acamprosate

Adjunctive therapy

Brands: Campral

Last reviewed 2025-12-30

Reviewed by PsychMed Editorial Team.

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Quick answers

What is acamprosate?
Acamprosate (brand Campral; generics) is used to support maintenance of abstinence in alcohol use disorder (AUD) after a person has already stopped drinking (label/guideline).
What is Campral?
Campral is a brand name for acamprosate.
What is Campral (acamprosate) used for?
Label indications include: Maintenance of abstinence in alcohol use disorder in patients who are abstinent at treatment initiation (label).
What drug class is Campral (acamprosate)?
Glutamatergic/GABAergic modulator used to help maintain abstinence in alcohol use disorder after detoxification; best suited for people who are already alcohol-free and want support staying abstinent (label/guideline).
What strengths does Campral (acamprosate) come in?
Oral delayed-release tablets (label): 333 mg.

Snapshot

Class: Adjunctive therapy
Common US brands: Campral
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2025-12-30

Label indications

Maintenance of abstinence in alcohol use disorder in patients who are abstinent at treatment initiation (label).

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Clinical Highlights

Acamprosate (brand Campral; generics) is used to support maintenance of abstinence in alcohol use disorder (AUD) after a person has already stopped drinking (label/guideline). It is not an acute alcohol withdrawal treatment. Withdrawal management (and medical complications like seizures or delirium) is typically addressed first, then relapse-prevention medications are considered as the care plan shifts toward sustained recovery (guideline/clinical).

Compared with some alternatives, acamprosate has minimal hepatic metabolism and is primarily renally eliminated. That can be helpful when liver disease is a major consideration, but it makes renal function an important constraint for safe use (label).
Clinical trials and systematic reviews suggest acamprosate can increase continuous abstinence rates versus placebo when paired with counseling and follow-up, especially when started in people who are already abstinent (review/guideline).
Adherence can be a practical limitation because the labeled regimen is split dosing across the day; in real-world use, medication selection often weighs this against tolerability, medical comorbidities, and the person’s treatment goals (abstinence-focused vs reduction-focused) (label/clinical).
The compare view, acamprosate evidence feed, and acamprosate print page support counseling when alcohol use disorder treatment is being discussed alongside mood symptoms, sleep disruption, and relapse-risk planning.

Dosing & Formulations

Oral delayed-release tablets (label): 333 mg. Label dosing is divided across the day (often three times daily) and is typically started once abstinence is achieved (label/guideline).

Dose reduction is recommended in moderate renal impairment and the medication is not recommended in severe renal impairment (label).
If adherence to multiple daily dosing is not realistic, clinicians often discuss alternative relapse-prevention options rather than relying on a regimen that is unlikely to be taken consistently (clinical).

Monitoring & Risks

Common adverse effects include diarrhea and other GI symptoms; these are often the main tolerability reasons people stop the medication early (label/clinical). Mood symptoms and suicidality have been reported in clinical trials; in practice, monitoring usually reflects standard care for co-occurring depression or anxiety during early recovery (label/clinical).

Renal function is a key safety parameter because acamprosate is renally cleared; baseline kidney assessment and periodic re-checks are commonly used when medical comorbidity is present (label/clinical).
Because acamprosate is not sedating and has few pharmacokinetic interactions, it is often considered when polysubstance use or complex medication lists make other options more complicated (clinical).

Drug Interactions

Clinically meaningful pharmacokinetic interactions are limited because acamprosate is not significantly metabolized and is largely excreted unchanged (label). Interaction checks still matter in alcohol use disorder care because people may also be treated with antidepressants, benzodiazepines (for withdrawal), sleep agents, or pain medicines; overall regimen safety is typically assessed as a whole (clinical).

Practice Notes

Guidelines often position acamprosate alongside naltrexone as a first-line pharmacotherapy option for alcohol use disorder (AUD), with selection guided by liver/renal considerations, goals of treatment, and past response (guideline). When the goal is sustained abstinence (rather than reduction), many clinicians prefer acamprosate’s “abstinence-support” framing and pair it with structured follow-up, therapy, and relapse-prevention planning (clinical).

References

Acamprosate Calcium Delayed Release Tablets Prescribing Information — DailyMed (2025)
Pharmacotherapy FOR Adults With Alcohol USE Disorders IN Outpatient Settings: A Systematic Review AND Meta Analysis — JAMA (2014)
The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder — American Journal of Psychiatry (2018)
Anticraving therapy for alcohol use disorder: A clinical review — Neuropsychopharmacology Reports (2018)