Acamprosate
CAMPRAL
Pronunciation: a-KAM-pro-sayt
“A camp roast”
for alcohol use disorder
standard dose is 666 mg T.I.D.
What it isGlutamatergic modulator — a negative modulator at the NMDA receptor polyamine site; maintenance of abstinence in alcohol use disorder.
Why this oneHas no hepatic metabolism, so it is usable in liver disease where naltrexone is not.
What limits itThree-times-daily dosing with a large tablet burden. Renally cleared; it does not reduce craving in active drinking.
FDA-approved for
- alcohol use disorder (2004)
Principal riskThree-times-daily dosing; renally cleared
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Maintenance of abstinence in alcohol dependence (abstinent at initiation) | adult | 666 mg TID | 666 mg TID | 666 mg TID |
Renal Moderate (CrCl 30–50 mL/min): 333 mg TID; severe (CrCl ≤30 mL/min): contraindicated.
Hepatic Undefined
Instructions
- Initiate as soon as possible after alcohol withdrawal once abstinence is achieved; continue even if the patient relapses.
- Use as part of a comprehensive psychosocial treatment program.
- May be taken with or without food (dosing with meals may aid adherence).
- Swallow delayed-release tablets whole.
- Monitor for emergence of depression or suicidal ideation.
Available strengths
- DR tab 333 mg
Contraindications
- Severe renal impairment (CrCl ≤30 mL/min)
Cautions
- Dose reduction required in moderate renal impairment
- Suicidality and depression — monitor patients and alert families/caregivers
- Does not eliminate or diminish alcohol withdrawal symptoms
Adverse reactions
- diarrhea, flatulence, nausea, anorexia, asthenia, pain, accidental injury, anxiety, depression, dizziness, dry mouth, insomnia, paresthesia, pruritus, sweating
Pregnancy Teratogenic in animals; use during pregnancy only if potential benefit justifies the potential fetal risk.
Lactation Unknown whether excreted in human milk (present in rat milk); exercise caution in nursing women.
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 333 mg | DR tab | 90 TID | $53.02 | offered |
Generic entry2013
Open Acamprosate in the interactive console ↗
Memory aids: interaction avatars
Open Acamprosate in the interactive console ↗
Self-check
- Does acamprosate reduce craving during active drinking?
No. - How often is acamprosate dosed?
Three times daily.