Key Points

  • Antabuse was a widely prescribed medication for alcohol dependency, used in cases of chronic alcoholism.
  • Antabuse’s generic name is disulfiram, a drug that was developed as an antiparasitic treatment before scientists discovered its use to treat alcoholism.
  • The brand-name drug Antabuse was discontinued in 2023 amid stock shortages of the ingredients and potential loss of profits.
  • Disulfiram is still available as a generic version, although shortages continue to impact the supply and demand of this drug.
  • The drug works by making someone very ill if they drink alcohol, with symptoms including headaches, confusion, and vomiting.
  • Alternatives to disulfiram include naltrexone, acamprosate, and topiramate, although the latter option is not yet FDA-approved for this purpose.

The other drugs we’ve mentioned are all FDA-approved for dealing with alcoholism. Topiramate, often branded as Topamax, is FDA-approved as a seizure medication but not for dealing with AUD. However, some studies suggest that Topiramate may be as effective if not more so than naltrexone at reducing heavy drinking. More research will be required before this medicine becomes approved for general use. [11]Alcohol misuse and addiction are major problems across the United States. More locally, more than 1.7 million report binge drinking in the state of Georgia each month. [1] Many individuals need medical intervention to help them fight their alcohol addiction, with some medications used to make alcohol intolerable to the body. Antabuse was one such medication, often employed in cases of chronic alcoholism where other measures had failed. Although discontinued now, the generic form of Antabuse is still available and is called disulfiram.

Knowing the generic names of brand-name alcohol dependency medications can help you understand what a physician or other medical professional is prescribing you and why. It’s also useful to learn how Antabuse and its generic alternatives work, and the possible side effects of taking these powerful anti-alcohol dependency drugs.

What is Antabuse?

Antabuse, originally called Antabus, was developed by a Danish drug company called Medicinalco in the 1940s. It was an accidental discovery made while trying to use the primary ingredient to create a medication for intestinal parasites. While testing the drug, it was noted that individuals who consumed alcohol while on the drug became sick. Despite not fully understanding the mechanism of how the drug made the body react badly to alcohol, the FDA approved Antabuse for treating alcoholism back in 1951. [2]

Alcohol addicts, sometimes called alcoholics, may be prescribed a drug similar to Antabuse in conjunction with therapy or other treatments. Taking the drug at the same time as drinking alcohol causes a very unpleasant reaction. Users quickly discover that they have distressing symptoms if they consume even the slightest amount of alcohol while on the drug. These symptoms include severe headaches, neck pain, confusion, light-headedness, and vomiting. [2] Antabuse and its equivalents should only be taken under the advice of a healthcare provider and with the full knowledge of the person taking it.

About Alcohol Use Disorder (AUD)

an assortment of glasses with varying levels of alcohol in them on a table top

Alcoholism, more technically known as alcohol use disorder or AUD, describes a situation where an individual has become addicted to alcohol. The latest figures from the National Institute on Alcohol Abuse and Alcoholism show that at least 28.9 million Americans each year suffer from AUD. [3] The difference between someone who enjoys a social drink and someone trapped in a cycle of addiction can be difficult to detect. However, there are diagnostic criteria used to determine if someone has AUD, and these criteria are found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). [4]

The DSM-5 states that AUD presents as a “problematic pattern of alcohol use,” which, if left unchecked, may lead to distress and “clinically significant impairment.” [4]

Risk Factors for AUD

Anyone can become addicted to alcohol, but there are risk factors that make that outcome more likely. Some of these are genetic, while others are environmental. Research shows that 50-60% of vulnerability to alcohol dependence is genetic. A predisposition to stress and some other mental health conditions can also increase the likelihood of alcohol dependence. Trauma and a person’s neurotype may also be contributing factors. The age at which someone starts drinking may also impact the likelihood of them becoming addicted, with AUD associated more strongly with those who begin drinking in adolescence. [4]

Antabuse Generic Name: Disulfiram

Because AUD is such a significant problem, there are various treatments for this addiction. While therapy, 12-step programs, and abstinence via willpower may work for some, in cases of chronic alcoholism, medications like Antabuse are an option. Antabuse’s generic name is disulfiram, which is the primary ingredient. The technical term for this type of drug is an alcohol antagonist, which means it prevents a biological reaction associated with alcohol. [5]

Why It’s Important to Know Antabuse’s Generic Name

Asking a doctor or addiction specialist for Antabuse today is impossible, as this brand-name version of disulfiram has been discontinued. The pharmaceutical company that produced it, Sanofi, decided to cease its production and worldwide distribution in 2023. [6] If you or someone you know previously had access to Antabuse, you may now find that your prescription is under the generic name of disulfiram. Similarly, if you need treatment for AUD, it may benefit you to know that disulfiram and Antabuse are exactly the same drug.  

How Does Disulfiram Work?

Disulfiram works by making it completely intolerable for you to consume alcohol. Even the tiniest amount of alcohol can cause negative symptoms. By understanding this, AUD sufferers can make the choice to take a tablet that effectively prevents them from consuming alcohol. The medication makes it so unpleasant to have an alcoholic drink that most people will avoid drinking rather than go through the negative effects. [7]

However, this does not mean that disulfiram is a cure for alcoholism. If someone decided that they wanted to continue drinking, they could simply stop taking the tablets. In this way, there is still an element of willpower required for the medication to be fully effective. That’s why disulfiram is usually prescribed alongside therapy or addiction-specific treatments such as residential treatment.

The mechanism by which disulfiram works is the blockage of an enzyme that helps the body process alcohol. The enzyme normally transforms acetaldehyde into acetate and other chemicals the body can reabsorb or pass in the urine. Because the body can’t process the alcohol properly, there is an almost immediate negative reaction to the excess acetaldehyde, with symptoms ranging from flushing and sweating to headaches to confusion, nausea, and vomiting. [7]

Results of Taking Disulfiram

The goal of taking disulfiram is to make the idea of consuming alcohol too unpleasant to even consider. As long as the individual doesn’t drink alcohol, they won’t experience the adverse side effects. However, for those who can’t resist having a drink, they can undergo extremely unpleasant symptoms. The idea is that those symptoms will deter the person from attempting to drink alcohol in the future. It doesn’t take the addiction away — it simply puts a barrier in the way of alcohol consumption.

Studies note that disulfiram is effective in treating alcohol dependency. They also state that the drug is only effective when the person is highly compliant or where medication is supervised. [8]

Possible Side Effects of Disulfiram

The whole point of disulfiram is that it has unpleasant side effects. People who take this drug and consume alcohol may experience common side effects such as:[7]

  • Flushing and reddened skin
  • Excessive sweating
  • Thirst
  • Nausea
  • Vomiting
  • Light-headedness or syncope (passing out)
  • Erratic heart rate
  • Shortness of breath
  • Chest pain
  • Headaches
  • Blurred vision

Many of these symptoms are similar to those of a severe hangover. [7] However, there are some serious side effects that can occur even if you don’t consume any alcohol. These are potentially dangerous and should prompt you to seek medical advice immediately:

  • Any eye pain or vision loss
  • Respiratory depression
  • Hypotension
  • Numbness and/or tingling (peripheral neuropathy or neuritis)
  • Confusion or a change in character or behavior; psychosis
  • Jaundice (yellowing of the skin and eyes), tiredness/fatigue, skin rash, loss of appetite, dark urine, or any other symptoms associated with liver failure

Your healthcare team or doctor will normally want to check your liver function throughout your time on disulfiram to ensure cirrhosis (scarring of the liver) doesn’t occur. You may also not be able to take this medicine if you have heart disease, diabetes, an underactive thyroid, epilepsy, or certain other conditions. Individuals or medical professionals who observe adverse effects or interactions not noted in disulfiram literature should call 1-800-FDA-1088 to report the observations.

Negative drug interactions can occur with disulfiram, so make sure your physician knows anything you’re taking, even supplements, whether it’s a prescription or nonprescription substance. For example, metronidazole can cause a severe reaction, as can paraldehyde and theophylline. Disulfiram may cause sedatives to have an increased effect by preventing the liver from metabolizing them properly. Anticoagulants like warfarin may need redosing. Some antibiotics like isoniazid and antiepileptic medications like phenytoin may not have the desired effect when mixed with disulfiram. Talk to your doctor or use an online interaction checker if you’re unsure. [7]

In rare cases, a disulfiram-alcohol reaction can lead to death, so you must stay away from alcohol while taking this medication. That includes alcohol-containing products like cough syrups, some lotions, vinegar, and mouthwash. [7]

A missed dose should be taken if it’s within 12 hours of when you were supposed to take it. If it’s been more than 12 hours, skip this dose and take the next one. Still, stay away from alcohol and seek medical help if you consume some by accident. Store your disulfiram at room temperature, out of reach of children. Breastfeeding isn’t recommended while taking disulfiram. [7]

Alternatives to Antabuse/Disulfiram

Disulfiram is not the only medication available to AUD sufferers. There are two more FDA-approved medications called naltrexone and acamprosate. [9][10] There is also some research to suggest that topiramate could be useful for reducing cravings for alcohol. [11]

Naltrexone

Unlike disulfiram, which causes the equivalent of an allergic reaction to alcohol, naltrexone works to curb the cravings for alcohol instead. Naltrexone comes as tablets or as an injection and is also used for opioid use disorder. Naltrexone blocks opioid receptors and changes the way different areas of the brain interact in order to reduce the intensity of cravings and help moderate alcohol consumption. [9]

Acamprosate

Acamprosate also interacts with the brain, affecting neurotransmitters that help reduce the negative impact of alcohol withdrawal. Research shows that acamprosate is a preferred medication for individuals with existing liver disease or hepatitis because it is not metabolized in the liver. In trials, acamprosate was effective at increasing the duration of abstinence from alcohol. [10]

Topiramate

The other drugs we’ve mentioned are all FDA-approved for dealing with alcoholism. Topiramate, often branded as Topamax, is FDA-approved as a seizure medication but not for dealing with AUD. However, some studies suggest that Topiramate may be as effective if not more so than naltrexone at reducing heavy drinking. More research will be required before this medicine becomes approved for general use. [11]

Get the Help You Need for AUD

Alcohol use affects so many people today — but you don’t have to go through it alone. Understanding the medications available is just one aspect of recovering from AUD. With the right support from professionals who offer compassion without judging, you can rediscover your life again. Whether you need support for yourself or a loved one, contact Southeast Detox GA, and find out how we can help with detoxification, medication-assisted treatment, plus supportive rehabilitation. We’re ready to help you get your life back on track again.