The Food and Drug Administration (FDA) approved Campral in 2004 to treat alcohol dependence or alcoholism after having been used widely in Europe for many years. More than 4 million people have been treated worldwide with Campral. Campral is no longer available under its brand name, but it is still available in the generic form acamprosate.
Uses
Acamprosate can help people who have already stopped drinking alcohol. It does not work in a person who continues to drink alcohol, nor does it help ease withdrawal symptoms. Rather, it helps the person who has given up drinking to maintain sobriety by reducing the desire for alcohol. Acamprosate is believed to restore chemical balance in the brain that is disrupted by long-term or chronic alcohol misuse. In other words, it helps the brain to begin working normally again by correcting the underlying neurochemical changes caused by chronic drinking. In this way, it helps people maintain alcohol abstinence. When a person drinks heavily or frequently, the balance of neurotransmitters in the brain changes. Specifically, drinking decreases the excitatory neurotransmitter glutamate, creating a sedative effect. When someone with alcohol dependence quits drinking, glutamate increases, resulting in central nervous system hyperactivity and excitability. This can cause the person to crave alcohol to quell uncomfortable symptoms. Acamprosate is thought to somewhat inhibit the release of glutamate as well as activate taurine, an inhibitory neurotransmitter, ultimately decreasing the level of excitation the person experiences. While Antabuse (disulfiram) works by making someone sick if they drink alcohol and naltrexone blocks the “high” people get when drinking, acamprosate reduces the physical distress and emotional discomfort people usually experience when they quit drinking. Acamprosate reduces many of the post-acute withdrawal symptoms that many people experience during the early stages of alcohol abstinence, such as sweating, anxiety, and sleep disturbances. It does not help with withdrawal symptoms experienced while going through early detoxification from alcohol. However, acamprosate has been shown to reduce sleep disturbances commonly experienced during early sobriety by people recovering from alcohol use disorder.
Before Taking
People who have stopped drinking alcohol can begin taking acamprosate. It does not work if you are still drinking, or if you are using illicit drugs or abusing or overusing prescription medications. It is also important to recognize that acamprosate is not a standalone treatment for alcohol addiction. Treatment for alcohol withdrawal should only be provided by a trained healthcare professional as symptoms can range from uncomfortable to life-threatening.
Precautions and Contraindications
Taking acamprosate can cause drowsiness, dizziness, and decreased alertness in some people. For this reason, it is important to determine how the medication will affect you before operating a motor vehicle. Acamprosate should not be taken if you have any of the following conditions:
Allergic reaction to Campral, sulfites, or other medicinesAllergic reaction to foods, dyes, or preservativesBreastfeedingDepressionKidney diseasePregnant or trying to get pregnantSuicidal thoughts
Dosage
Acamprosate is typically prescribed in 333mg time-release tablets, with two tablets (666mg total) taken three times a day. Some people may do fine with lower doses. Because acamprosate tablets are time-release, they should be swallowed whole and never crushed, cut, or chewed. Acamprosate is contraindicated in people with severe kidney impairment, but lower doses may be prescribed in less severe cases. Because the side effects of acamprosate are few and mild and because acamprosate is not addictive, it is usually prescribed for up to 12 months after ceasing alcohol consumption.
How to Take and Store
In case of a missed dose of acamprosate, the medication should be taken as soon as possible. However, if it is almost time for the next dose, people should simply skip the missed dose and take the next dose as they usually would. Never take two doses of acamprosate to make up for a missed dose. Acamprosate is usually taken three times per day, but always follow your doctor’s recommendations. A lower dose may be effective in some cases. The tablets can be taken with or without food. The medication should be stored away from heat, moisture, or direct light and kept in a closed container. It should be kept out of the reach of children. Always discard any outdated mediations.
Side Effects
Campral was “generally well-tolerated in clinical trials” and the side effects that were reported are usually mild and temporary.
Common
DiarrheaDizzinessDry mouthGasHeadachesInsomniaItchingJoint or muscle painLoss of appetiteSweatingVomiting
Severe
In rare cases, acamprosate can cause more severe side effects. Anyone who experiences any of the following symptoms should stop taking acamprosate immediately and contact their healthcare provider:
Anxiety or nervousnessBurning, prickling, or tingling in arms, legs, hands, or feetDepressionChest painsPassing urine less oftenSuicidal thoughts
Warnings and Interactions
Research has not indicated negative effects associated with the long-term use of acamprosate. While there are no known interactions that will alter the effects of the medication, you should always talk to your doctor about any medications, supplements, or substances that you are taking. For more mental health resources, see our National Helpline Database. The medication is usually tolerated well and has a low risk of drug interactions. Acamprosate can also be prescribed to people with mild to moderate liver impairment without dosage adjustments. If you have impaired kidney function, your doctor may prescribe a lower dose or the medication may be contraindicated altogether.
