Drug Detail:Acamprosate (Acamprosate calcium)
Drug Class: Drugs used in alcohol dependence
Usual Adult Dose for Alcohol Dependence
666 mg orally 3 times a day
Comments:
- Doses should be taken with meals in patients who regularly eat 3 meals a day.
- Treatment should begin as soon as possible after the withdrawal period (when the patient achieves abstinence) and should be maintained if the patient relapses.
- This drug should be used as part of a comprehensive psychosocial treatment program.
- Lower doses may be effective in some patients.
Use: For the maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation
Renal Dose Adjustments
Mild renal dysfunction (CrCl greater than 50 mL/min): Data not available
Moderate renal dysfunction (CrCl 30 to 50 mL/min):
- Initial dose: 333 mg orally 3 times a day
- Maintenance dose: 333 to 666 mg orally 3 times a day
Severe renal dysfunction (CrCl 30 mL/min and less): Contraindicated
Liver Dose Adjustments
Mild to moderate liver dysfunction (Child-Pugh Classes A and B): No adjustment recommended.
Severe liver dysfunction (Child-Pugh Class C): Data not available
Precautions
CONTRAINDICATIONS:
- Hypersensitivity to the active component or any of the ingredients
- Severe renal dysfunction (CrCl less 30 mL/min or less)
Safety and efficacy have not been established in pediatric patients.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Tablets should be swallowed whole; crushing or chewing should be avoided.
- Doses should be administered with meals.
General:
- Limitation of use: Treatment does not constitute treatment for the withdrawal period.
- Limitation of use: The efficacy in promoting abstinence from alcohol in patients with polysubstance abuse has not been adequately assessed.
- Limitation of use: Efficacy has not been demonstrated in promoting abstinence in patients who have not undergone detoxification and achieved abstinence prior to beginning treatment.
- Treatment does not prevent harmful effects of continuous alcohol abuse, and continued alcohol abuse negates therapeutic benefits of this drug.
Monitoring:
- PSYCHIATRIC: Signs/symptoms of depression and suicidality
Patient advice:
- Counsel patients regarding the signs and symptoms of depression and suicidality; instruct patients to contact their physician immediately if signs or symptoms occur.
- Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
Frequently asked questions
- Acamprosate vs naltrexone: How do they compare?
- Does acamprosate make you sick if you drink alcohol?
- How long does it take for acamprosate to work?
- Does acamprosate cause weight gain?
- How does acamprosate work?
