Prescription onlyLower-cost generic availableClass: Neuro/psych

Antabuse Alternatives

(disulfiram)

Prescription onlyLower-cost generic availableClass: Neuro/psych
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Compare Antabuse (disulfiram) to alternatives

These medications are comparable to Antabuse (disulfiram) or used for similar purposes.

Antabuse
(disulfiram)

Campral
(acamprosate)

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 alcoholism. Campral (acamprosate) reduces your craving for alcohol, but it works better if you're also in a support group.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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Side effects
AntabuseacamprosateNaltrexone

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

More about Antabuse side effects »
  • Diarrhea 7%
  • Generalized pain 1%
  • Itching 1%
  • Flatulence 2%
  • Nausea 1%
More acamprosate side effects »
  • Nausea 10%
  • Headache 7%
  • Dizziness 4%
  • Nervousness 4%
  • Fatigue 4%
  • Insomnia 3%
  • Vomiting 3%
  • Anxiety 2%
  • Somnolence 2%
More Naltrexone side effects »
How it works
AntabuseacamprosateNaltrexone
Antabuse (disulfiram) is an aldehyde dehydrogenase inhibitor. It prevents your body from processing alcohol when you drink it and discourages you from drinking.Campral (acamprosate) is a GABA agonist and glutamate antagonist. It lowers your cravings and need for alcohol.Vivitrol (Naltrexone) blocks all opioid receptors in your body and prevents you from feeling the effects of opioid medications and alcohol.
Type of medication
AntabuseacamprosateNaltrexone
Prescription onlyPrescription onlyPrescription only
Available as
AntabuseacamprosateNaltrexone
  • Pill
  • Delayed release
  • Pill
Used for
AntabuseacamprosateNaltrexone
Risk factors for serious side effects
AntabuseacamprosateNaltrexone
  • Drinking alcohol while on Antabuse (disulfiram)
  • Allergy to latex rubber or pesticides
Detailed Antabuse (disulfiram) risks & warnings »
    Detailed Campral (acamprosate) 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.

    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
    AntabuseacamprosateNaltrexone
    • 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.
    • 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.
    • Unlike other medicines used for alcoholism, Campral (acamprosate) doesn't produce any unpleasant effects if you slip and have a drink. You can keep taking it if you break your sobriety, but talk to your doctor.
    • 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.
    • Can be used with behavior modification therapy to treat opioid or alcohol use disorders.
    Kidneys and liver
    AntabuseacamprosateNaltrexone
    • If you have diabetes, hypothyroidism, seizures, brain, liver or kidney damage, Antabuse (disulfiram) might not be safe for you to use.
    • If you have severe kidney damage, you can't take Campral (acamprosate).
    • Not a good choice if you have liver problems, depression, or are pregnant or breastfeeding.
    Pain
    AntabuseacamprosateNaltrexone
    • 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.No pain related info.
    Upsides and benefits
    AntabuseacamprosateNaltrexone
    • Antabuse (disulfiram) is a first choice medicine for alcoholism.
    • You're less likely to start drinking again with Antabuse (disulfiram) than other medicines.
    • Campral (acamprosate) reduces your cravings for alcohol and can help to maintain your sobriety.
    • Unlike other medicines used for alcoholism, Campral (acamprosate) doesn't produce any unpleasant effects if you slip and have a drink. You can keep taking it if you break your sobriety, but talk to your doctor.
    • 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
    AntabuseacamprosateNaltrexone
    • 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.
    • Campral (acamprosate) can't replace the support you get from counseling or group therapy for maintaining your sobriety.
    • Campral (acamprosate) doesn't treat symptoms of alcohol withdrawal.
    • Campral (acamprosate) can be started only for those who have been able to safely stop drinking alcohol.
    • It may be difficult to remember to take Campral (acamprosate) three times daily.
    • If you have severe kidney damage, you can't take Campral (acamprosate).
    • 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
    AntabuseacamprosateNaltrexone
    • 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.
    • Campral (acamprosate) works better if you're also going to counseling or group therapy for alcoholism.
    • Don't drive or do anything that requires concentration until you know how Campral (acamprosate) affects you.
    • Taking Campral (acamprosate) won't help with symptoms of alcohol withdrawal.
    • If you break your sobriety while taking Campral (acamprosate), keep taking it, but talk to your doctor right away.
    • 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 acamprosateSide effectsFDA package insert
    Have you used Campral (acamprosate)?
    Worth itNot sureNot worth it
    More about NaltrexoneSide effectsReviews & ratingsFDA package insert
    Have you used Vivitrol (naltrexone)?
    Worth itNot sureNot worth it