Disulfiram: Price, Dosage & Where to Buy

Disulfiram is an aldehyde dehydrogenase inhibitor, also described as an alcohol-aversive medicine, used to support the management of chronic alcohol dependence in people who want to remain abstinent. It is intended to accompany motivation, supportive care and psychological treatment rather than act as a stand-alone treatment, and it requires a prescription in the United Kingdom.

Disulfiram interferes with the way the body breaks down alcohol. Normally, alcohol is converted into a substance called acetaldehyde, which is then broken down further by the enzyme aldehyde dehydrogenase. Disulfiram inhibits this enzyme, allowing acetaldehyde to build up if alcohol is consumed.

This produces an unpleasant and potentially serious reaction, which can include flushing, headache, nausea, vomiting and changes in heartbeat or blood pressure. The prospect of this reaction helps support avoidance of alcohol, but the medicine does not replace motivation or supportive therapy.

Disulfiram is used as an aid in managing chronic alcohol dependence in selected people who want to remain abstinent. Its role is to support a period of sobriety during which supportive care and psychological treatment can be used. The medicine is intended for people who understand its effects and are motivated to avoid alcohol.

Used alone, without proper motivation and supportive therapy, it is unlikely to produce a substantial change in drinking patterns. Treatment therefore forms part of a broader approach to maintaining abstinence rather than replacing psychological or supportive treatment.

The label lists oral tablets in strengths of 250 mg and 500 mg. The label lists an initial maximum of 500 mg daily, given as a single dose for one to two weeks. The label lists an average maintenance dose of 250 mg daily, with a range of 125 mg to 500 mg and a maximum of 500 mg daily.

The label lists at least 12 hours of abstinence from alcohol before treatment begins. The label describes morning administration as usual, with administration on retiring as an alternative when sedation occurs. A downward adjustment may also be considered by the prescriber if sedation is troublesome.

Treatment duration depends on the individual's recovery and the establishment of sustained self-control. Maintenance treatment may be needed for months or years.

The label describes continuous daily treatment as part of this maintenance approach. These are label facts; the prescribed regimen requires individual assessment by the treating clinician.

The label specifies storage at 20°C to 25°C (68°F to 77°F) in a tight, light-resistant container. Keep the container securely closed and protect the tablets from light to maintain quality.

A missed dose can interrupt the intended regular treatment routine. Consult the dispensing label or a pharmacist for advice about resuming the prescribed schedule, and do not double a dose to make up for a missed one. Missing a dose does not make drinking alcohol safe, because an alcohol reaction can still occur after disulfiram has been stopped.

Safe use of disulfiram during pregnancy has not been established. The label states that use during pregnancy should be considered only when the doctor judges that the probable benefits outweigh the possible risks. The label does not specify breastfeeding information; discuss breastfeeding with a doctor or pharmacist.