Acamprosate calcium is a synthetic drug used as an anti-craving agent for the maintenance of abstinence in alcohol-dependent patients. It is a structural analogue of the neurotransmitter gamma-aminobutyric acid (GABA) and the amino acid taurine. It is not a sedative, hypnotic, or anti-anxiety agent and does not cause alcohol aversion or a disulfiram-like reaction. Its efficacy is best when used as part of a comprehensive treatment program that includes psychosocial support.
Adult: 666 mg (two 333 mg tablets) three times daily. Total daily dose: 1998 mg.
Note: Swallow tablets whole with water. Can be taken with or without food, but taking with food may reduce gastrointestinal side effects and slightly decrease absorption. Maintain consistent timing of doses.
Acamprosate's exact mechanism is not fully elucidated but is believed to restore the neurochemical balance disrupted by chronic alcohol exposure. It modulates the glutamatergic and GABAergic systems, which are central to alcohol dependence, withdrawal, and craving.
Pregnancy: Category C (US FDA). Animal studies have shown fetal toxicity. There are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus.
Driving: May cause dizziness. Patients should be cautioned about operating hazardous machinery, including driving, until they are reasonably certain that acamprosate does not adversely affect their abilities.
| Alcohol | Does not cause a disulfiram-like reaction, but concurrent use negates therapeutic goal. No direct pharmacokinetic interaction. | Major (Therapeutic) |
| Antidepressants (e.g., SSRIs, TCAs) | Additive risk of depression/suicidal ideation. Pharmacokinetic interaction unlikely. | Moderate |
| Naltrexone | Often used in combination for alcohol dependence. No significant pharmacokinetic interaction reported. Monitor for additive GI effects. | Minor |
| Diuretics (e.g., Furosemide) | May increase risk of dehydration and electrolyte imbalance, potentially affecting renal function and acamprosate clearance. | Moderate |
| NSAIDs (e.g., Ibuprofen, Diclofenac) | May impair renal function, reducing acamprosate clearance and increasing risk of toxicity. | Moderate |
Same composition (Acamprosate (333mg)), different brands: