disulfiram

General information

• Class: Adjunctive therapy
• Common US brands: Antabuse
• Typical dose range: Typically administered once daily; supervised dosing improves adherence and is associated with better outcomes in many settings (label/clinical).
• Therapeutic drug monitoring not routinely recommended.
• Last reviewed: 2025-12-30

Dosing & forms

• Forms/strengths: Oral tablets (label): 250 mg, 500 mg.
• Frequency: Typically administered once daily; supervised dosing improves adherence and is associated with better outcomes in many settings (label/clinical).
• Typical range: Typically administered once daily; supervised dosing improves adherence and is associated with better outcomes in many settings (label/clinical).

Mechanism (brief)

Aldehyde dehydrogenase inhibitor used as aversive therapy for alcohol use disorder; can cause a severe and prolonged reaction if alcohol is consumed (label/guideline).

Metabolism & Half‑life

• Metabolism: Hepatic metabolism to diethyldithiocarbamate and other metabolites (label)
• Half‑life: —

Therapeutic Drug Monitoring (TDM)

Recommended: No

Monitoring highlights

• Confirm alcohol abstinence at initiation and review “hidden alcohol” sources and emergency planning (label/clinical).
• Liver monitoring: baseline assessment and follow-up labs are commonly used, especially early in treatment or if symptoms of hepatitis appear (label/clinical).
• Track adherence and consider supervised dosing when feasible because missed doses reduce effectiveness (guideline/clinical).
• Review medication list for interactions at each visit and when new OTC products are started (label/clinical).

Sources

• Disulfiram tablets prescribing information — DailyMed (2025)
• Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis — JAMA (2014)
• The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder — American Journal of Psychiatry (2018)
• Anticraving therapy for alcohol use disorder: A clinical review — Neuropsychopharmacology Reports (2018)