Compare Antabuse vs. Naltrexone

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Antabuse
(disulfiram)

Vivitrol
(naltrexone)

Treats alcoholism. While Antabuse (disulfiram) is a good way to help stop alcoholism, it works best if you're also seeing a therapist.Treats alcohol dependence and prevents relapse of addiction to opioids. Vivitrol (Naltrexone) is good for treating opioid and alcohol dependence. It needs to be used as directed and can't be used with alcohol or opioid pain medications.
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Coupons for Antabuse
Best available price for 30 (250mg) tablets of disulfiram
Coupons for Naltrexone
Best available price for 30 (50mg) tablets of naltrexone
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
Reviews for Antabuse (disulfiram)
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of people (All ages) say Antabuse (disulfiram) is worth it
Not enough review data. Review it!
say it works well
Not enough review data. Review it!
say it's a big hassle
Have you used Antabuse (disulfiram)?
Worth itNot sureNot worth it
Reviews for Vivitrol (naltrexone)
Not enough review data. Review it!
-50% worse vs. Antabuse (disulfiram)
Not enough review data. Review it!
-50% worse vs. Antabuse (disulfiram)
Not enough review data. Review it!
-33% worse vs. Antabuse (disulfiram)
Have you used Vivitrol (naltrexone)?
Worth itNot sureNot worth it
Side effects
AntabuseNaltrexone

The Antabuse FDA package insert doesn’t have numbers about how common side effects are.

More about Antabuse side effects »
  • Nausea 10%
  • Headache 7%
  • Dizziness 4%
  • Nervousness 4%
  • Fatigue 4%
  • Sleep difficulty 3%
  • Vomiting 3%
  • Anxiety 2%
  • Drowsiness 2%
More Naltrexone side effects »
How it works
AntabuseNaltrexone
Antabuse (disulfiram) is an aldehyde dehydrogenase inhibitor. It prevents your body from processing alcohol when you drink it and discourages you from drinking.Vivitrol (Naltrexone) blocks all opioid receptors in your body and prevents you from feeling the effects of opioid medications and alcohol.
Type of medication
AntabuseNaltrexone
Prescription only
Prescription only
Available as
AntabuseNaltrexone
  • Pill
  • Pill
Used for
AntabuseNaltrexone
Risk factors for serious side effects
AntabuseNaltrexone
  • Drinking alcohol while on Antabuse (disulfiram)
  • Allergy to latex rubber or pesticides
Detailed Antabuse (disulfiram) risks & warnings »
  • Prior use of opioid medications
  • Use of Vivitrol (Naltrexone)
  • Current use of opioid medications
  • New use of Vivitrol (Naltrexone)
  • Women of childbearing age
Detailed Vivitrol (naltrexone) risks & warnings »
Pregnancy

The FDA hasn’t classified this medicine’s effects on unborn babies. Talk with your doctor about this medicine if you’re pregnant or planning on it.

