acamprosate

General

Pronunciation:
a-cam-pro-sate

Trade Name(s)

  • Campral Canadian Trade name

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)

ROUTEONSETPEAKDURATION
POunknown3–8 hrunknown

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

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. .