Disulfiram

Overview

Aversive alcohol-deterrent medicine for selected motivated abstinent patients receiving counselling/psychiatric support. It does not reduce craving; it creates risk of a severe reaction if alcohol is consumed.

Maximum Dose

Maximum 300 mg/day. Maintenance is usually 200 mg/day for 6 weeks to 6 months, with review before longer-term use.

Clinical Focus

Use only with informed consent, clear abstinence, and strict counselling about hidden alcohol sources. Alcohol reactions can be severe, unpredictable, and rarely fatal.

Bottom Line

Disulfiram is an alcohol deterrent causing severe acetaldehyde reaction with any alcohol intake, but requires strict patient motivation and compliance and has hepatotoxicity risk.

Brand Names

Antabuse

Oral Routes

Effervescent tablets containing disulfiram 200 mg.

Prescribing & PBS

S4 prescription medicine. PBS search did not identify a disulfiram item on the checked date; recheck PBS before making subsidy/access claims.

Primary

Alcohol-deterrent aid in the overall management of selected chronic alcohol-dependent patients who are motivated to abstain and engaged in counselling/psychiatric support.

Clinical Place

Third-line behind Acamprosate and Naltrexone. Used only when fear of violent sickness is required to stop impulsive drinking.