Acamprosate

What Is Acamprosate?

Acamprosate is a prescription medication that belongs to a class of drugs used in the treatment of alcohol dependence. It works differently from medications that cause an unpleasant reaction with alcohol — instead, it helps support ongoing abstinence.

Approved use:

• Maintenance of abstinence from alcohol in adults with alcohol dependence who are already abstinent at the time treatment begins

Available formulation:

• Delayed-release (enteric-coated) oral tablets, commonly in Acamprosate 333mg

Acamprosate is intended for use as part of a broader treatment plan that includes psychosocial support, such as counseling or behavioral therapy. It does not treat or prevent alcohol withdrawal symptoms and is not intended to help someone stop drinking who has not already gone through detoxification.

What Is the Recommended Dosage of Acamprosate?

Dosage depends on several factors, including:

• Kidney function, since acamprosate is cleared by the kidneys and requires dose adjustment in people with reduced kidney function
• Age, since older adults may be more likely to have reduced kidney function
• Individual tolerability

Available dosage form: delayed-release tablets, generally taken multiple times daily with a standard regimen.

Treatment is typically started as soon as possible after a person has achieved abstinence from alcohol and is generally continued as part of an ongoing recovery plan, even if a relapse occurs. Dosing may need to be reduced for patients with moderate kidney impairment, and acamprosate should not be used at all in patients with severe kidney impairment. Because appropriate dosing depends heavily on kidney function and individual response, patients should always follow the specific plan set by their prescribing specialist.

How Acamprosate Works

Acamprosate is thought to work by helping to restore the balance of certain brain chemicals — particularly glutamate and GABA (gamma-aminobutyric acid) — that become disrupted with long-term alcohol use.

• Chronic alcohol use can alter the balance between these excitatory and calming brain signals.
• By helping to rebalance this activity, acamprosate may reduce some of the lingering effects associated with early recovery, supporting the ability to maintain abstinence.

Acamprosate supports the maintenance of abstinence; it does not eliminate the underlying condition of alcohol dependence, and it works best when combined with counseling, behavioral therapy, or other psychosocial support.

Is a Prescription Required to Buy Acamprosate Online?

Yes. Acamprosate is available only by prescription.

• Patients should consult a physician or addiction medicine specialist before starting, adjusting, or stopping acamprosate.
• Because kidney function affects dosing, an evaluation of kidney health is an important part of starting treatment.
• Patients should avoid any online source offering acamprosate without requiring a valid prescription, as such products may be counterfeit or unsafe.
• Only licensed, verified pharmacies should be used to obtain this medication.

Side Effects of Acamprosate

Common Side Effects

• Diarrhea (the most common side effect, often dose-related)
• Nausea, gas, or loss of appetite
• Dry mouth
• Weakness or fatigue
• Anxiety or sleep problems (insomnia)
• Itching, sweating, or tingling sensations
• Mild pain

Serious Side Effects

• Changes in mood or behavior, including new or worsening depression
• Thoughts of suicide or self-harm
• Severe or persistent diarrhea
• Signs of kidney problems, such as swelling, reduced urination, fatigue, or shortness of breath
• Allergic reactions (rare)

Seek immediate medical attention for thoughts of self-harm, signs of a serious allergic reaction, or symptoms suggesting significant kidney problems.

This list is not exhaustive. Report any new or worsening symptoms — especially changes in mood — to a healthcare provider promptly. Family members and caregivers should also stay alert to any signs of depression or suicidal thinking during treatment.

Drug Interactions

Acamprosate has relatively few significant drug-metabolism interactions, but important considerations include:

• Other medications processed by the kidneys, since acamprosate is cleared renally and kidney function affects overall drug levels
• Medications that affect mood, given the need to monitor for depression or suicidal thoughts during treatment
• Over-the-counter (OTC) medications and supplements, which should be reviewed with a pharmacist before starting treatment
• Acamprosate can be used alongside other alcohol dependence treatments, such as naltrexone or disulfiram, under specialist supervision

Patients should provide their prescribing specialist and pharmacist with a complete list of current medications, OTC products, and supplements before starting acamprosate.

Safety & Important Considerations

• Kidney disease: Dose adjustment is required for moderate kidney impairment, and acamprosate is contraindicated in patients with severe kidney impairment. Kidney function should be assessed before starting treatment and monitored periodically, especially in older adults.
• Liver disease: Dose adjustment is generally not necessary for mild to moderate liver impairment, though safety in severe liver impairment has not been well studied; this should be discussed with the prescribing specialist.
• Mental health monitoring: Patients should be monitored for new or worsening depression or suicidal thoughts during treatment, and any such symptoms should be reported to a healthcare provider immediately.
• Pregnancy: Use during pregnancy should only occur if a specialist determines that the benefits outweigh potential risks.
• Breastfeeding: Should be discussed directly with the prescribing specialist.
• Older adults: There is limited experience in patients 65 and older, so dosing should be selected with caution and kidney function monitored regularly.
• Children and adolescents: Safety and effectiveness have not been established in this age group.
• Ongoing abstinence support needed: Acamprosate is intended to be used alongside psychosocial support; its effectiveness has not been established in patients who have not already stopped drinking or who use multiple substances.

This information is not exhaustive. Any personal risk factors, especially related to kidney function or mental health history, should be discussed directly with the prescribing specialist.

Who This Medication Is For

Acamprosate is generally prescribed for:

• Adults with a diagnosis of alcohol dependence who have already achieved abstinence and want support maintaining it
• Patients participating in a broader treatment plan that includes psychosocial support, such as counseling or behavioral therapy

Who Should Not Take Acamprosate

Acamprosate should not be used by individuals with:

• A known hypersensitivity to acamprosate or its components
• Severe kidney impairment

Additional caution or specialist evaluation is needed for patients with:

• Moderate kidney impairment (requires dose adjustment)
• A history of depression, suicidal thoughts, or other psychiatric illness
• Older age, due to limited data and higher likelihood of reduced kidney function

A full medical history, including kidney function testing, should always be reviewed by the prescribing specialist before starting acamprosate.

What to Do If You Miss a Dose

• If a dose of acamprosate is missed, contact the prescribing specialist or pharmacist for specific guidance, as consistent use supports the medication’s effectiveness.
• Do not take a double dose to make up for a missed one unless specifically instructed to do so.
• If a dose is missed close to the time of the next scheduled dose, do not guess — check with the care team first.
• If doses are regularly missed or forgotten, discuss this with the prescribing specialist, as adjustments to the regimen may help improve consistency.

Related medications to Acamprosate

Acamprosate is used to help maintain abstinence from alcohol in patients who are abstinent when treatment begins and is intended as part of a broader management program. Related pages include Naltrexone and Disulfiram, which work through different mechanisms.

Storage Instructions

• Store tablets at room temperature, protected from excess heat and moisture.
• Keep in the original, tightly closed container, away from direct light.
• Keep out of the reach and sight of children and pets.
• Do not use expired medication; consult a pharmacist with any disposal questions.

Disclaimer:

This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Patients must consult a licensed medical specialist — such as a physician or addiction medicine specialist — before starting, changing, or stopping acamprosate. Treatment decisions must be based on a full clinical evaluation by a qualified specialist.