acamprosate
General
Pronunciation:
a-cam-pro-sate
Trade Name(s)
- Campral
Ther. Class.
alcohol abuse therapy adjuncts
Pharm. Class.
gamma aminobutyric acid gaba analogues
Indications
Maintenance of alcohol abstinence; part of a comprehensive alcohol abstinence program.
Action
Interacts with and restores balance to CNS glutamate and GABA neurotransmitter systems.
Therapeutic Effect(s):
Continued alcohol abstinence.
Pharmacokinetics
Absorption: 11% absorbed following oral administration.
Distribution: Unknown.
Metabolism and Excretion: Not metabolized, excreted mainly unchanged in urine.
Half-life: 20–33 hr.
TIME/ACTION PROFILE (blood levels)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
PO | unknown | 3–8 hr | unknown |
Contraindication/Precautions
Contraindicated in:
- Hypersensitivity
- CCr ≤30 mL/min.
Use Cautiously in:
- CCr 30–50 mL/min (dose ↓ necessary)
- History of depression or suicide attempt
- OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk
- Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
- Pedi: Safety and effectiveness not established in children.
Adverse Reactions/Side Effects
CNS: abnormal thinking, anxiety, depression, drowsiness, headache
CV: palpitations, peripheral edema, syncope, vasodilation
Derm: rash
EENT: abnormal vision
GI: abdominal pain, anorexia, constipation, diarrhea, flatulence, ↑ appetite, nausea, taste perversion, vomiting
GU: ↓ libido, erectile dysfunction
Metabolic: weight gain
MS: arthralgia, back pain, myalgia
Neuro: tremor
Resp: cough, dyspnea, pharyngitis, rhinitis
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
Interactions
Drug-Drug
None reported.
Route/Dosage
PO (Adults): Two 333-mg tablets (666 mg/dose) 3 times daily. Lower doses may be effective in some patients.
Renal Impairment
PO (Adults): CCr 30–50 mL/min– One 333-mg tablet 3 times daily.
Availability (generic available)
Delayed-release tablets: 333 mg
Assessment
- Assess for signs of alcohol withdrawal at start of therapy. Acamprosate does not eliminate or diminish withdrawal symptoms.
Lab Test Considerations:
May cause anemia, lymphocytosis, thrombocytopenia, hyperglycemia, abnormal liver function tests, ↑ AST, ↑ ALT, hyperuricemia, and bilirubinemia.
Potential Diagnoses
- Ineffective coping (Indications)
Implementation
- Treatment with acamprosate should be started as soon as possible after the period of alcohol withdrawal, when the patient has achieved abstinence, and should be continued if the patient relapses.
- PO Administer without regard to meals. May be given with meals to increase adherence.
Patient/Family Teaching
- Instruct patient to take medication as directed, even if relapse occurs. Advise patient to discuss any renewed drinking with health care professional.
- May cause dizziness and changes in vision. Caution patients to avoid driving and other activities requiring alertness until response to medication is known.
- Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
- Encourage patient to continue active counseling and support. Acamprosate helps maintain abstinence only when used as part of a comprehensive psychosocial treatment program.
Evaluation/Desired Outcomes
Continued abstinence from alcohol.
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Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drugs, procedures, and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and PRIME Journals. Complete Product Information.