Your body may react if you drink alcohol while on disulfiram for alcohol use disorder. Signs can include flushing, stomach upset, or a headache. In bad cases, blood pressure can drop too low. Heart problems may occur. You could even have a seizure.
If you have these severe signs, call 911 right away. Or go to the nearest emergency room. Do not sit and wait for a doctor's appointment. Do not wait to see a quiz result. If you are unsure about a recent drink, call Poison Control for help.
Our guide has more on medications for alcohol use disorder. We share a directory of treatment centers, but we are not a treatment provider. This guide gives general facts, not medical advice for you. Ask your prescriber about your care plan.
Drank on Disulfiram? Here Is What to Do
Get help now if you drank while taking disulfiram. Do not keep this secret. Do not deal with a bad reaction on your own. The reaction can be very serious.[1]
- Stop drinking. Make sure no more alcohol is taken. If you drink heavily or regularly, contact a clinician or emergency service promptly for a withdrawal assessment rather than trying to manage withdrawal alone. Keep the pill bottle and alcohol packaging ready for doctors.
- Check for severe signs. Look for trouble breathing, fainting, seizures, or passing out.
- Call 911 or go to the ER. Go now if you see severe signs.
- Call Poison Control. If there are no severe signs, call Poison Control first.[2] Then tell your prescriber or pharmacist what happened.
What Is the Safest Next Step?
This self-check is for information only and isn't a diagnosis.
Staying safe means knowing what to do if you drink on disulfiram. To learn about slips with naltrexone or acamprosate, read our guide on steps after drinking on medication.
Drinking on Disulfiram: Possible Reactions
When you drink while taking disulfiram, the drug stops alcohol from breaking down fully. This causes acetaldehyde to pile up in your body.[4] A disulfiram-alcohol reaction can cause flushing, a headache, nausea, vomiting, and sweating.[5] Your heart may also beat fast or hard.[5] Changes in breathing can happen, too.[5]
The reaction's intensity varies from person to person.[1] In severe cases, it can lead to breathing depression, heart rhythm problems, heart attack, cardiovascular collapse, unconsciousness, seizures, or death.[1]
30 minutes to several hours
is how long symptoms may last[6]
Please do not test the medicine to see if it is active. Do not sit and wait for symptoms to worsen. If you have severe symptoms or danger signs, call 911 or go to the nearest emergency room now. If you drank alcohol while taking disulfiram and have no danger signs, call Poison Control at 1-800-222-1222 for free, confidential guidance,[2] and contact your prescriber or pharmacist for advice.
Where Alcohol Hides and Wait Times
Alcohol can show up in spots you might not think of. It may be in some medicines and personal-care items. Muscle rubs, cough syrups, tonics, elixirs, and cold and flu products are examples.[7] The type of product does not tell you if it is safe. Read the ingredient list closely each time.
The FDA-approved label says disulfiram should never be started until a person has gone at least 12 hours without alcohol.[8] This is a general rule from the maker. Talk to your prescriber or pharmacist to set your start or restart plan. They can guide you on the right timing. If you stop using disulfiram, do not guess that drinking is safe right away. Look at the current label and check with your care team before having any alcohol.
Check for Possible Alcohol Sources
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Key Safety Precautions for Disulfiram
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Read our guide on that topic to learn more about managing medication side effects if you have reactions or other issues on this medication.
How Disulfiram for Alcohol Use Disorder Works
Taking disulfiram changes how your body breaks down alcohol. It blocks one step in this process. A chemical called acetaldehyde then builds up in your blood.[4] If you drink, this buildup makes you feel very ill.
The reaction from disulfiram serves as a deterrent. It aims to stop you from drinking. However, it does not directly lower your cravings.[13]
Your goals help decide which medicine is right for you. Your health history and personal preferences also count. No single option works best for every person. Doctors may suggest disulfiram for people with moderate to severe alcohol dependence who have a clear goal of complete abstinence, especially if they have not responded to acamprosate or naltrexone and understand the risks.[14] It is not a treatment for acute alcohol withdrawal and should only be started after detoxification or once abstinence has been established.[11]
In the U.S., the FDA has cleared three drugs for alcohol use disorder: disulfiram, naltrexone, and acamprosate.[15] Each works differently. Check the table below before you see your doctor. If cost is a concern, our guide to insurance coverage for naltrexone explains how to verify your prescription benefits. For a broader look at medication options for alcohol use disorder, see our guide to MAT for alcohol use disorder.
| Medication | General Approach | Key Considerations |
|---|---|---|
| Disulfiram | A deterrent that causes an unpleasant physical reaction if you drink. | Requires a goal of complete abstinence. Can cause serious liver injury, so liver function is monitored. Not suitable if you cannot guarantee abstinence or have certain medical conditions.[14][9][10] |
| Naltrexone | Helps reduce cravings and the rewarding effects of alcohol. | May be an option for those who want to cut down or stop. Discuss potential interactions with other medications. Read our guide on naltrexone for alcohol cravings. |
Findings on the effectiveness of disulfiram are mixed. Another review noted that while double-blind studies showed no difference from controls, open-label trials suggested disulfiram was better than controls on alcohol-related outcomes.[16] Your doctor can help you weigh this information against your personal health needs.
