What is Acamprosate: Uses, Dosage, Side Effects and More

Acamprosate is a prescription medication that helps people maintain sobriety after they've stopped drinking alcohol. It works by restoring balance to brain chemicals that become disrupted during long-term alcohol use, making it easier to resist the urge to drink again.

This medication isn't a cure for alcohol dependence, but it can be a valuable tool in your recovery journey. Think of it as one piece of a larger puzzle that includes counseling, support groups, and lifestyle changes.

What is Acamprosate?

Acamprosate is a medication specifically designed to support alcohol recovery by helping your brain readjust to functioning without alcohol. It belongs to a class of drugs called alcohol deterrents, though it works differently from other medications in this category.

The drug was originally developed in Europe and has been helping people maintain sobriety for decades. It's particularly helpful for people who have successfully stopped drinking but struggle with cravings or the psychological aspects of staying sober.

Unlike some other alcohol recovery medications, acamprosate doesn't make you sick if you drink alcohol. Instead, it quietly works in the background to reduce the mental discomfort that often comes with early sobriety.

What is Acamprosate Used For?

Acamprosate is primarily used to help people who have alcohol use disorder maintain their sobriety after they've already stopped drinking. It's not meant to help you quit drinking initially, but rather to help you stay quit once you've made that commitment.

Your doctor will typically prescribe this medication as part of a comprehensive treatment plan that includes counseling, support groups, or other therapeutic approaches. The medication works best when combined with these other forms of support.

Some people find acamprosate particularly helpful during the first few months of sobriety, when cravings and psychological discomfort can be most intense. It can help smooth out some of the emotional ups and downs that are common during early recovery.

How Does Acamprosate Work?

Acamprosate works by helping to restore the natural balance of brain chemicals that get disrupted by long-term alcohol use. Specifically, it affects neurotransmitters called glutamate and GABA, which play important roles in how your brain responds to stress and reward.

When you drink alcohol regularly over time, your brain adapts by changing how these chemicals work. After you stop drinking, it takes time for your brain to readjust to functioning without alcohol, which can cause cravings, anxiety, and other uncomfortable feelings.

This medication is considered moderately effective rather than a strong intervention. It provides gentle support rather than dramatic changes, which means you might not notice its effects immediately. Many people describe it as helping them feel more stable and less preoccupied with thoughts about drinking.

How Should I Take Acamprosate?

Acamprosate is typically taken three times a day with meals, usually at breakfast, lunch, and dinner. Taking it with food helps your body absorb the medication more effectively and can reduce the chance of stomach upset.

You should take each dose with a full glass of water. The tablets should be swallowed whole and not crushed, chewed, or broken, as this can affect how the medication is released in your body.

It's important to take acamprosate even if you don't feel like it's working right away. The medication needs time to build up in your system, and you might not notice its full effects for several weeks. Consistency is key to getting the maximum benefit from this medication.

How Long Should I Take Acamprosate For?

Most people take acamprosate for about a year, though some may benefit from taking it longer. Your doctor will work with you to determine the right duration based on your individual situation and how well you're responding to treatment.

The medication is most helpful during the first year of sobriety, when the risk of relapse is typically highest. Some people find they can gradually reduce their dose or stop taking it as they develop stronger coping skills and their brain chemistry continues to heal.

Your doctor will regularly check in with you to assess how the medication is working and whether you're ready to consider tapering off. This decision should always be made together with your healthcare provider rather than on your own.

What Are the Side Effects of Acamprosate?

Like all medications, acamprosate can cause side effects, though many people tolerate it well. Understanding what to expect can help you feel more prepared and know when to contact your doctor.

The most common side effects are generally mild and often improve as your body adjusts to the medication:

• Diarrhea (this is the most frequently reported side effect)
• Nausea or stomach discomfort
• Gas or bloating
• Loss of appetite
• Headache
• Dizziness
• Fatigue or weakness
• Dry mouth
• Muscle pain
• Sleep problems

These common side effects usually fade within the first few weeks of treatment. If they persist or become bothersome, your doctor can often adjust your dose or suggest ways to manage them.

Less common but more serious side effects require immediate medical attention. While these are rare, it's important to be aware of them:

• Severe mood changes or thoughts of self-harm
• Signs of kidney problems (changes in urination, swelling in legs or feet)
• Severe allergic reactions (rash, swelling, difficulty breathing)
• Chest pain or irregular heartbeat
• Severe stomach pain or persistent vomiting

If you experience any of these serious side effects, contact your doctor immediately or seek emergency medical care. Remember that serious side effects are uncommon, and most people can take acamprosate safely with proper medical supervision.

Who Should Not Take Acamprosate?

Acamprosate isn't suitable for everyone, and your doctor will carefully review your medical history before prescribing it. Certain health conditions or circumstances make this medication inappropriate or potentially dangerous.

You should not take acamprosate if you have severe kidney disease or kidney failure. The medication is processed through your kidneys, so impaired kidney function can lead to dangerous buildup of the drug in your system.

People who are still actively drinking alcohol should not start acamprosate. The medication is designed to help maintain sobriety, not to help you quit drinking initially. You need to be alcohol-free before starting treatment.

Other situations where acamprosate may not be appropriate include:

• Pregnancy or breastfeeding (safety hasn't been established)
• Severe liver disease
• History of severe depression or suicidal thoughts
• Allergy to acamprosate or any of its ingredients

Your doctor will also consider your age, other medications you're taking, and your overall health status when deciding if acamprosate is right for you.

Acamprosate Brand Names

Acamprosate is most commonly sold under the brand name Campral in the United States. This is the original brand name for the medication and remains the most widely recognized version.

Generic versions of acamprosate are also available, which contain the same active ingredient but may cost less than the brand-name version. Your pharmacist can help you understand the differences between brand-name and generic options.

Whether you take the brand-name or generic version, the medication works the same way and has the same effectiveness. The choice often comes down to insurance coverage and cost considerations.

Acamprosate Alternatives

If acamprosate isn't right for you or isn't working well enough, several other medications can help support alcohol recovery. Each works differently, so your doctor can help you find the best option for your situation.

Naltrexone is another commonly prescribed medication that reduces cravings for alcohol. Unlike acamprosate, it can be taken as a daily pill or a monthly injection, and it works by blocking the pleasurable effects of alcohol.

Disulfiram (Antabuse) takes a different approach by making you feel sick if you drink alcohol. This can be effective for some people, but it requires careful medical supervision and isn't suitable for everyone.

Newer options include topiramate and gabapentin, which are medications originally developed for other conditions but have shown promise in helping with alcohol cravings. Your doctor can discuss whether these might be appropriate for your situation.

Is Acamprosate Better Than Naltrexone?

Both acamprosate and naltrexone are effective medications for supporting alcohol recovery, but they work in different ways and may be better suited for different people. Neither is universally "better" than the other.

Acamprosate tends to be particularly helpful for people who have successfully stopped drinking but struggle with ongoing cravings or anxiety. It works by helping restore brain chemistry balance and is generally well-tolerated.

Naltrexone may be more effective for people who have occasional slips or who struggle with the rewarding aspects of alcohol. It can reduce both cravings and the pleasure you get from drinking, which can help break the cycle of alcohol use.

Some people respond better to one medication than the other, and in some cases, doctors may recommend using both together. Your doctor will consider your specific situation, medical history, and treatment goals when helping you choose between these options.