doesn’t end when you stop taking the pills. A reaction can still happen for up to two weeks after the last dose. Plan for that window.
Safety Rules That Matter
A few non-negotiables come straight from MedlinePlus. Antabuse should never be given to someone who’s intoxicated, and never without the person’s full knowledge. Slipping it into someone’s food or drink to “teach them a lesson” is dangerous and wrong. It also shouldn’t be started until at least 12 hours after the last drink.
Liver problems are uncommon but can be serious. Call your doctor right away if you notice yellowing of the skin or eyes, dark urine, pale or clay-colored stools, or unusual tiredness. People with existing liver damage need close monitoring; our post on signs your liver is struggling lists other warning signs.
Whether Antabuse is right for you, and how it’s taken, is a decision for your prescriber. Don’t start or stop it on your own.
Who Antabuse Is For
Antabuse is meant for people who’ve already stopped drinking and want help staying stopped. It isn’t a way to quit, and it isn’t something to try while still drinking. Some people find it most useful in high-risk stretches: the first months after treatment, a work trip, the holidays. Others take it as a daily promise to themselves, a decision made once in the morning so they don’t have to make it again at 5 p.m. Your doctor will look at your health, your liver and your other medications before deciding whether it’s a fit.
Does Antabuse Work?
It depends heavily on whether people take it. Antabuse only works if it’s in your system, and stopping it is as easy as skipping a pill for a few days. Research summarized on Wikipedia finds it has a very small effect when people take it on their own, and works better when someone supervises each dose, like a spouse, a pharmacist or a clinic.
It also does nothing for cravings or for the reasons someone drinks. That’s why it’s best used as one tool inside a larger plan: counseling, peer support, sometimes other medications such as naltrexone, and real work on what’s underneath the drinking.
Frequently Asked Questions
What happens if you drink on Antabuse?
You’ll likely have a disulfiram-alcohol reaction within about 10 minutes: flushing, headache, nausea, vomiting, a racing heart and sometimes trouble breathing or a drop in blood pressure. It can last an hour or more.
How long after stopping Antabuse can you drink?
A reaction can happen for up to two weeks after you stop. If you’re thinking about drinking again, though, that’s worth talking over with your counselor or doctor first.
Can drinking on Antabuse kill you?
Severe reactions are uncommon but can be dangerous, including very low blood pressure and collapse. Treat any reaction with chest pain, fainting or trouble breathing as an emergency and call 911.
Does Antabuse stop alcohol cravings?
No. It makes drinking unpleasant but doesn’t reduce the urge. That’s why it works best alongside counseling and support.
Alcohol Treatment at Covenant Hills
Medication can buy you time. Lasting change usually takes more. Covenant Hills is a Christian-based treatment center in Orange County, California, offering residential treatment for alcoholism with faith-based and traditional tracks. For more on alcohol itself, see our post on what EtOH means.
If you’re ready to stop drinking for good, call 800-662-2873 for a free, confidential assessment.
