Acamprosate

Overview

Anti-craving agent indicated to maintain abstinence in alcohol-dependent patients. Use with counselling; initiate after the withdrawal period and continue if relapse occurs.

Clinical Focus

Renal function is the key safety limiter: Australian PI contraindicates use in renal insufficiency (serum creatinine >120 micromol/L). Severe hepatic failure (Child-Pugh C), pregnancy, and breastfeeding are contraindications; avoid use in children/adolescents <18 and adults >65 because safety/efficacy are not established.

Bottom Line

Acamprosate is an anti-craving agent for maintaining alcohol abstinence after detoxification, but requires good renal function and is only effective when combined with psychosocial support.

Brand Names

Campral

Oral Routes

Enteric-coated tablets (333 mg). Do not crush.

Prescribing & PBS

Authority Required (STREAMLINED PBS), item 8357W; acamprosate calcium 333 mg enteric tablet, 180.

Primary

Maintenance of abstinence in alcohol-dependent patients.

Clinical Place

First-line relapse-prevention option for patients seeking abstinence, alongside naltrexone. Particularly useful when opioid therapy makes naltrexone unsuitable, but avoid renal insufficiency and severe hepatic failure (Child-Pugh C).