II. Indications
- Maintenance of Alcohol abstinence
III. Contraindications
- Severe Renal Insufficiency (CrCl <30 ml/min)
- Advanced Cirrhosis (although appears safe in most with impaired hepatic function)
IV. Mechanism
- Balances GABA and glutamate Neurotransmitters
- Reduces anxiety from abstinence
V. Dosing
- Campral 666 mg (two 333 mg tabs) orally three times daily
- Start with one tablet three times daily
- Increase with one additional tablet daily each week
- Slow titration reduces gastrointestinal side effects
- Indications to decrease to 333-666 mg AM, 333 noon, 333 PM
- Weight <60 kg
- Renal Insufficiency
- Creatinine Clearance <50 ml/min, but >30 ml/min
- Contraindicated if Creatinine Clearance <30 ml/min
VI. Safety
- Pregnancy Category C
- Lactation: Unknown
VII. Adverse Effects
- Transient Diarrhea (10%)
- Flatulence
- Nausea
- Insomnia
- Depressed mood
- Pruritus
- Paresthesias
- Diaphoresis
VIII. Efficacy
- Reduces short and longterm relapse rates
- Sustains Alcohol abstinence (NNT 12) and reduces Problem Drinking (NNT 9)
- Yahn (2013) Subst Abuse 6:1-12 [PubMed]
- Rosner (2010) Cochrane Database Syst Rev (9): CD004332 [PubMed]
IX. Drug Interactions
- May be used in combination with Naltrexone
- No interaction with Alcohol or Benzodiazepines
- No interaction with Disulfiram (Antabuse)
X. Resources
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acamprosate (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
ACAMPROSATE CALC DR 333 MG TAB | Generic | $0.52 each |
Ontology: acamprosate (C0284941)
Definition (CSP) | calcium salt of N-acetylhomotaurine; an adjunct to psychotherapy in maintaining abstinence after alcohol withdrawal in patients with alcohol dependence. |
Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
MSH | C043877 |
SnomedCT | 420804003, 391698009 |
LNC | MTHU047786, LP182301-4 |
English | AOTA, Acamprosate, Acamprosate (product), acamprosate (medication), Acamprosate (substance), Acamprosate - chemical, Acamprosate - chemical (substance), acamprosate [Chemical/Ingredient], ACAMPROSATE, acamprosate, acamprostate, N-acetylhomotaurine |
Spanish | acamprosato, acamprosato (producto), acamprosato - sustancia química (sustancia), acamprosato (sustancia), acamprosato - sustancia química |
Ontology: Campral (C0592792)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C043877 |
English | Campral, Campral EC, Alphapharma brand of acamprosate calcium, Lipha brand of acamprosate calcium, Merck brand of acamprosate calcium, AWD.pharma brand of acamprosate calcium |