Disulfiram (Antabuse)

Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.

About Disulfiram

What it is

Disulfiram blocks aldehyde dehydrogenase, the enzyme that clears acetaldehyde, a toxic product of alcohol. If someone taking it drinks alcohol, acetaldehyde builds up and causes flushing, nausea, a pounding heart and other unpleasant symptoms, which helps people stay abstinent. It is used to support treatment of alcohol dependence. It is sold as Antabuse.

How genes come into it

Disulfiram mimics in everyone what the common ALDH2*2 variant does naturally in many people of East Asian ancestry, who flush after alcohol. Most gene studies on disulfiram concern its off-label use for cocaine dependence and looked at DBH (dopamine beta-hydroxylase, which disulfiram also blocks), DRD2, SLC6A3 and others. The findings come from single or a few studies, and there is no CPIC or DPWG guideline.

What research found

Every published finding on gene variants and Disulfiram. Upload your DNA file to see which of these rows apply to you.

Rated evidence (5 rated variants)

PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.

DRD2 rs2283265: Level 3. Efficacy: Cocaine dependence. 1.

ANKK1 rs1800497: Level 3. Efficacy: Cocaine dependence. 1.

MTHFR rs1801133: Level 3. Efficacy: Cocaine dependence. 1.

OPRD1 rs678849: Level 3. Efficacy: Cocaine dependence. 1.

Response (9 findings)

Studies of how well it worked in people carrying a variant.

ADRA1A rs1048101: Genotypes AA + AG is associated with increased response to disulfiram in people with Cocaine-Related Disorders as compared to genotype GG.

ALDH2 ALDH2 deficiency: ALDH2 deficiency is associated with increased response to disulfiram in people with Alcoholism as compared to ALDH2 non-deficient.

DBH rs1611115: Genotype CC is associated with increased response to disulfiram in men with Alcoholism as compared to genotypes CT + TT.

MTHFR rs1801133: Genotypes AA + AG are associated with increased response to disulfiram in people with Cocaine-Related Disorders as compared to genotype GG.

Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.

Related Drugs

More drugs from the same category

Alcohol Dependence Drugs (class) (Alcohol Dependence Agents)

Campral (Alcohol Dependence Agents)

Abilify (Antipsychotics)

Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.

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Content updated September 2026.

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