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What Happens if You Drink on Antabuse?

Drinking alcohol while taking Antabuse, also known as disulfiram, can lead to a range of adverse effects due to its mechanism in the body. The drug is prescribed to help people who are in recovery from alcohol use disorder avoid relapse.[1]

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Antabuse works by inhibiting the release and function of enzyme aldehyde dehydrogenase, which plays a key role in how alcohol is metabolized in the body.[2]

What results is an inability to metabolize alcohol while taking Antabuse, which in turn leads to a buildup of a toxic byproduct of alcohol metabolism called acetaldehyde. High levels of acetaldehyde can cause someone to feel physically ill—so ill that it deters them from attempting to drink while on Antabuse again.[3]

Antabuse’s Sensitivity 

Antabuse should only be used by those who are completely alcohol abstinent.

It is important to note that Antabuse can be activated with the ingestion of just a small amount of alcohol. For this reason, users must avoid eating foods prepared with alcohol, fermented foods, vinegar, and some sauces and marinades as well as medications that contain alcohol.[4,5]

If you or someone you love is taking Antabuse and you experience a negative reaction due to alcohol ingestion, reach out to your healthcare provider for assistance or get emergency medical help. 

Why Is It Not Recommended to Drink on Antabuse?

Antabuse is a drug that remains dormant in the system of the user as long as there is no alcohol present. However, if the person is exposed to any amount of alcohol, the drug can be activated and cause negative physical symptoms within minutes. 

Antabuse is so sensitive that even smelling fumes caused by paint thinners or nail polish remover can be enough to trigger the medication.[6] In fact, users of Antabuse are even encouraged to take caution when applying skincare products that contain alcohol externally and test it on a small area of skin before using too much.

The effects of Antabuse can be severe if the person is exposed to even a small amount of alcohol. It is unlikely that the person would even be able to feel the effects of the alcohol before the negative effects of Antabuse kick in.[7]

In short, it’s not recommended to drink while taking Antabuse because you will not feel the effects of the alcohol. Instead, you will feel the effects of Antabuse, and those effects are similar to extreme physical illness. 

What Could Happen When You Drink on Antabuse?

Everyone is different but when someone drinks alcohol while taking Antabuse, it can trigger a range of symptoms that can vary in severity. The following issues often occur: [1]

Skin Problems & Irritations 

It’s normal for the skin to become flushed when Antabuse is triggered. Some people may experience this on the face and neck, or this reaction may appear to look more like a rash on other parts of the body. This is one of the most commonly experienced symptoms of Antabuse activation.

Mental Difficulties 

Confusion, disorientation, and a hard time concentrating are all common for someone experiencing a reaction to Antabuse. It may be difficult to have a conversation, accurately explain what you are feeling, or just feel okay. 

Emotional Issues 

Anxiety and agitation are common experiences for people who drink alcohol while on Antabuse. Restlessness can also occur. These symptoms may happen on their own, or they may be in response to the other effects of Antabuse that can feel overwhelming or disturbing.

Gastrointestinal Problems 

Some of the most severe issues related to an Antabuse reaction are the intense nausea and vomiting that can occur. This can be triggered within minutes of being exposed to alcohol. The reaction can feel violent and uncontrollable. 

Cardiovascular Distress 

Rapid heartbeat, heart palpitations, and a sudden drop in blood pressure can all occur when alcohol and Antabuse are mixed. In some cases, this may come with extreme chest pain that feels like angina or heartburn. For many, this can be one of the scarier symptoms because it seems to appear out of nowhere and can be severe. 

General Illness 

Many people report feeling generally ill and experiencing issues like mild to severe headache, shortness of breath, chest tightness or discomfort, and profuse sweating. They may feel clammy all over and overheated. For many, the combination of these symptoms can bring on a sense of panic. 

Varied Results

It’s important to note that while not everyone will experience the same symptoms or the same severity of symptoms, everyone will experience something. If you are on Antabuse, do not consume any alcohol. If you have consumed alcohol while on the medication, seek medical care. 

How Long Will These Symptoms Last?

The severity of symptoms, the exact combination of symptoms, and how long those symptoms will last will vary significantly from person to person. Some of the factors that play a role in determining how long it will last include how much alcohol is ingested, the dose of Antabuse, and other metabolic factors that will impact how quickly the body is able to complete the metabolization of alcohol on its own. 

In general, however, the Antabuse reaction should last anywhere from 30 minutes to an hour. In some cases, it may last up to several hours or longer if there are other factors slowing down metabolism.[8]

It’s also important to note that Antabuse can trigger a reaction in the user up to two weeks after it is ingested. Even those who decide not to keep taking the drug should refrain from drinking until the medication is completely out of their system.[6]

The Importance of Medical Care

With the assistance of medical help, the duration and severity of the symptoms and side effects may be diminished, and any residual medical emergency can be managed as well. Don’t try to manage the situation on your own. Seek medical guidance if you have consumed alcohol while on disulfiram. 

No matter how long the effects of an Antabuse reaction lasts, it is important to work with your treatment team to address the issues that led to relapse. Without addressing the underlying issues as part of a comprehensive addiction treatment program, it’s likely that relapse will occur again.[9] 

Updated April 10, 2024
  1. Stokes M, Abdijadid S. Disulfiram. StatPearls. Published October 24, 2022. Accessed March 25, 2024.
  2. Haydock, S. Aldehyde dehydrogenase inhibitor. Science Direct, Clinical Pharmacology Second Edition. Published 2012. Accessed March 25, 2024.
  3. Chapter 3—Disulfiram, incorporating alcohol pharmacotherapies into medical practice. National Institutes of Health Center for Substance Abuse Treatment. Published 2016. Accessed March 25, 2024.
  4. Guide to alcohol-free products and incidental exposure index and products containing alcohol. California Board of Occupational Therapy. Accessed March 25, 2024.
  5. Cuvelier E, Gutium C, Béné J, et al. [Oral drugs containing alcohol: Should we be careful?]. Therapie. 2022;77(6):673-681.
  6. Disulfiram. U.S. National Library of Medicine. Published December 2019. Accessed March 25, 2024.
  7. Van Zyl PM. Doctors’ views of disulfiram and their response to relapse in alcohol dependent patients, Free State, 2009. African Journal of Primary Health Care & Family Medicine. 2016;8(1).
  8. ANTABUSE® (Disulfiram tablets USP) in alcoholism. National Institutes of Health. Revised April 2012. Accessed March 25, 2024.
  9. Brewer C, Streel E, Skinner M. Supervised disulfiram’s superior effectiveness in alcoholism treatment: Ethical, methodological, and psychological aspects. Alcohol and Alcoholism. 2017;52(2):213-219.
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