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Where Can I Buy Disulfiram Over the Counter

Where to buy Antabuse

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What is the Disulfiram?

Disulfiram is the brand name of the most widely used drug for the treatment of alcoholism. The active ingredient of Disulfiram is disulfiram or tetraethyl thiuram disulfide. It is a drug that modifies the metabolism of alcohol, which causes a considerable increase in the level of acetaldehyde in the blood. As a result, when alcohol is ingested in the presence of Disulfiram, very characteristic reactions such as facial redness, tachycardia, nausea, or headache appear. Drugs that act in this way are called interdictors and act as deterrents from alcohol consumption. Disulfiram clearly improves the results of psychosocial therapy (the most effective to solve alcohol dependence). However, we must emphasize that currently there is no pharmacological therapy that by itself is capable of curing alcoholism.

Disulfiram (Antabuse) is the brand name of the most widely used drug for the treatment of alcoholism

The Origin of Disulfiram

The discovery of the Disulfiram was almost accidental. Dr. Erik Jacobsen (1948, Copenhagen) was doing research at the Medicinalco Inc. laboratories. with different drugs to combat intestinal parasitosis. At that time it was common for scientists to experiment with the substances they were investigating. In this way, Dr. Jacobsen and his collaborators (J. Hald, V. Larsen) found that (in the presence of disulfiram) they suffered very characteristic discomfort when they consumed alcohol. Hald and Jacobsen perceived a clear difference between those symptoms and those caused by alcohol poisoning. This was the origin of the so-called “Disulfiram effect”.

In 1914 it was documented how some workers in the rubber industry (in which thiuram disulfide is used) presented these problems when consuming alcohol. In the same way, in some chemical fertilizer companies they also observed similar problems. In the latter case, they appeared due to the simultaneous consumption of alcohol and cyanamide. It was then that the use of disulfiram as an alcohol aversive was considered. People with alcohol dependence problems were given small doses of alcohol and disulfiram simultaneously to create a rejection experience. As a result of that research, disulfiram was marketed under the name Disulfiram® (anti-abuse). Since then (1950), both disulfiram (Disulfiram®) and calcium cyanamide (Colme®) became the pharmacological treatment of choice for alcoholism.

The Disulfiram effect

We know by Disulfiram effect the set of adverse symptoms caused by alcohol consumption in the presence of disulfiram. Due to these symptoms, Disulfiram exerts a deterrent effect with respect to alcohol consumption. The Disulfiram effect is due to the accumulation of acetaldehyde in the body (one of the components resulting from the metabolism of alcohol). We also know as the cheap Disulfiram effect to the alcoholic hypersensitivity caused by some medications (ketoconazole, griseofulvin, antibiotics) in the presence of alcohol.

In the lecture given at the Royal Academy of Medicine of Barcelona on October 25, 1949 (‘The Disulfiram in the treatment of alcoholism’), Doctor A. Granell explains in detail the Disulfiram effect:

  • Between 5 and 15 minutes after drinking alcohol, a strong sensation of heat appears on the face; soon after, an intense vasodilation occurs that causes a characteristic facial redness.
  • At the same time, a large vasodilation appears in the sclera (whites of the eyes), with slight edema of the lower eyelid. The local temperature increases and the pulse becomes tachycardial (120-140 beats per minute). The blood tensions are not altered, or at most the person has a slight hypotension and some tachypnea (accelerated breathing).
  • Sometimes, after 30 to 60 minutes, they experience nausea, vomiting and marked systolic and diastolic hypotension. These symptoms are usually accompanied by a headache. If the dose of alcohol is high, the patient shows a lipothymic tendency. In the latter case, some patients have remained unconscious or fainting for about half an hour.
  • To this series of symptoms is added a subjective feeling of extremely unpleasant discomfort. These discomforts are so intense that the individual usually abstains from alcoholic beverages while under the influence of Disulfiram.

Disulfiram for the treatment of alcoholism

Until the discovery and commercialization of the Disulfiram (1950) alcoholism was considered and approached in different ways. At that time, alcoholism was still not accepted as a disease in almost any part of the world. Contextualizing the moment, we must remember the prohibition era (Prohibition Law) in the United States (1919-1933), or the creation of Alcoholics Anonymous (1935). On the other hand, the American Medical Association (AMA) did not recognize alcoholism as a disease until 1956. A medical trend that pointed to the pathological condition of alcoholism was already postulated in Europe earlier (1849). In any case, with the appearance of the Disulfiram, the foundations of the current pharmacological treatment of detoxification and rehabilitation of alcoholism were laid.


