Acamprosate (brand name Campral) is a prescription medication used to help prevent people who are dependent on alcohol from drinking again.

Acamprosate: An Overview

Acamprosate (Campral) is one of the three FDA-approved medications for treating alcohol dependence. As such, acamprosate addresses one of the most challenging aspects of recovering from alcohol use disorder (AUD), which is staying sober. 

What Is Acamprosate?

Acamprosate is a synthetic amino acid approved by the FDA in 2004 that promotes abstinence from drinking alcohol. It is generally a safe and well-tolerated drug to combat the global alcoholism crisis.

How Does Acamprosate Work?

Although the exact mechanism by which acamprosate helps people stay sober is not completely understood, it is believed to work by binding to the brain’s NMDA (glutamate) receptors. This is significant because chronic alcohol consumption increases the number and activity of these receptors, which produces cravings, sleep disruptions and mood swings when you stop drinking. By blocking these receptors, acamprosate helps the person avoid these effects. 

Treatment with acamprosate should start as soon as the person has stopped drinking. Although it does not prevent withdrawal symptoms associated with alcoholism, it can be initiated during the withdrawal process under medical supervision, if necessary. The full effect of this medication is achieved in approximately five to eight days. 

How Effective Is Acamprosate in Treating Alcohol Abuse? 

Acamprosate is considered moderately effective in treating alcohol abuse, reducing the risk of relapse by about 14% and helping to keep people sober for about 11% longer than they otherwise would.

Acamprosate vs. Naltrexone

Naltrexone (Vivitrol) works by binding to opiate receptors in the body, obstructing the pleasant feelings associated with alcohol use. Whereas acamprosate effectively prevents relapse, naltrexone helps prevent a slip in drinking from becoming a relapse. If people consume alcohol while on naltrexone, they do not experience the enjoyable effects of drinking. 

Experts consider acamprosate and naltrexone first-line choices for treating alcohol use disorder. They believe the choice between them should come from patient-specific factors like ease of administration.

Is Acamprosate Used Alone or With Other Treatment? 

It is important to note that acamprosate and psychosocial therapy should be administered together. Acamprosate combined with behavioral support produces better outcomes. This medication poses no known risk for abuse or tolerance. It can be given safely to patients with several medical issues because no clinically significant drug interactions are associated with this drug. 

Acamprosate Dosage

Acamprosate is available as a 333 mg tablet. The dose to treat alcohol dependence is typically two tablets taken three times daily. The medication can be taken with or without food. The tablets must be swallowed whole and not cut or crushed. 

Since the kidneys excrete this medication, dose adjustments may be warranted for elderly patients or those with reduced kidney function; however, it is unnecessary to lower the dose for those with mild kidney impairment. 

Acamprosate Side Effects

Acamprosate has a good safety profile and few side effects. However, it is still important to be aware of the possible side effects of the medication.

What are the common side effects of acamprosate?

The most common side effects of acamprosate are:

  • Fatigue
  • Weight loss
  • Diarrhea
  • Passing gas
  • Nausea
  • Headache
  • Dizziness
  • Insomnia
  • Tingling
  • Itching 
  • Sweating

What are the serious side effects of acamprosate?

In rare cases, acamprosate may cause serious side effects like suicidal thoughts or behaviors or hypersensitivity. If these side effects occur, you should seek emergency medical attention.

Can acamprosate cause allergic reactions?

In rare cases, acamprosate may cause an allergic reaction. If you experience an allergic reaction to the drug, such as trouble breathing, hives or swelling around the lips, face or tongue, you should stop the medication immediately and seek emergency medical care.

What should I do if I experience side effects?

If you experience side effects from acamprosate, you should speak to your doctor. You should avoid stopping the medication without your doctor’s consent due to the risk of relapse.

Acamprosate Interactions

Since the liver does not metabolize acamprosate, the likelihood of interactions with other drugs is low. Drugs that may be taken by an individual with alcohol use disorder, such as diazepam, disulfiram and antidepressants, do not interact with acamprosate. 

One interaction exists between acamprosate and naltrexone, another medicine used to treat alcohol use disorder. Naltrexone can increase acamprosate levels in the body. 

Acamprosate Use in Special Populations

Some people may need to be more cautious when they take acamprosate. This can be due to medical conditions, age or other issues. Your doctor will inform you if you require a dose adjustment or additional monitoring while on acamprosate.

Can Pregnant or Breastfeeding Women Use Acamprosate?

Pregnant or breastfeeding women may use acamprosate if the doctor deems its benefits outweigh the risks. Acamprosate falls under pregnancy category C, implying some risks based on animal tests, but human evidence is insufficient. Animal studies indicate acamprosate appears in milk. However, its presence in human milk remains unknown. 

On the other hand, drinking alcohol during pregnancy poses serious risks, including fetal alcohol syndrome. Therefore, your doctor may consider acamprosate an acceptable risk to support sobriety.

Is Acamprosate Safe for Children and Adolescents?

It is impossible to know whether acamprosate is safe in children and adolescents as it has not been studied in children. However, although the drug is not approved for those under 18, it has been studied in adolescents as young as 16 with no safety issues noted.

Can Acamprosate Be Used in Elderly Patients?

Acamprosate may be used in elderly patients but has not been extensively studied in those over 65. For this reason, doses should be selected cautiously. Because older patients are more likely to have kidney problems and acamprosate is eliminated through the kidneys, a dose reduction may sometimes be needed.

Is Acamprosate Safe for Those With Kidney or Liver Problems?

Acamprosate is safe for those with mild to moderate liver and kidney problems, although the dose may need to be lowered in those with kidney problems. However, the drug has not been studied in those with severe liver disease and should be avoided in those with serious kidney problems.

Can Acamprosate Really Help Me?

Acamprosate can help you, but it is only part of a larger treatment plan needed to fight alcohol use disorder. The Recovery Village at Palmer Lake is an accredited facility offering comprehensive treatment for anyone struggling with alcohol use disorder. We provide multiple levels of care, including medical detox, inpatient rehab, a partial hospitalization program and outpatient rehab. As part of our integrated medication-assisted treatment (MAT) options, we offer acamprosate as medically appropriate while you are under medical supervision and with our social support to remain sober.

Our state-of-the-art center offers our patients a peaceful environment with serene views of the beautiful Colorado landscape. We have an array of amenities, including a heated swimming pool, basketball courts and walking trails.
If you or someone you love is struggling with alcohol use disorder, learn how we can help. Our team of empathetic and expert healthcare professionals is ready to assist you in living a more fulfilling and healthy life on your road to recovery. Contact a Recovery Advocate today to learn more.

Editor – Theresa Valenzky
Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more
Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more
Sources “New FDA Pregnancy Categories Explained.” Accessed May 29, 2023.

Cayley, William E. “Effectiveness of Acamprosate in the Trea[…]f Alcohol Dependence.” American Family Physician, 2011. Accessed May 29, 2023.

American Psychiatric Association. “Practice Guideline for the Pharmacologic[…]Alcohol Use Disorder.” 2018. Accessed May 29, 2023. “Naltrexone Monograph for Professionals.” July 19, 2021. Accessed May 29, 2023. “Acamprosate Monograph for Professionals.” April 21, 2023. Accessed May 29, 2023. “Acamprosate Interactions Checker.” Accessed May 29, 2023.

National Institute of Diabetes and Digestive and Kidney Diseases. “Acamprosate.” LiverTox, September 7, 2021. Accessed May 29, 2023.

Medical Disclaimer

The Recovery Village at Palmer Lake aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.