acamprosate

Contraindicated in:

Hypersensitivity;
Severe renal impairment.

Use Cautiously in:

Moderate renal impairment (↓ dose);
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.

Adv. Reactions/Side Effects ⬆ ⬇

CV: palpitations, peripheral edema, syncope, vasodilation

Derm: rash

EENT: abnormal vision, pharyngitis, rhinitis

GI: abdominal pain, anorexia, constipation, diarrhea, flatulence, nausea, taste perversion, vomiting

GU: ↓libido, erectile dysfunction

Metab: ↑appetite, weight gain

MS: arthralgia, back pain, myalgia

Neuro: abnormal thinking, anxiety, depression, drowsiness, headache, tremor

Resp: cough, dyspnea

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

(Generic available)

Delayed-release tablets: 333 mg

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.

Action ⬆ ⬇

Interacts with and restores balance to CNS glutamate and GABA neurotransmitter systems.

Therapeutic effects:

Continued alcohol abstinence.

Classifications ⬆ ⬇

Therapeutic Classification: alcohol abuse therapy adjuncts

Pharmacologic Classification: gamma aminobutyric acid gaba analogues

Pharmacokinetics ⬆ ⬇

Absorption: 11% absorbed following oral administration.

Distribution: Unknown.

Metabolism/Excretion: Not metabolized; excreted mainly unchanged in urine.

Half-Life: 20–33 hr.

Canadian Brand Names ⬆ ⬇

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	3–8 hr	unknown

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.
Rep: Advise females of reproductive potential 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.

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Indications ⬇

Contraind./Precautions ⬆ ⬇