Mediclarum
Medicine guide

Disulfiram

250 mg · Tablet

  • Prescription only
  • Aldehyde Dehydrogenase Inhibitor
Active substance
Disulfiram
Made by
Golden State Medical Supply, Inc.

Quoted from the official source. Not yet reviewed by Mediclarum — the leaflet in your pack is authoritative.

At a glance

Quoted from the official label · 2026-05-27

What it is

Aldehyde Dehydrogenase Inhibitor

Used for
  • Disulfiram is an aid in the management of selected chronic alcohol patients who want to remain in a state of enforced sobriety so that supportive and psychotherapeutic treatment may be applied to best advantage.
The label’s usual adult dose

After the first one to two weeks' therapy with 500 mg daily, a drink of 15 mL (1/2 oz) of 100 proof whiskey, or equivalent, is taken slowly.

Initial Dosage Schedule In the first phase of treatment, a maximum of 500 mg daily is given in a single dose for one to two weeks.

Full directions ↓
Serious warning

Disulfiram should never be administered to a patient when he is in a state of alcohol intoxication, or without his full knowledge. The physician should instruct relatives accordingly.

All warnings ↓
Good to know
  • Prescription only
  • FDA enforcement reports list no ongoing recall, and none from the last two years, for this product code · checked 2026-10-02
6other products contain Disulfiram — compare makers, forms and strengths

Every line above is selected, not written, from the official label. Nothing is reworded. DailyMed

What it is for

  • Disulfiram is an aid in the management of selected chronic alcohol patients who want to remain in a state of enforced sobriety so that supportive and psychotherapeutic treatment may be applied to best advantage.
  • Disulfiram is not a cure for alcoholism.
  • When used alone, without proper motivation and supportive therapy, it is unlikely that it will have any substantive effect on the drinking pattern of the chronic alcoholic.

From the official label · 2026-05-27 · DailyMed

How it works

From this product’s own US prescribing label.

Disulfiram produces a sensitivity to alcohol which results in a highly unpleasant reaction when the patient under treatment ingests even small amounts of alcohol.

Disulfiram blocks the oxidation of alcohol at the acetaldehyde stage.

How the body breaks it down

This reaction, which is proportional to the dosage of both disulfiram and alcohol, will persist as long as alcohol is being metabolized.

Quoted from the prescribing label, sections “Mechanism of Action” and “Pharmacokinetics”. DailyMed · 2026-05-27

Serious warning

The strongest warning the FDA requires. It is printed in a box at the top of the label.

Disulfiram should never be administered to a patient when he is in a state of alcohol intoxication, or without his full knowledge. The physician should instruct relatives accordingly.

Quoted from the official label, section “Boxed Warning”.

Do not take it if

  • Patients who are receiving or have recently received metronidazole, paraldehyde, alcohol, or alcohol-containing preparations, e.g., cough syrups, tonics and the like, should not be given disulfiram.
  • Disulfiram is contraindicated in the presence of severe myocardial disease or coronary occlusion, psychoses, and hypersensitivity to disulfiram or to other thiuram derivatives used in pesticides and rubber vulcanization.

Quoted from the official label, section “Contraindications”.

How to take it

These directions are for this exact strength and form. Another one is different.

  • Disulfiram should never be administered until the patient has abstained from alcohol for at least 12 hours.
  • Initial Dosage Schedule In the first phase of treatment, a maximum of 500 mg daily is given in a single dose for one to two weeks.
  • Although usually taken in the morning, disulfiram may be taken on retiring by patients who experience a sedative effect.
  • Alternatively, to minimize, or eliminate, the sedative effect, dosage may be adjusted downward.
  • Maintenance Regimen The average maintenance dose is 250 mg daily (range, 125 mg to 500 mg), it should not exceed 500 mg daily.
  • Note:
  • Occasionally patients, while seemingly on adequate maintenance doses of disulfiram, report that they are able to drink alcoholic beverages with impunity and without any symptomatology.
  • All appearances to the contrary, such patients must be presumed to be disposing of their tablets in some manner without actually taking them.
  • Until such patients have been observed reliably taking their daily disulfiram tablets (preferably crushed and well mixed with liquid), it cannot be concluded that disulfiram is ineffective.
  • Duration of Therapy The daily, uninterrupted administration of disulfiram must be continued until the patient is fully recovered socially and a basis for permanent self-control is established.
  • Depending on the individual patient, maintenance therapy may be required for months or even years.
  • Trial with Alcohol During early experience with disulfiram, it was thought advisable for each patient to have at least one supervised alcohol-drug reaction.
  • More recently, the test reaction has been largely abandoned.
  • Furthermore, such a test reaction should never be administered to a patient over 50 years of age.
  • A clear, detailed and convincing description of the reaction is felt to be sufficient in most cases.
  • However, where a test reaction is deemed necessary, the suggested procedure is as follows:
  • After the first one to two weeks' therapy with 500 mg daily, a drink of 15 mL (1/2 oz) of 100 proof whiskey, or equivalent, is taken slowly.
  • This test dose of alcoholic beverage may be repeated once only, so that the total dose does not exceed 30 mL (1 oz) of whiskey.
  • Once a reaction develops, no more alcohol should be consumed.
  • Such tests should be carried out only when the patient is hospitalized, or comparable supervision and facilities, including oxygen, are available.
  • Management of Disulfiram-Alcohol Reaction In severe reactions, whether caused by an excessive test dose or by the patient's unsupervised ingestion of alcohol, supportive measures to restore blood pressure and treat shock should be instituted.
  • Other recommendations include:
  • oxygen, carbogen (95% oxygen and 5% carbon dioxide), vitamin C intravenously in massive doses (1 g) and ephedrine sulfate.
  • Antihistamines have also been used intravenously.
  • Potassium levels should be monitored, particularly in patients on digitalis, since hypokalemia has been reported.

Quoted from the official label, section “Dosage & Administration”.

Other warnings

  • The patient must be fully informed of the disulfiram-alcohol reaction.
  • He must be strongly cautioned against surreptitious drinking while taking the drug, and he must be fully aware of the possible consequences.
  • He should be warned to
  • avoid alcohol in disguised forms, i.e., in sauces, vinegars, cough mixtures, and even in aftershave lotions and back rubs.
  • He should also be warned that reactions may occur with alcohol up to 14 days after ingesting disulfiram.
  • The Disulfiram-Alcohol Reaction Disulfiram plus alcohol, even small amounts, produce flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusion.
  • In severe reactions there may be respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death.
  • The intensity of the reaction varies with each individual, but is generally proportional to the amounts of disulfiram and alcohol ingested.
  • Mild reactions may occur in the sensitive individual when the blood alcohol concentration is increased to as little as 5 mg to 10 mg per 100 mL.
  • Symptoms are fully developed at 50 mg per 100 mL, and unconsciousness usually results when the blood alcohol level reaches 125 mg to 150 mg.
  • The duration of the reaction varies from 30 to 60 minutes, to several hours in the more severe cases, or as long as there is alcohol in the blood.
  • Concomitant Conditions Because of the possibility of an accidental disulfiram-alcohol reaction, disulfiram should be used with extreme caution in patients with any of the following conditions:
  • diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, chronic and acute nephritis, hepatic cirrhosis or insufficiency.
  • Patients with a history of rubber contact dermatitis should be evaluated for hypersensitivity to thiuram derivatives before receiving disulfiram (see CONTRAINDICATIONS ).
  • It is suggested that every patient under treatment carry an Identification Card stating that he is receiving disulfiram and describing the symptoms most likely to occur as a result of the disulfiram-alcohol reaction.
  • In addition, this card should indicate the physician or institution to be contacted in an emergency.
  • (Cards may be obtained from Alvogen, Inc. upon request.) Alcoholism may accompany or be followed by dependence on narcotics or sedatives.
  • Barbiturates and disulfiram have been administered concurrently without untoward effects; the possibility of initiating a new abuse should be considered.
  • Hepatic toxicity including hepatic failure resulting in transplantation or death have been reported.
  • Severe and sometimes fatal hepatitis associated with disulfiram therapy may develop even after many months of therapy.
  • Hepatic toxicity has occurred in patients with or without prior history of abnormal liver function.
  • Patients should be advised to immediately notify their physician of any early symptoms of hepatitis, such as fatigue, weakness, malaise, anorexia, nausea, vomiting, jaundice, or dark urine.
  • Baseline and follow-up liver function tests (10 to 14 days) are suggested to detect any hepatic dysfunction that may result with disulfiram therapy.
  • In addition, a complete blood count and serum chemistries, including liver function tests, should be monitored.
  • Patients taking disulfiram tablets should not be exposed to ethylene dibromide or its vapors.
  • This precaution is based on preliminary results of animal research currently in progress that suggest a toxic interaction between inhaled ethylene dibromide and ingested disulfiram resulting in a higher incidence of tumors and mortality in rats.
  • A correlation between this finding and humans, however, has not been demonstrated.
  • Drug Interactions Disulfiram appears to decrease the rate at which certain drugs are metabolized and therefore may increase the blood levels and the possibility of clinical toxicity of drugs given concomitantly.
  • Pediatric Use Safety and effectiveness in pediatric patients have not been established.
  • Nursing Mothers It is not known whether this drug is excreted in human milk.
  • Geriatric Use A determination has not been made whether controlled clinical studies of disulfiram included sufficient numbers of subjects aged 65 and over to define a difference in response from younger subjects.

Quoted from the official label, section “Warnings”.

Pregnancy and breastfeeding

  • Usage In Pregnancy The safe use of this drug in pregnancy has not been established. Therefore, disulfiram should be used during pregnancy only when, in the judgement of the physician, the probable benefits outweigh the possible risks.
  • It is not known whether this drug is excreted in human milk. Since many drugs are so excreted, disulfiram should not be given to nursing mothers.

Quoted from the official label, section “OTC — Pregnancy or Breast Feeding”.

Other medicines

  • Disulfiram appears to decrease the rate at which certain drugs are metabolized and therefore may increase the blood levels and the possibility of clinical toxicity of drugs given concomitantly.
  • DISULFIRAM SHOULD BE USED WITH CAUTION IN THOSE PATIENTS RECEIVING PHENYTOIN AND ITS CONGENERS, SINCE THE CONCOMITANT ADMINISTRATION OF THESE TWO DRUGS CAN LEAD TO PHENYTOIN INTOXICATION.
  • PRIOR TO ADMINISTERING DISULFIRAM TO A PATIENT ON PHENYTOIN THERAPY, A BASELINE PHENYTOIN SERUM LEVEL SHOULD BE OBTAINED.
  • SUBSEQUENT TO INITIATION OF DISULFIRAM THERAPY, SERUM LEVELS OF PHENYTOIN SHOULD BE DETERMINED ON DIFFERENT DAYS FOR EVIDENCE OF AN INCREASE OR FOR A CONTINUING RISE IN LEVELS.
  • INCREASED PHENYTOIN LEVELS SHOULD BE TREATED WITH APPROPRIATE DOSAGE ADJUSTMENT.
  • It may be necessary to adjust the dosage of oral anticoagulants upon beginning or stopping disulfiram, since disulfiram may prolong prothrombin time.
  • Patients taking isoniazid when disulfiram is given should be observed for the appearance of unsteady gait or marked changes in mental status, the disulfiram should be discontinued if such signs appear.
  • In rats, simultaneous ingestion of disulfiram and nitrite in the diet for 78 weeks has been reported to cause tumors, and it has been suggested that disulfiram may react with nitrites in the rat stomach to form a nitrosamine, which is tumorigenic.
  • Disulfiram alone in the rat's diet did not lead to such tumors.
  • The relevance of this finding to humans is not known at this time.

Quoted from the official label, section “Drug Interactions”.

If you take too much

In an emergency, call your local emergency number or a poison control centre.

No specific information is available on the treatment of overdosage with disulfiram. It is recommended that the physician contact the local Poison Control Center.

Quoted from the official label, section “Overdosage”.

Use in children

Safety and effectiveness in pediatric patients have not been established.

Quoted from the official label, section “Pediatric Use”.

Use in older people

  • A determination has not been made whether controlled clinical studies of disulfiram included sufficient numbers of subjects aged 65 and over to define a difference in response from younger subjects.
  • Other reported clinical experience has not identified differences in responses between the elderly and younger patients.
  • In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.

Quoted from the official label, section “Geriatric Use”.