What Is the Usual Time on Disulfiram?
There is no single set time for everyone to take disulfiram. The plan is tailored to each person, not a fixed schedule.[11] Your prescriber picks when to end the drug. They weigh your history and how you handle it.[11]
Before starting
You and your prescriber talk about goals and health history.
During treatment
You keep follow-up appointments. Your clinician may check liver function before and during treatment to ensure safety.[10]
At follow-up visits
You review benefits and side effects. You can also talk about changing goals.
Later on
You and your prescriber decide together whether to continue or stop. There is no standard stop date.
Serious, potentially fatal liver injury can happen with disulfiram.[9] Tell your prescriber about any new symptoms. Even after many months of therapy, severe liver problems can appear.[9] Ask your doctor which liver safety questions to raise at visits. Our guide to monitoring alcohol medication progress helps you prepare the right questions for your next follow-up visit.
Handling Cravings, Withdrawal, and Extra Help
Quick fixes do not exist for heavy urges to drink. Call a trusted friend or your clinician when a craving shows up. Tell them exactly what you feel. Ask about treatment options for alcohol use disorder. Never switch your medicine without checking first.
Counseling can be part of your care plan. These talks pair well with medication.[17] They help you build skills. They teach you to manage stress and steer clear of triggers. Your team can help you locate a fitting therapist or group.
If cravings stay high, your doctor may bring up other medicines. Acamprosate helps people stay away from alcohol.[18] Talk to your prescriber before you switch or add any meds.
Do not use disulfiram to handle withdrawal at home. Acute alcohol withdrawal is not treated by it.[11] If you have been drinking heavily, get a medical check. Your doctor must safely manage your withdrawal. Only after detox and abstinence does disulfiram start.[11]
Pair medicine, counseling, and support to lower the urge to drink alcohol. This combination often works best. Your doctor can help you create a complete recovery plan.
Alcohol Use Disorder Basics and Support Options
Treatment can help people with alcohol use disorder. Most people with the condition can gain from some type of care.[19]
If you worry about your drinking, speak with a professional. Doctors say to screen for unhealthy alcohol use during primary care visits. They also suggest brief counseling for people who drink at risky levels.[20] If you are nervous about that conversation, our guide to what to expect from an alcohol use evaluation can help you prepare.
Check out the symptoms of alcohol use disorder to get ready.
What to Bring Up With a Clinician
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Explore more ideas on talking to your doctor about meds.
Frequently Asked Questions
What should I do if I drank while taking disulfiram?
Call 911 or go to the emergency room now if you have severe symptoms. Do not wait for a quiz result. For other exposures, call Poison Control right away.[22] Also contact your prescriber or pharmacist. Do not test the reaction or change your dose on your own.
How long should someone be on disulfiram?
There is no one-size-fits-all time frame. Your prescriber will look at your goals and health needs. They will help you decide how long to stay on the medication. Talk with them before you stop or change anything.
How long after stopping disulfiram should someone avoid alcohol?
A reaction can happen for up to two weeks after the last dose.[12] Check with your prescriber or pharmacist for personal advice. Do not assume this time frame clears you for everyone.
What is the success rate of disulfiram?
What can help reduce the urge to drink alcohol?
There is no instant fix for cravings. Medications can help lower relapse risk and ease withdrawal symptoms like craving.[11] Naltrexone is one option to ask about. Behavioral support can also be part of your care plan. Talk with a clinician about what fits your goals.
What are the 11 symptoms of alcohol use disorder?
The DSM-5 lists 11 symptoms of problematic drinking.[23] These include drinking more than planned and failing to cut down. Other signs are spending time recovering and having strong cravings.[24] You might also miss work, ignore relationship issues, or build tolerance. Meeting two or more symptoms in 12 months meets the diagnostic threshold.[23] This list is not a diagnosis. Seek a professional evaluation if you are worried about your drinking.
What are the three medications used to treat alcohol use disorder?
Naltrexone, acamprosate, and disulfiram are FDA-approved for alcohol use disorder.[15] The right choice depends on your health history and goals. Discuss these options with a clinician to find the best fit. See the medication-comparison table above for more details.
What is the most effective treatment for alcohol use disorder?
No single treatment works best for everyone. Your goals and health history matter most.[15] A clinician can guide you through your options. Combining medication and behavioral support may be helpful for some people.
