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What is Acamprosate (Campral)?

Acamprosate has been used in Europe to treat alcohol dependence since 1989. In 2004, acamprosate became the third drug to receive approval from the United States Food and Drug Administration (FDA) for this type of treatment, following disulfiram (brand name Antabuse) and naltrexone (brand name ReVia.)

The medication can help those who quit drinking and need help with cognitive function. Long-term alcohol consumption damages the brain’s ability to work correctly. Acamprosate may be able to support it.

Acamprosate is unlikely to help if you have not already quit drinking or undergone detoxification. It may also not help if you are also addicted to other drugs besides alcohol.

The medication has a good safety profile. It is a typically well-tolerated treatment for individuals suffering from alcoholism and appears to improve the likelihood that patients continue to remain abstinent. 

Most evidence indicates that acamprosate is as effective as naltrexone but with less adverse events and reactions. Acamprosate may also be more effective when used with naltrexone or disulfiram.

Acamprosate used in combination with psychosocial support should be determined as first-line therapy for maintenance of alcohol abstinence.

How is Acamprosate Used to Treat Alcohol Use Disorder (AUD)?

Acamprosate is used with counseling support and behavior modification to help an individual who has recently stopped drinking alcohol continue to choose not to drink.

When it comes to dosing, patients should take two 333 mg tablets three times daily. These tablets are delayed release. 

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How Does the Medication Work?

Acamprosate works by affecting chemicals in the brain that may be unbalanced in an individual who is addicted to alcohol. The medication restores this chemical balance in the brain in an alcohol-dependent patient who has recently quit drinking.

Potential Side Effects of Acamprosate

Common side effects of Acamprosate include:

  • Pain or weakness
  • Loss of appetite
  • Nausea
  • Diarrhea
  • Flatulence
  • Dizziness
  • Constipation
  • Anxiety
  • Itching
  • Sweating
  • Feeling depressed
  • Sleep issues (insomnia)
  • Dry mouth
  • Numbness or a tingly feeling

If you have any of the following severe side effects, seek emergency medical help:

  • Hives
  • Difficulty breathing
  • Swelling of your face, lips, tongue, or throat
  • Severe anxiety or depression
  • Mood or behavior shifts
  • Thoughts about suicide or hurting yourself
  • Swelling in your hands or feet
  • Pounding heartbeats or fluttering in your chest
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Are There Any Risks Associated with Acamprosate?

If you are considering using acamprosate, you must consider the risks. Be sure to discuss the following risks with your healthcare provider.

For this medicine, there are several factors you must consider.

Allergies

Let your doctor know if you have ever experienced any unusual or allergic reaction to this medicine or any others. You should also tell your healthcare provider if you have any other types of allergies, like foods, preservatives, dyes, or animals.

Pediatric Safety

Efficiency and safety in pediatric patients have not been determined yet.

Breastfeeding

There are no sufficient studies in women for understanding infant risk when using acamprosate during breastfeeding. However, it is essential to weigh the potential benefits against the risks before taking this medication while breastfeeding.

Drug Interactions

Although specific medications should not be used together, in other cases, two different medicines may be used together, even if an interaction might happen. It is essential to speak with your doctor to adjust the dose or take other precautions if necessary.

Always tell your doctor or healthcare professional if you are taking any other prescription or nonprescription (OTC) medicines.

Other Interactions

Certain medications should not be used at or around the same of consuming food or eating certain types of food as interactions may occur. Using alcohol or tobacco with specific medicines may also lead to interactions occurring.

Also, discuss the use of acamprosate with food, alcohol, or tobacco with a healthcare professional.

What Happens If You Miss a Dose of Acamprosate?

If you miss a dose of acamprosate, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next dose. Do not take the additional medicine to make up for the missed dose.

Benefits of Medication-Assisted Treatment (MAT) for Alcoholism

MAT for the treatment of alcoholism has proved to be clinically effective and highly reduces the need for inpatient detoxification services for those suffering from alcoholism. MAT delivers a comprehensive, customized treatment program of medication and behavioral therapy that helps most patients.

The end goal of MAT is full recovery, including the chance to live an autonomous, self-directed life.

