Acamprol (acamprosate calcium) is a prescription medication specifically developed to support the maintenance of abstinence in alcohol-dependent patients following detoxification. As a synthetic compound with a structure similar to that of endogenous amino acid neurotransmitters, it modulates the dysregulated glutamatergic and GABAergic systems associated with chronic alcohol use. Its mechanism of action targets the neuroadaptations that sustain craving and relapse, offering a pharmacological approach to complement psychosocial interventions in comprehensive treatment programs. Clinical studies demonstrate its efficacy in increasing cumulative abstinence duration and reducing relapse rates when used as part of a structured therapeutic regimen.

Features

• Contains acamprosate calcium as the active pharmaceutical ingredient
• Delayed-release tablet formulation for consistent systemic delivery
• Standardized 333 mg enteric-coated tablets
• Designed for twice-daily oral administration
• Stable at room temperature with protection from moisture
• Manufactured under current Good Manufacturing Practice (cGMP) standards

Benefits

• Reduces physiological craving for alcohol by normalizing neurotransmitter imbalances
• Supports long-term abstinence maintenance when combined with counseling
• Demonstrates favorable safety profile with minimal abuse potential
• Does not require hepatic metabolism, making it suitable for patients with liver impairment
• Shows no pharmacokinetic interactions with disulfiram or naltrexone
• Provides continuous effect with consistent dosing regimen

Common use

Acamprol is indicated for the maintenance of abstinence in alcohol-dependent patients who have achieved initial detoxification. It is typically initiated as soon as possible after the acute withdrawal period, once physical withdrawal symptoms have subsided. The medication is most effective when integrated into a comprehensive treatment program that includes psychological support, counseling, and social rehabilitation. Treatment duration generally ranges from several months to over a year, depending on individual patient needs and treatment response. Clinical evidence supports its use in both first-time and recurrent treatment scenarios.

Dosage and direction

The recommended dosage of Acamprol is 666 mg (two 333 mg tablets) taken three times daily. For patients with moderate renal impairment (creatinine clearance 30-50 mL/min), the dosage should be reduced to 333 mg three times daily. Administration should occur with meals to enhance gastrointestinal tolerance, though food does not significantly affect absorption. Tablets should be swallowed whole without crushing or chewing to preserve the enteric coating. Treatment initiation should occur after the completion of alcohol withdrawal, typically within one week of abstinence. Duration of therapy should be individualized based on treatment response and patient circumstances.

Precautions

Patients should be monitored for emergence of depression or suicidal ideation, particularly during early treatment phases. Renal function should be assessed before initiation and periodically during treatment, with dosage adjustment for impaired renal function. Use with caution in patients with known hypersensitivity to acamprosate calcium or any excipients in the formulation. While Acamprol does not cause alcohol-disulfiram-like reactions, continued alcohol consumption during treatment may reduce efficacy and worsen outcomes. Patients should be advised that Acamprol does not eliminate withdrawal symptoms nor reduce the intoxicating effects of alcohol.

Contraindications

Acamprol is contraindicated in patients with severe renal impairment (creatinine clearance ≤30 mL/min) due to reduced elimination and potential accumulation. It should not be used during pregnancy unless clearly necessary, as human data are limited. Breastfeeding is not recommended during treatment due to excretion in milk. Concomitant use with other medications that significantly affect renal function requires careful consideration. Hypersensitivity to acamprosate calcium or any component of the formulation constitutes an absolute contraindication.

Possible side effects

The most frequently reported adverse reactions include diarrhea (occurring in approximately 10-15% of patients), nausea, abdominal pain, and pruritus. These gastrointestinal effects are typically mild to moderate in intensity and often diminish with continued treatment. Less common reactions may include headache, dizziness, insomnia, anxiety, and fatigue. Cutaneous reactions including rash and urticaria have been reported in some patients. Laboratory abnormalities are infrequent but may include fluctuations in liver enzymes and electrolyte imbalances. Most side effects occur during the initial treatment period and decrease in frequency with continued therapy.

Drug interaction

Acamprol demonstrates low protein binding and is not metabolized by cytochrome P450 enzymes, minimizing its potential for pharmacokinetic interactions. No clinically significant interactions have been observed with disulfiram, diazepam, or antidepressants. Concomitant administration with naltrexone does not affect the pharmacokinetics of either drug. However, medications that affect renal function may alter acamprosate clearance. While theoretical interactions exist with other drugs acting on the GABA system, no clinically relevant interactions have been documented. Nevertheless, caution should be exercised when combining with CNS depressants.

Missed dose

If a dose is missed, patients should take it as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling of doses to make up for missed administrations is not recommended. Consistent adherence to the prescribed three-times-daily regimen is important for maintaining stable plasma concentrations and optimal therapeutic effect. Patients should be educated about the importance of regular dosing and strategies to maintain adherence.

Overdose

Experience with Acamprol overdose is limited. In reported cases, doses up to 56 grams have been associated with diarrhea but no other serious symptoms. Given its mechanism of action and safety profile, serious consequences of overdose are unlikely. However, symptomatic and supportive measures should be instituted as appropriate. Gastrointestinal decontamination may be considered if ingestion occurred recently. Hemodialysis may enhance elimination due to the drug’s water solubility and low molecular weight, though specific data are limited. Medical supervision is recommended for any suspected overdose situation.

Storage

Acamprol tablets should be stored at room temperature (15-30°C/59-86°F) in their original container with the lid tightly closed. Protection from moisture is essential to maintain tablet integrity and prevent degradation of the enteric coating. The medication should be kept out of reach of children and pets. Tablets should not be used beyond the expiration date printed on the packaging. Proper storage conditions help ensure stability and efficacy throughout the product’s shelf life.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Acamprol is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Treatment decisions must be based on individual patient assessment by a licensed practitioner. Patients should not adjust dosage or discontinue treatment without medical consultation. The manufacturer and distributors are not liable for any consequences arising from the use or misuse of this information.

Reviews

Clinical trials involving over 4,000 patients demonstrate Acamprol’s efficacy in maintaining abstinence, with meta-analyses showing significant improvement in continuous abstinence rates compared to placebo. Treatment effects typically emerge within the first month and are sustained throughout therapy. Real-world evidence supports its effectiveness in diverse patient populations when integrated with comprehensive treatment programs. Patient-reported outcomes indicate reduced craving intensity and improved quality of life measures. Long-term follow-up studies suggest sustained benefits post-treatment in a significant proportion of patients. The medication has received regulatory approval in multiple countries based on robust clinical evidence.