Acamprosate calcium is a prescription medication that helps people who are dependent on alcohol to abstain from drinking it. It is used along with psychosocial support and helps to prevent the cravings and urge to drink alcohol that people with alcohol use disorder experience.

Drinking alcohol alters the balance of the chemical messengers or neurotransmitters in your brain. Acamprosate is thought to work by helping to restore the balance of these neurotransmitters. It's thought that it primarily works by decreasing the excessive excitation that accompanies alcohol dependence.

Acamprosate is similar in structure - an analog of - two neurotransmitters called GABA (gamma-aminobutyric acid) and taurine. And while it's not clear exactly how it works, it's been suggested that acamprosate works by targeting GABA and NMDA (N-methyl-D-aspartate) glutamatergic receptor activity. It's also been suggested that it works by supplying calcium.

In 2004, the US Food and Drug Administration (FDA) approved a branded version of acamprosate calcium called Campral. Campral has since been discontinued, but generic versions of acamprosate calcium delayed-release tablets are available.

What is acamprosate used for?

Acamprosate is used for the maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation. Acamprosate should be used as part of a comprehensive management program that includes psychosocial support.

Acamprosate is not used to help the symptoms of alcohol withdrawal.

• Before starting treatment with acamprosate you must have stopped drinking alcohol.
• If you relapse and start drinking alcohol, continue to take acamprosate and see your healthcare provider as soon as possible. In the event of a relapse, treatment with acamprosate should be continued.
• Do not stop taking acamprosate, even when you feel better. Talk with your healthcare provider about how long you should take acamprosate for.
• Missing doses of acamprosate may increase your chances of relapsing.
• If you have kidney problems you may need lower doses and need blood tests while using acamprosate. If you have severe kidney problems acamprosate may not be right for you.
• People with substance use disorders are at a higher risk for depression and suicidal thoughts. If you experience any thoughts of self-harm, call 911 or go to your closest emergency room.
• Acamprosate should be used in combination with counseling and other support.

• Take acamprosate exactly as your doctor tells you to.
• Take two tablets three times a day or as directed by your doctor.
• Acamprosate can be taken with or without food.
• Swallow tablets whole. Do not crush or chew.

The recommended dose of acamprosate is 666 mg (two tablets) taken three times a day.

See full prescribing information for further details about acamprosate dosing.

Do not take acamprosate if you are allergic to acamprosate calcium or any of the other ingredients in it. Do not use acamprosate if you have severe renal impairment.

What should I tell my doctor before taking acamprosate?

Before taking acamprostate tell your healthcare provider about all of your medical conditions including if you:

• have kidney disease
• have depression
• have thoughts of suicide or harming yourself
• use illegal drugs or narcotics

Missing doses of acamprosate may increase your chances of relapsing. If you miss a dose of acamprosate take your next dose as soon as you remember. If it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if you take too much acamprosate. If you take too much acamprosate you may develop diarrhea. If you take too much acamprosate on a regular basis you may develop hypercalcemia or too much calcium in your blood.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unless your doctor tells you otherwise, continue your normal diet.

Avoid drinking alcohol while taking acamprosate.

Common side effects of acamprosate include:

• accidental injury
• asthenia
• pain
• anorexia
• diarrhea
• flatulence
• nausea
• anxiety
• depression
• dizziness
• dry mouth
• insomnia
• paresthesia
• pruritus
• sweating

These are not all of the possible side effects of acamprosate.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Keep all appointments with your doctor and counselor or support group.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.