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Alcohol
AntabuseNaltrexone
  • Don't have any alcohol for at least 12 hours before you start taking Antabuse (disulfiram).
  • You might get a reaction with Antabuse (disulfiram) if you have any type of alcohol, even in medicines or in sauces containing alcohol.
  • If you try to drink alcohol while taking Antabuse (disulfiram), you might experience vomiting, bad headaches, flushing, nausea, and shortness of breath. This can happen for up to two weeks after you stop taking it.
  • Drinking alcohol while on Antabuse (disulfiram) can cause nausea, vomiting, bad headaches, flushing and shortness of breath. This usually lasts for 30 to 60 minutes. Also, you can still get this reaction for 2 weeks after you stop taking Antabuse (disulfiram). Never give Antabuse (disulfiram) to someone who's drunk, and especially do not give it to someone without their knowledge because it can be hard to tell if someone's drunk alcohol.
  • Can be used with behavior modification therapy to treat opioid or alcohol use disorders.
  • If you're taking Vivitrol (Naltrexone) for alcohol dependence, it'll make you not want to drink alcohol, but it won't stop the effects of alcohol if you do drink.
Kidneys and liver
AntabuseNaltrexone
  • If you have diabetes, hypothyroidism, seizures, brain, liver or kidney damage, Antabuse (disulfiram) might not be safe for you to use.
  • Not a good choice if you have liver problems, depression, or are pregnant or breastfeeding.
Pain
AntabuseNaltrexone
  • Antabuse (disulfiram) can damage your liver. Your doctor will do blood tests to check your liver while you're on Antabuse (disulfiram). Talk to your doctor right away if you get a high fever, abdominal pain or notice your skin or eyes turning yellow.
No pain related info.
Upsides and benefits
AntabuseNaltrexone
  • Antabuse (disulfiram) is a first choice medicine for alcoholism.
  • You're less likely to start drinking again with Antabuse (disulfiram) than other medicines.
  • Available in two different forms: a tablet you take every day and as a shot your doctor gives you once a month.
  • Good for people who have a mild opioid use disorder and who are highly motivated, or who can be supervised as they take their medication.
  • Can be used with behavior modification therapy to treat opioid or alcohol use disorders.
  • Higher success rates are seen in people who use this under supervision.
  • The tablet is available as a generic.
Downsides and risks
AntabuseNaltrexone
  • Antabuse (disulfiram) can cause bad reactions to all types of alcohol, even in sauces or in medicines.
  • If you have diabetes, hypothyroidism, seizures, brain, liver or kidney damage, Antabuse (disulfiram) might not be safe for you to use.
  • People who try to take opioids after taking Vivitrol (Naltrexone) are at risk for opioid overdose and death since it takes a large amount of opioids to overcome the effects of Vivitrol (Naltrexone).
  • You won't be able to use any medications with opioids for pain relief since Vivitrol (Naltrexone) prevents them from working.
  • The shot is only available as brand name only, so it can be expensive.
  • Not a good choice if you have liver problems, depression, or are pregnant or breastfeeding.
Tips from our pharmacists for people taking the medication
AntabuseNaltrexone
  • Don't have any alcohol for at least 12 hours before you start taking Antabuse (disulfiram).
  • You might get a mild rash or skin irritation from taking Antabuse (disulfiram). You can treat this by taking an antihistamine like Benadryl (diphenhydramine). Talk to your doctor if you're not sure.
  • You might get a reaction with Antabuse (disulfiram) if you have any type of alcohol, even in medicines or in sauces containing alcohol.
  • If you miss a dose of Antabuse (disulfiram), take it as soon as you remember, otherwise don't double up if it's time for your next dose.
  • Some people notice an aftertaste of either garlic or metal when you start taking Antabuse (disulfiram). This is normal and goes away after a couple of weeks. Talk to your doctor if this bothers you.
  • If you try to drink alcohol while taking Antabuse (disulfiram), you might experience vomiting, bad headaches, flushing, nausea, and shortness of breath. This can happen for up to two weeks after you stop taking it.
  • Before starting Vivitrol (Naltrexone), you should be off all opioid medications (including buprenorphine and methadone) for at least 7 to 10 days, otherwise you'll get withdrawal symptoms.
  • You'll need to use non-opioid pain medications (if necessary) while on Vivitrol (Naltrexone).
  • Wear a medical alert identification if you're taking Vivitrol (Naltrexone) since you would need to be given non-opioid medications in case of an emergency.
  • If you're taking Vivitrol (Naltrexone) for alcohol dependence, it'll make you not want to drink alcohol, but it won't stop the effects of alcohol if you do drink.
  • Vivitrol (Naltrexone) can make you feel dizzy the first few times you take it, so avoid doing anything requiring concentration until you know how your body reacts to it.
Learn more
More about AntabuseSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Antabuse (disulfiram)?
Worth itNot sureNot worth it
More about NaltrexoneSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Vivitrol (naltrexone)?
Worth itNot sureNot worth it