Acamprosate (Oral)

Alcoholism and dependency have had a significant impact on many people over the years, and Acamprosate is a medicine that goes under the trade name Campral.

Overview

One of the problems that seems to occur in people who are trying to quit alcohol is that they encounter a chemical imbalance in the brain during a period of withdrawal. For that reason, Acamprosate can help to stabilize this situation so that the chance of a relapse decreases, and there has been research showing that abstinence rates do increase as well. If this medication is combined with some type of therapeutic intervention in the form of a counselor, then that is likely to help it work best so that individuals can at least achieve reduced consumption or, in the best cases, total sobriety even if they have had problems doing so in the past.

The medicine first began to be marketed by Forest Laboratories inside of the United States, and in other foreign countries, this process was handled by the company Merck KGaA. It can basically act as naltrexone, and is usually given over a period of something like three to twelve months total in order to see this helpful effect. Europe has had a longer past with Acamprosate because of the fact that it has been in use there since 1989. However, the United States only gave Food and Drug Administration approval to it in 2004. It took this long because of some concerns about uncertainty in regards to the exact mechanism of action that was allowing it to achieve the results in addicted people. The Campral prescription drug has now become a generic form within the United States.

Treated Conditions

  • Alcohol dependence

Type of Medicine

  • Delayed-release tablet 333mg

Side Effects

The range of side effects experienced with Acamprosate can be quite diverse, and a physician should be consulted if any of these occur so that they can be taken into consideration:

  • dry mouth
  • dizziness
  • anxiety
  • difficulty falling asleep or staying asleep
  • sweating
  • diarrhea
  • itching
  • weakness
  • nausea
  • gas
  • upset stomach
  • loss of appetite

The aforementioned are some of the more minor side effects that are commonly seen. However, there are more serious ones that need immediate medical attention should they manifest, and they are the following:

  • rash
  • burning, numbness, or tingling in the hands, feet, arms, or legs

Also, any mood changes or altered behavior is a reason to seek swift medical attention. This is especially true if the patient is starting to have thoughts about harming themselves or if there is confusion and disorientation that was not present before taking the medication.

These side effects are quite diverse and so they can come to affect many different regions depending on the person, but most of the time these are mild enough that the medication prescription can be continued without having to drop out. For example, in the gastrointestinal section, only diarrhea was significant enough to cause a dropout rate that was greater than 1% in the trials where there was a control group as well. The nervous system and cardiovascular system both also have a diverse range of possible problems that include anxiety, insomnia, dizziness, palpitations, and hypertension. Anemia, ecchymosis, eosinophilia, lymphocytosis, and thrombocytopenia have all been seen in relation to the hematologic system. With the genitourinary system, the main problem reported has been impotence.

Weight gain has been seen as a side effect in the metabolic system, and peripheral edema is secondary. Myalgia and arthralgia have been seen in patients' musculoskeletal system. Leg cramps were also reported in a number of instances. The top dermatological side effects that were seen in patients during trials include pruritus, rash, and sweating. One instance of the skin condition erythema multiforme was seen in a 40-year old woman who had cirrhosis of the liver, but it is not certain whether acamprosate was the actual cause or whether a herpes simplex virus led to the condition.

SGOT along with an increased SGPT are some of the frequently seen side effects in relation to the hepatic system. Immunologic responses have been an infection, chills, and the flu syndrome. The respiratory effects might include an increased cough along with rhinitis, pharyngitis, and bronchitis with asthma increase reported at a lesser rate. Finally, the psychiatric effects might include depression or suicidal ideation, anger, and hostility. These all need to be reviewed carefully if they manifest in a patient using the acamprosate.

Dosage

These delayed-release tablets come in a 333mg form, and the recommended dosage of these is two for three times daily. Lower doses may be recommended depending on the individual circumstances, but the general advice is to take the total of 666mg thrice daily. It is best to take this dosage at the same time as a meal so that there is food that can help the body to properly absorb the Acamprosate and to achieve full efficacy. However, it can be taken without food if a person does not eat three times each day or just has to miss a meal.

Drug Interactions

There are no known drug interactions that have been discovered between Acamprosate and anything else. This does not necessarily mean that there is nothing to be concerned about because everything combination has not been tested, and patients taking this drug should always proceed with caution with a readiness to alert the prescribing physician if any new symptoms or complications become present. The interactions that have been looked at already through research are alcohol, disulfiram, diazepam, and imipramine.

Warnings

The Acamprosate that has been utilized by the body is then subsequently removed by the patient's kidneys. For this reason, it is important that anyone with severe kidney impairment is not given this medication. The level of impairment that is considered severe in this regard is a metric of a creatinine clearance that is less than 30ml per minute. It is possible that those patients who only have a moderate impairment of their kidneys are still able to take Acamprosate in order to assist with their alcohol cessation, but the dose will need to be made lower because of the fact that the organs are not able to act as strongly as they might in a healthier person. For this consideration, the measurement that would be considered moderate complication is a level of creatinine clearance of between 30 to 50ml per minute.

Acamprosate calcium is the substance that is used in the capsules, and it is important that anyone who has a strong allergic reaction to such avoid the medication because that is considered a contraindication. Also, there have been investigations into various acute overdoses of the medication with the maximum reported amount taken being at the level of 56 grams, but even then the only linked adverse reaction was diarrhea. Alcohol consumption should be avoided while taking Acamprosate so that it does not interfere with the mechanism, and if a consumer does relapse, then it is important to advise a doctor about this indiscretion.

Storage

The medicine is generally stored in Opaque HDPE bottles with a count of 180 tablets per bottle. This needs to be kept at a temperature of 77 degrees Fahrenheit (25 degrees Celsius) for most of the time, although it can be taken out to areas of between 59 to 86 degrees Fahrenheit (15 to 30 degrees Celsius) for short periods such as when about to be administered to a patient.

Summary

While this medication is primarily used as an adjunct to other treatment options for Alcoholism such as the 12-step program and group therapy, it does seem to have a significant efficacy in reducing the relapse rate of patients during the withdrawal stage. That stage can be the hardest hurdle to overcome, and if this medication can help push through that region, then it is more likely that a patient will be able to maintain complete abstinence for the future. It is a fact that within America there is about one-third of the population that is taking in enough alcohol that they are considered at risk for adverse medical effects related to that substance. Many countries in the rest of the world, especially the developed part of the globe, have similar rates of abuse.

The amount of money that this abuse is costing annually is already in the range of the hundreds of billions. Therefore, it is important that alcoholism is treated for the health benefit of the population, but there is also a monetary incentive that should help to push progress in this arena. The side effects related to the use of Acamprosate are low, and it has been shown to be a safe treatment option for most people except those that have one of the problematic conditions listed in the warning section above. Hopefully, this medication will continue to help people to stay away from the darkness that lies within alcoholism and the disease of progression that so many fall to.

Resources
Last Reviewed:
December 10, 2017
Last Updated:
April 04, 2018
Content Source: