A Complete List of Foods to Avoid on Antabuse 

Antabuse, or disulfiram, is a drug that is prescribed to people who struggle with alcohol abuse and alcohol use disorder (AUD).[1] The drug has been prescribed for the treatment of AUD since the 1950s in the U.S. A person becomes very ill if they drink alcohol while Antabuse is in their system. 

Essentially, anyone taking Antabuse needs to avoid any food and drink that has any amount of alcohol in it. Even the smallest amount of alcohol can activate Antabuse and trigger a host of serious adverse reactions. This means users must research in advance and use only alcohol-free products.[3]

If you are taking Antabuse and concerned that you have eaten something inappropriate or are having an adverse response to the medication, contact your doctor. If you believe you are experiencing a medical emergency, call 911.

Foods to Avoid on Antabuse

It’s obvious that avoiding all alcoholic beverages is imperative while taking Antabuse, and many medications even list alcohol as a component. However, it’s not always so clear which foods may contain alcohol or are fermented to the point that they activate Antabuse in one’s system.[4]

Some of the types of foods to avoid while taking Antabuse include the following. 

Foods That Contain Alcohol

There are a number of different types of foods that are cooked or baked with alcohol. For example, you may find that the pasta you order at an Italian restaurant is made with a dry white wine or the barbecue in your deli sandwich was roasted with beer or whiskey. 

Some of the most common foods to contain alcohol are desserts. Anything that is flambeed usually contains alcohol, as do some common desserts like rum cake, fruit cakes, tiramisu, and some chocolate candies.[5]

Though many people claim that the alcohol will be “cooked off” during the cooking process, making it less potent than if you were to drink the same amount, there is enough left in the dish to trigger Antabuse.[6]

Certain Sauces & Marinades

Many sauces are made with alcohol as a base, especially in high-end culinary kitchens and restaurants. For example, the wine in a pasta is usually a reduction sauce and used to coat the pasta after it has already been cooked. Alcohol-based marinades are also very popular, especially for grilled meats.

Similarly, there can be sauces that have a beer or ale base to them or that call for some cooking sherry or vinegar. 

Marinades for chicken or other meat cooked on the grill may include whiskey or rum. Teriyaki sauce often contains mirin, which is a Japanese rice wine. There can even be condiments and hot sauces that contain alcohol.[7,8]

Vinegar-Based Products

All vinegars are made from alcohol, including apple cider vinegar, white vinegar, and balsamic vinegar.[8] Red wine vinegar and white wine vinegar even have the word wine in the name to alert users to the alcohol content. 

While the overall alcohol content of vinegars is low—like the alcohol content in most sauces and foods—and created during the fermentation process, it is still present and in high enough amounts to active Antabuse.[9,10]

Fermented Foods & Sauces

There are a number of fermented foods on the shelves designed to manage the bacterial flora of the gut and help people with digestive and system regulation. Some of these foods include common sides or condiments like sauerkraut and kimchi as well as beverages like kombucha and lesser known foods like miso, kefir, and even tempeh.[11]

Though these have been eaten for thousands of years and are typically viewed as health foods, eating or drinking fermented food and beverages can result in a negative reaction for those taking Antabuse.[12]

The Importance of Reading Labels 

It’s important to read the labels of processed foods even if you are purchasing them off the shelves in the grocery store. Always ask about ingredients in any dish when ordering in a restaurant. If exposed to even a small amount of alcohol while on Antabuse, the reaction is usually still intense. It’s worth the extra effort to avoid inadvertently ingesting or coming into close contact with alcohol.[13] 

The response of Antabuse to alcohol is so serious that it is recommended to even avoid breathing in fumes of products that may contain alcohol, such as paint thinner. Be cautious when applying products that contain alcohol to the skin (such as aftershave lotion or facial toner) or using certain medications.[3]

If you have questions or are unsure about which foods to avoid and which ones are okay while taking Antabuse, reach out to your healthcare provider with questions to be safe. Your treatment team can guide you on right choices to make while participating in medication-assisted treatment, ensuring you have the best chances of sustained recovery.