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
- Blocks glutaminergic N-methyl-D-Aspartate receptors
- Activates GABA Type A receptors
- Reduces anxiety from abstinence
V. Efficacy
- Reduces short and longterm relapse rates
- Sustains Alcohol abstinence (NNT 12) and reduces Problem Drinking (NNT 9)
VI. Dosing
- Campral 666 mg (two 333 mg tabs) orally three times daily
- Start with one 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
VII. Drug Interactions
- No interaction with Alcohol or Benzodiazepines
- No interaction with Disulfiram (Antabuse)
VIII. Safety
- Pregnancy Category C
- Lactation: Unknown
IX. Adverse effects
- Transient Diarrhea (10%) and other gastrointestinal symptoms (Flatulence, Nausea)
- Insomnia
- Depressed mood
- Pruritus
- Paresthesias
- Diaphoresis
X. Disadvantages
- Cost: $150/month trade name (but generic available for $55 per month)
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| acamprosate (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ACAMPROSATE CALC DR 333 MG TAB | Generic | $0.86 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 |