Disulfiram is indicated for the treatment of alcoholism or alcohol dependence (chronic alcoholism) as a support in rehabilitation programs. It is important to remember that the doctor must inform the patient, before starting treatment with Disulfiram generic Antabuse, of the possible reactions that would involve the simultaneous consumption of alcohol. Therefore, to start treatment with disulfiram it is necessary that the patient has sufficient motivation and will. The use of Disulfiram is contraindicated in cases of liver or kidney failure. It is a widely used drug in detoxification centers for alcoholics. Disulfiram is also widely used in the treatment of cocaine addiction.

How to use

The most common presentation of Disulfiram no prescription are tablets. The dosage regimen should be established by a medical doctor. Do not use Disulfiram without a doctor prescription on your own or recommend it to anyone without first going through the doctor's office. To start treatment with Disulfiram it is necessary not to have consumed alcohol at least in the previous 24 hours. The duration of treatment is variable; it can be extended for months or even years (always under medical supervision).

Interactions with other medicines

Disulfiram is a medicine that interacts with other medicines. For example, disulfiram is contraindicated if you are being treated with metronidazole, with medicines containing alcohol, or with some antibiotics. You should consult with your doctor to ensure the compatibility of any other treatment with Disulfiram.

Disulfiram is the most widely used drug to get rid of alcohol. When we are under treatment with Disulfiram we must have a series of precautions. For example, we should avoid using sauces (such as mustard or ketchup) since they contain small amounts of wine vinegar. Many foods contain small traces of alcohol or vinegar. We should even avoid cooking with alcohol because it does not evaporate completely, contrary to what many people think.

In the same way, we should avoid the use of some cosmetics (such as the ’after shave' or cologne), as they could trigger undesirable dermatological reactions. Taking into account the alcohol content in other products (such as mouthwashes) is also advisable if you are being treated with Disulfiram. Finally, some medicines (such as syrups) usually contain alcohol, so it is advisable to use alternative pharmaceutical forms.

Disulfiram has represented in the last 72 years the best medical support of psychotherapy to treat alcoholism. However, the use of Disulfiram seems to have its days numbered. Although it is a safe drug, we must keep in mind that its prolonged use can affect liver function. On the other hand, many patients abandon treatment based on the adverse effects that Disulfiram can cause (described but not very frequent).

Recently a research has been published (Dicerna Pharmaceuticals, Inc.) that promotes a messenger RNA therapy as an alternative to Disulfiram treatment. It basically consists of silencing the expression of the gene that encodes the synthesis of aldehyde dehydrogenase (ALDH). The aim is to prevent the formation of the enzyme responsible for the transformation of acetaldehyde into acetic acid. That is, through a genetic modification the same effect as with disulfiram is achieved, but avoiding all kinds of adverse reactions. The Disulfiram of the future.

What pills are good to stop drinking alcohol?

Alcohol cessation pills only serve as a support to stop drinking. The pharmacological treatment of alcoholism must always be accompanied by a psychosocial intervention for it to be effective. In addition to Disulfiram, there are other pills used for the treatment of alcohol dependence, such as naltrexone or acamprosate. You should never use these medicines on your own or without medical supervision. Check out this link to learn more about alcohol cessation pills.

Can I drink non-alcoholic beer if I am taking Disulfiram?

No. It is best not to drink non-alcoholic beer if you are on generic Disulfiram treatment. Many of these drinks contain small traces of alcohol that could generate adverse reactions. In any case, even being totally “zero-zero” or “alcohol-free" beer, it is best to avoid the consumption of this type of drinks. For different reasons, the consumption of non-alcoholic beer could trigger a sudden and powerful desire for alcohol and precipitate a relapse. You can also consider other alternatives to non-alcoholic beer, such as mocktails or non-alcoholic cocktails.

How long does the effect of Disulfiram on the body last?

The duration of the Disulfiram effect ranges from 2 to 4 hours when alcohol is consumed in the presence of Antabuse. On the other hand, Disulfiram can trigger adverse reactions in the presence of alcohol up to 3 weeks after its administration. Obviously, the intensity of these reactions decreases with time, being of great intensity between the first 8 and 12 hours after its administration.

Can I use cologne if I am taking Disulfiram?

When you are on Disulfiram treatment you should be careful with the use of perfumes, colognes and all cosmetics in general. The cologne is a high alcohol content product that contains ethanol diluted between 70 and 90 percent. If you use cologne, a part of the ethanol can be absorbed through the skin and trigger reactions typical of the Disulfiram effect (redness, palpitations, accelerated breathing, etc.). In the best case, we will only notice small dermatological reactions (itching, redness, etc.).

Is injectable Disulfiram more effective than pills?

The injectable cheap Disulfiram is not marketed as such. This must be expressly prepared in a laboratory or in a Pharmacy Office as a master formulation at the request of the doctor. It is a sustained-release formula (up to 3 months) that aims to ensure compliance with the treatment. Different studies point to better results when Disulfiram is administered orally and daily, for as long as the medical practitioner deems necessary.


About the Author

Shahid Zaman is a senior policy analyst at America's Essential Hospitals.

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