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Disulfiram Uses & Side Effects

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What is Antabuse (Disulfiram)? 

Antabuse® is the brand name of the medicine disulfiram. It’s usually prescribed as part of medication-assisted treatment (MAT) for alcohol abuse and dependence.

Researchers have also been looking into using disulfiram as a weight loss drug. Trials have shown disulfiram’s potential to treat obesity.5

However, some pharmaceuticals have discontinued disulfiram tablets, causing a shortage in the market. Current treatment programs may prescribe other types of alcohol deterrent drugs.

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Antabuse and Weight Loss

Recently, researchers have been trying to repurpose Antabuse as a weight loss drug. One study looked at the effects of Antabuse in obese mice.4 They tried to determine if Antabuse can reduce body weight.

The researchers fed the mice a high-fat diet for 12 weeks to induce obesity. As expected, the mice gained weight and showed other health problems. 

Afterward, the researchers divided the mice into four groups:

  • Mice on a standard diet alone
  • Mice on a high-fat diet alone
  • Mice on a high-fat diet with a low amount of disulfiram (100mg/kg)
  • Mice on a high-fat diet with a higher amount of disulfiram (200mg/kg)

These mice were observed for another 12 weeks.

Once the 12 weeks were over, the researchers observed the following:4

  • The mice on a standard diet gradually returned to their normal weight. They also returned to normal adiposity and fasting blood glucose levels.
  • The mice on a high-fat diet alone continued to gain weight.
  • Both mice groups on a high-fat diet with disulfiram exhibited a rapid drop in body weight. They also showed significant improvement in blood glucose levels.

According to the researchers, the mice's weight loss seems to come from the drug's anti-inflammatory properties. The mice weren't subjected to any exercise. They also didn't show any changes in behavior. 

This research shows disulfiram's potential to help reduce body weight. However, there aren’t enough studies to show that Antabuse for weight loss is safe for humans. 

Is Antabuse Discontinued?

The latest FDA notices say that there's a current disulfiram shortage. Some pharmaceuticals have decided to discontinue disulfiram production. 

The latest update on the American Society of Health-System Pharmacists (ASHP) website is as follows:6

  • “Alvogen has disulfiram tablets available. They are the sole supplier of disulfiram tablets.
  • Teva discontinued disulfiram tablets in late 2020.
  • Mylan discontinued disulfiram tablets.
  • Rising Pharmaceuticals discontinued disulfiram tablets”
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How Does Antabuse Work?

Antabuse works by binding to and inhibiting an enzyme called aldehyde dehydrogenase (ALDH). ALDH helps to break down alcohol by converting acetaldehyde into acetic acid. 

Since Antabuse blocks the breakdown of alcohol, the body builds up acetaldehyde. This can lead to an unpleasant reaction when an individual drinks alcohol. Healthcare professionals refer to this group of undesirable symptoms as the disulfiram-alcohol reaction. 

This reaction will last until the body metabolizes the alcoholic beverage. 

The body absorbs disulfiram slowly. It has an approximate half-life of 60 to 120 hours. This is the time it takes to eliminate at least half of the dosing concentration in the body. 

Still, the drug does take immediate effects. Within 1 to 2 hours, a single dose can start to affect how the body metabolizes alcohol. 

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Side Effects of Antabuse

Like any other prescription medication, using Antabuse may cause some side effects. Drinking alcohol after taking Antabuse can worsen some of those side effects. 

Some of the more common side effects include:

  • Skin rash
  • Acne
  • Throbbing headache
  • Drowsiness
  • Fatigue
  • Impotence
  • Metallic or garlic-like aftertaste

If anyone experiences the following symptoms, it’s advisable to seek medical help immediately. These symptoms may indicate a more serious health problem: 

  • Excessive fatigue
  • Weakness
  • Lethargy
  • Loss of appetite
  • Stomach ache
  • Vomiting
  • Chest pain
  • Jaundice (when the skin or whites of the eyes take on a yellow appearance)
  • Dark urine
  • A sharp drop in blood pressure

Antabuse is known to potentially cause liver injury. This can occur within two to 12 weeks after using the drug. Liver injury may arise sooner if individuals have taken Antabuse before. 

Healthcare professionals will do the following to prevent serious liver injury:

  • Control dosing
  • Monitor health
  • Stop the medication (if necessary)

What Other Drugs Affect Antabuse?

You must seek medical advice before taking additional medication. Drug interactions may worsen disulfiram’s unwanted side effects. 

Individuals receiving treatment with Antabuse should avoid alcohol-containing products. This includes:

  • Aftershave or lotions
  • Mouthwashes
  • Cough syrups
  • Sauces
  • Vinegar
  • Paint thinners
  • Elixirs

People should also consult their healthcare specialists before using any medications. The following drugs can cause unwanted side effects:

  • Benzodiazepines, including chlordiazepoxide (Librium®) and diazepam (Valium®)
  • Anticoagulants, including warfarin (Coumadin®), isoniazid, metronidazole (Flagyl®), phenytoin (Dilantin®)
  • Theophylline (used for chronic obstructive pulmonary disorder or asthma)
  • Vitamins or natural supplements

Is Antabuse Addictive?

Antabuse doesn’t cause tolerance or dependence. The longer an individual takes the drug, the more sensitive the individual becomes to alcohol. Individuals who stop taking Antabuse won’t experience withdrawal symptoms.

Also, cases of disulfiram abuse or overdose are not frequent. Overdose incidents have occurred primarily among younger children due to the drug’s easy access.

Summary

Antabuse can treat alcoholism by preventing the body from producing acetaldehyde. It causes unpleasant reactions when someone drinks alcohol. This drug also has the potential to treat obesity. 

Research shows disulfiram's potential to help reduce body weight. However, there aren’t enough studies to show that Antabuse for weight loss is safe for humans. 

Antabuse isn't addictive, but some precautions must be considered before taking it.

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Updated on October 3, 2022
6 sources cited
  1. National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services. “Alcohol Facts and Statistics.” 2020, 
  2. FDA Drug Shortages, U.S. Food and Drug Administration, “Current and Resolved Drug Shortages and Discontinuations Reported to FDA.”
  3. Petrakis, Ismene L, and Karin E Kerfoot. Interventions for Addiction. “Chapter 38 - Disulfiram for Alcohol and Other Drug Use.” Elsevier Acad. Press, 2013.
  4. Bernier et al. “Disulfiram Treatment Normalizes Body Weight in Obese Mice” Cell Metabolism, 2020.
  5. National Institutes of Health. “Repurposed drug helps obese mice lose weight, improve metabolic function.” 2020.
  6. Ashp.org. “Current Drug Shortages: Disulfiram Tablets.” 2021.

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