MAT treatment for alcoholism has been shown to:

  • Improve patient survival
  • Boost retention in treatment
  • Lessen criminal activity among people with substance use disorders
  • Enhance patients’ ability to gain and maintain employment 
  • Improve birth outcomes among women with alcohol and substance use disorders who are pregnant

Research also shows that MAT medications and therapies can reduce an individual’s risk of contracting HIV or hepatitis C by reducing the potential for relapse.

Other Therapies Used With MAT for Alcoholism Treatment

MAT patients receiving treatment for alcoholism usually have counseling, which may include various types of behavioral therapy. Regardless of what setting MAT is delivered in, it is more effective when counseling and other behavioral health therapies give patients a whole-person approach.

The coexistence of both alcoholism and a mental illness is common, too. This is known as a co-occurring disorder. Patients with a co-occurring disorder often receive treatment for both conditions.

What to Discuss With Your Health Care Provider Before Taking Acamprosate

There are several things to discuss with your health care provider before taking acamprosate.

The first is whether you have severe kidney disease. This is because acamprosate will not treat or prevent alcohol withdrawal symptoms. To ensure that the medication is safe for you, let your doctor know if you have any kidney problems.

It is also possible that you may have suicidal thoughts while taking acamprosate. If you feel depressed or suicidal before taking the drug, be sure to discuss this with your doctor. Your doctor can check your progress at regular visits.

Tell your doctor if you are pregnant or plan to fall pregnant while taking acamprosate. It is unknown whether the drug passes into breast milk or can cause adverse effects on a nursing baby. Tell your doctor if you are breastfeeding a baby.

How to Find Treatment for Alcoholism

When researching treatment for alcoholism, gather as much information as you can about the provider or program before making a decision. If you know someone who has personal knowledge of the program, it may help to ask about their experience.

Here are some questions to consider that may help guide your choice:

What kind of treatment does the program or provider offer?

It is essential to learn whether the facility provides all the currently available treatment methods of alcoholism or relies on one approach. You may want to determine if the program or provider offers medication and if mental health problems are addressed alongside addiction treatment.

Is treatment customized to the individual?

Matching the proper treatment to the individual is essential for success. No single therapy will benefit everyone. It may also help to understand whether treatment is adapted to meet changing requirements as they arise.

What is expected of the patient?

You may want to know what will be asked of you or a loved one to decide what treatment is best for you.

Is treatment success measured?

By determining whether and how the program measures treatment effectiveness, you can compare your options more effectively.

How does the program or provider deal with relapse?

Relapse is common in recovering addicts, and you should find out how a program or provider addresses it.

When seeking professional treatment of alcohol dependence, it is essential that you feel respected and understood. You should have a feeling of trust that this organization, program, or person can help you on the road to recovery. Consider, though, that relationships with doctors and other health professionals can sometimes take a while to develop.

Resources

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Center for Substance Abuse Treatment. Incorporating Alcohol Pharmacotherapies Into Medical Practice. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2009. (Treatment Improvement Protocol (TIP) Series, No. 49.) Chapter 2—Acamprosate. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64035/ 

Acamprosate (Campral) for Treatment of Alcoholism, American Family Physician, August 2006, https://www.aafp.org/afp/2006/0815/p645.html 

Acamprosate (Oral Route), Mayo Clinic, February 2021, https://www.mayoclinic.org/drugs-supplements/acamprosate-oral-route/side-effects/drg-20066802?p=1 

MAT Medications, Counseling, and Related Conditions, Substance Abuse and Mental Health Services Administration (SAMHSA), August 2020, https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions 

Medication-Assisted Treatment (MAT),  Substance Abuse and Mental Health Services Administration (SAMHSA), January 2021, https://www.samhsa.gov/medication-assisted-treatment 

Treatment for Alcohol Problems: Finding and Getting Help, National Institute on Alcohol Abuse and Alcoholism (NIH), https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help 

al Qatari, M et al. “Acamprosate is neuroprotective against glutamate-induced excitotoxicity when enhanced by ethanol withdrawal in neocortical cultures of fetal rat brain.” Alcoholism, clinical and experimental research vol. 25,9 (2001): 1276-83, https://pubmed.ncbi.nlm.nih.gov/11584146/ 

Whitworth, A B et al. “Comparison of acamprosate and placebo in long-term treatment of alcohol dependence.” Lancet (London, England) vol. 347,9013 (1996): 1438-42, https://pubmed.ncbi.nlm.nih.gov/8676626/

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