Acamprosate

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Generic name: acamprosate (a KAM proe sate)

• Delayed release enteric coated tablets: 333mg

All FDA warnings are at the end of this fact sheet. Please consult them before taking this medication.

Medication Assisted Treatment (MAT)

Medication assisted treatment (MAT) is the use of medications in combination with counseling and behavioral therapies for the treatment of alcohol use disorder and substance use disorders. A combination of medication and behavioral therapies is effective in the treatment of substance use disorders and can help some people to sustain recovery.

What Is Acamprosate And What Does It Treat?

Acamprosate is a medication that works in the brain to treat alcohol use disorder. Acamprosate works by decreasing cravings and urges to use alcohol. This allows people who take the medication to control urges to drink and help to continue to not use alcohol. Acamprosate does not help with symptoms of alcohol withdrawal.

Symptoms of alcohol use disorder include:

• Being unable to quit using alcohol despite problems with health and relationships.
• Requiring more alcohol to achieve the same effect.
• Presence of withdrawal symptoms (sweating, shaking, nausea, vomiting, confusion, anxiety) when unable to use alcohol.
• Spending the majority of time using or finding a way to use alcohol.
• Having a desire but an inability to decrease the amount of alcohol used.
• Giving up enjoyable activities in order to use alcohol.

What Is The Most Important Information I Should Know About Acamprosate?

Abstinence, or the restraining of oneself from indulging in alcohol, is required to start treatment with acamprosate.

If you relapse, you should continue to take acamprosate and see your health care provider as soon as possible. Treatment with acamprosate should be continued in the event of relapse.

Do not stop taking acamprosate, even when you feel better. Only your health care provider can determine the length of treatment that is right for you.

Missing doses of acamprosate may increase your risk for relapse.

Patients with kidney problems may need lower doses and need to be monitored while using acamprosate. This can be accomplished through blood tests. Patients with severe kidney problems may not be candidates for acamprosate. Your health care provider can assess if the medication is appropriate for use.

Patients with substance use disorders are at a higher risk for depression and suicidal thoughts. If you experience any increased thoughts of suicide, call 911 or go to your closest emergency room.

It is important to combine acamprosate with counseling and other support.

Are There Specific Concerns About Acamprosate And Pregnancy?

If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with substance use disorders that wish to become pregnant face important decisions and challenges. Active substance use during pregnancy puts the fetus at great risk. It is important to discuss the risks and benefits of continued treatment with your doctor and caregivers.

There is limited data on the effects of acamprosate on the fetus when used in pregnant women. It is likely that acamprosate crosses the placenta and can be transferred to the fetus. Adverse events were observed in animal reproductive studies including structural abnormalities. These results cannot be applied to humans; therefore, acamprosate should only be used in pregnancy if the benefits outweigh the risk to the fetus.

Caution should be exercised when using acamprosate while breastfeeding as it is not known if acamprosate crosses into the breast milk. The effects of acamprosate on the baby are unknown.

What Should I Discuss With My Health Care Provider Before Taking Acamprosate?

• Symptoms of your condition that bother you the most
• If you have allergies to any medications
• If you have thoughts of suicide or harming yourself
• Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects
• If you experience side effects from your medications. Some side effects may pass with time, but others may require changes in the medication.
• Any other psychiatric or medical problems you have, including a history of kidney disease
• All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have
• Other non-medication treatments you are receiving, such as talk therapy. Your provider can explain how these different treatments work with the medication.
• If you are pregnant, plan to become pregnant, or are breastfeeding
• If you use illegal drugs or narcotics

How Should I Take Acamprosate?

The usual dose of acamprosate is 666 mg taken three times daily. However, a lower dose may be effective in some patients. Follow the directions of your health care provider in regards to the appropriate dose that you should take.

Acamprosate is available as an oral tablet that should be swallowed whole and not crushed or chewed.

Acamprosate oral tablets are usually taken three times daily with or without food. However, taking them three times daily with meals may help to increase compliance.

Consider using a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.

What Happens If I Miss A Dose Of Acamprosate?

If you miss a dose of acamprosate, take it as soon as you remember unless it is closer to the time of your next dose. Do not double your next dose or take more than what is prescribed.

What Should I Avoid While Taking Acamprosate?

Avoid drinking alcohol while using acamprosate.

What Are The Possible Side Effects Of Acamprosate?

Common side effects

• Diarrhea

Rare/serious side effects

• Chest pain, increased blood pressure or heart rate, swelling, nausea, changes in appetite, internal gas, weakness, pain, anxiety, depression, dizziness, dry mouth, headache, trouble sleeping (insomnia), weight gain, tingling sensation, itching, sweating, and vision changes may occur. If you experience any of these side effects, contact your health care provider for guidance.
• Suicidal thoughts have been reported. People experiencing suicidal thoughts while taking acamprosate should contact their provider immediately.

Are There Any Risks For Taking Acamprosate For Long Periods Of Time?

To date, there are no known problems associated with long term use of acamprosate. It is a safe and effective medication when used as directed.

What Other Medications May Interact With Acamprosate?

There are no known significant interactions involving a decrease or increase in effect.

Talk to your healthcare providers about all of the medications you are taking.

How Long Does It Take For Acamprosate To Work?

Acamprosate will begin working shortly after taking one dose.

Summary of Black Box Warnings

Acamprosate does not have any black box warnings.

Last Reviewed: September 2024

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This information is being provided as a community outreach effort of the American Association of Psychiatric Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The American Association of Psychiatric Pharmacists disclaims any and all liability alleged as a result of the information provided herein.

©2024 American Association of Psychiatric Pharmacists (AAPP). AAPP makes this document available under the Creative Commons Attribution-NoDerivatives 4.0 International License. Last Updated: January 2016.