II. Indications
- Maintenance of Alcohol abstinence
III. Contraindications
- Severe Renal Insufficiency (CrCl <30 ml/min)
- Advanced Cirrhosis (although appears safe in most with impaired hepatic function)
IV. Mechanism
- Balances GABA and glutamate Neurotransmitters
- Reduces anxiety from abstinence
V. Efficacy
- Reduces short and longterm relapse rates
- Sustains Alcohol abstinence (NNT 12) and reduces Problem Drinking (NNT 9)
VI. Dosing
- Campral 666 mg (two 333 mg tabs) orally three times daily
- Start with one three times daily
- Increase with one additional tablet daily each week
- Slow titration reduces gastrointestinal side effects
- Indications to decrease to 333-666 mg AM, 333 noon, 333 PM
- Weight <60 kg
- Renal Insufficiency
- Creatinine Clearance <50 ml/min, but >30 ml/min
- Contraindicated if Creatinine Clearance <30 ml/min
VII. Drug Interactions
- No interaction with Alcohol or Benzodiazepines
- No interaction with Disulfiram (Antabuse)
VIII. Safety
- Pregnancy Category C
- Lactation: Unknown
IX. Adverse effects
- Transient Diarrhea (10%) and other gastrointestinal symptoms (Flatulence, Nausea)
- Insomnia
- Depressed mood
- Pruritus
- Paresthesias
- Diaphoresis
X. Disadvantages
- Cost: $150/month trade name (but generic available for $55 per month)
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Related Studies
acamprosate (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
ACAMPROSATE CALC DR 333 MG TAB | Generic | $0.52 each |