Side effects

  • (See CONTRAINDICATIONS , WARNINGS , and PRECAUTIONS .) OPTIC NEURITIS, PERIPHERAL NEURITIS, POLYNEURITIS, AND PERIPHERAL NEUROPATHY MAY OCCUR FOLLOWING ADMINISTRATION OF DISULFIRAM.
  • Multiple cases of hepatitis, including both cholestatic and fulminant hepatitis, as well as hepatic failure resulting in transplantation or death, have been reported with administration of disulfiram.
  • Occasional skin eruptions are, as a rule, readily controlled by concomitant administration of an antihistaminic drug.
  • In a small number of patients, a transient mild drowsiness, fatigability, impotence, headache, acneform eruptions, allergic dermatitis, or a metallic or garlic-like aftertaste may be experienced during the first two weeks of therapy.
  • These complaints usually disappear spontaneously with the continuation of therapy, or with reduced dosage.
  • Psychotic reactions have been noted, attributable in most cases to high dosage, combined toxicity (with metronidazole or isoniazid), or to the unmasking of underlying psychoses in patients stressed by the withdrawal of alcohol.
  • To report SUSPECTED ADVERSE REACTIONS, contact Alvogen, Inc. at 1-866-770-3024 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Quoted from the official label, section “Adverse Reactions”.

What it looks like and how it is packed

  • Disulfiram Tablets, USP are white, round, unscored tablets debossed 607.
  • Bottle of 30 NDC 60429-196-30 Bottle of 100 NDC 60429-196-01 Dispense in a tight, light-resistant container as defined in the USP.
  • Store at 20°C to 25°C (68°F to 77°F). [See USP Controlled Room Temperature].
  • Manufactured by: Norwich Pharmaceuticals, Inc.
  • Norwich, NY 13815 USA Distributed by: Alvogen, Inc.
  • Morristown, NJ 07960 USA PI607-03 Rev. 01/2020 PKG02698 Marketed by: GSMS, Inc.
  • Camarillo, CA 93012 USA

Quoted from the official label, section “How Supplied”.

What is in it

  • Disulfiram is an alcohol antagonist drug.
  • CHEMICAL NAME: bis(diethylthiocarbamoyl) disulfide.
  • STRUCTURAL FORMULA:
  • Disulfiram occurs as a white to off-white, odorless, and almost tasteless powder, soluble in water to the extent of about 20 mg in 100 mL, and in alcohol to the extent of about 3.8 g in 100 mL.
  • Each tablet for oral administration contains 250 mg disulfiram, USP.
  • Tablets also contain colloidal silicon dioxide, anhydrous lactose, magnesium stearate, microcrystalline cellulose, sodium starch glycolate, and stearic acid. structure

Quoted from the official label, section “Description”.

Ingredients people check for

Lactose, gluten, dyes, sugars and other ingredients that matter with an allergy, intolerance or diet — as this product’s FDA label lists them.

The stored label for this product has no list of inactive ingredients. The list on the pack is the one to check.

Quoted from the FDA label. A label that does not name an ingredient is not a guarantee that the product is free of it, and formulations change. With an allergy, check the pack and ask a pharmacist.

Every version of this medicine (5)

The same active substance, strength and kind of form, from every company that sells it — with what each label lists.

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Same active substance, strength and form in other countries

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Every strength and form (2)

Details

Made byGolden State Medical Supply, Inc.
Active substanceDisulfiram
Strength250 mg
FormTablet
RouteOral
Packs100 TABLET in 1 BOTTLE · 30 TABLET in 1 BOTTLE, PLASTIC
NDC60429-196

Source: NDC Directory · 2026-09-13 · not reviewed by a clinician

Source: US Food and Drug Administration, NDC Directory. Reuse terms: US government work (FDA).

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Other strengths and forms

7 products are sold under this name. Grouped by form; a number on a strength means several companies make it.

Same active substance

These contain the same substance. That does not mean one can replace another — ask a pharmacist.

Disulfiram250 mgPrescription onlyTablet Sigmapharm Laboratories, LLC · DisulfiramDisulfiram500 mgPrescription onlyTablet Sigmapharm Laboratories, LLC · DisulfiramDisulfiram250 mgPrescription onlyTablet Alvogen Inc. · DisulfiramDisulfiram250 mgPrescription onlyTablet Chartwell RX, LLC · DisulfiramDisulfiram500 mgPrescription onlyTablet Chartwell RX, LLC · DisulfiramDisulfiram250 mgPrescription onlyTablet Bryant Ranch Prepack · Disulfiram

See every product with Disulfiram