Thursday September 29th 2016

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Is acamprosate safe?

Yes, acamprosate is a safe medication.

What is it? Acamprosate is a medication used along with counselling in the treatment of alcohol dependence. Sold under the brand name “Campral”, acamprosate can be safely used, even in alcohol-dependent people including those taking other medications, or people who have been diagnosed with  renal or hepatic impairment.

But what is the safe dosage of acamprosate use? Can its use cause serious side effects? Plus, some may be wondering if acamprosate is safe for long-term treatment, or not. We’ll review these questions here. Then, we invite your questions about the safe use of acamprosate at the end. In fact, we try to answer ALL legitimate questions personally and promptly.

Acamprosate safety

Acamprosate is safe and acceptably tolerated by most people, but in order to be useful, you need to take it as prescribed. Acamprosate is effective to help you achieve abstinence from alcohol…as long as you are taking it. It can take 5-8 days before acamprosate is fully effective. So, how does acamprosate work in the brain?

To be honest, scientists don’t know exactly. Drinking alcohol for a long time changes the way the brain works. Acamprosate works by helping the brains of people who have drunk large amounts of alcohol to work normally again. Acamprosate is thought to stabilize the chemical balance in the brain that would otherwise be disrupted by alcohol withdrawal.

Although acamprosate’s mechanism of action has not been clearly established, it is thought to work by reducing symptoms of postacute (protracted) withdrawal, such as:

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  • anxiety
  • insomnia
  • restlessness

NOTE HERE: Acamprosate does not prevent withdrawal symptoms that people may experience when they stop drinking alcohol.  While it can help you stop drinking (and stay stopped) acamprosate is most effective when used along with counseling and social support. So, acamprosate has not been shown to work in people who have not stopped drinking alcohol or in people who drink large amounts of alcohol and also overuse or abuse other substances such as street drugs or prescription medications.

Can taking acamprosate cause serious side effects?

Not usually.

Acamprosate can cause side effects, but these are usually minor and go away as patients continue to take the medication. You should tell your medical clinician if any of these side effects do not go away:

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

Uncommon serious side effects that may appear when you take acamrposate can include three major problems. If you experience either of them call your doctor immediately.

  • burning, tingling, or numbness in the hands, feet, arms, or leg
  • rash
  • suicidal thinking

In fact, suicidal events (suicidal ideation, attempted suicides, completed suicides) were recorded during clinical studies. Although rare, these serious thoughts were more common in acamprosate-treated participants than in participants receiving placebo. Therefore, if you are taking acamprosate, you should be monitored for symptoms of depression or suicidal thinking. Plus, families and caregivers should be informed of the need to monitor for these signs and report their occurrence to the substance abuse treatment counselor or prescribing professional.

Acamprosate safe dosage: How much acamprosate is safe to take?

The recommended dosage of Campral is two (2) 333 mg tablets three (3) times a day, with or without food. To help you remember to take acamprosate, take it around the same times every day. Taking acamprosate with breakfast, lunch, and dinner may help you to remember all three doses.

Treatment with acamprosate should be initiated as soon as possible after alcohol withdrawal and should be maintained even during a slip or relapse back to drinking. So, how long should you continue taking acamprosate? Treatment at this recommended dosage usually ranges from 3-12 months in clinical trials.

The manufacturer recommends treatment duration of one (1) full year. However, if you take too much acamprosate regularly for a long time, you may experience certain symptoms. Is acamprosate addictive? No. Still, call your doctor if you experience any of these symptoms:

  • confusion
  • constipation
  • extreme thirst
  • loss of appetite
  • muscle weakness
  • restlessness
  • tiredness
  • upset stomach

In any case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

How to use acamprosate safely?

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part of the prescribing guidelines that you do not understand. Take acamprosate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the tablets whole, do not split, chew, or crush them.

Acamprosate helps to prevent you from drinking alcohol only as long as you are taking it. If you drink alcohol while you are taking acamprosate, continue to take the medication and call your doctor. Acamprosate will not cause you to have an unpleasant reaction if you drink alcohol during treatment.

Acamprosate is not a miracle drug; continue counseling and 12-Step or mutual-help group participation while on acamprosate. Plus, we believe that people who take acamprosate should be informed about the benefits and limitations of the medication. Some other considerations include:

  1. Inform all treatment providers immediately if you become pregnant during therapy, if you are trying to become pregnant, or if you are breast-feeding.
  2. Report side effects of the drug.
  3. Talk to your prescribing professional about the duration of acamprosate therapy.
  4. Talk to your prescribing professional about other medications you are taking.
  5. You should be cautious driving or operating heavy machinery until you are certain that acamprosate has no adverse effects on your participation in these activities and you have adjusted to the drug.
  6. You should continue taking the medication if a slip or relapse occurs and to inform your counselor and prescribing professional immediately.

Is acamprosate safe for long term use?

The effectiveness and safety of the medication have not been evaluated for periods of use longer than a year. So, acamprosate therapy can be continued for one (1) year. Given this guideline, the length of time a particular person takes acamprosate will be determined, ideally, with input from the prescribing professional, the treatment provider, and the patient.

Acamprosate does not get you high and appears to have no potential for abuse; people maintained on the drug have developed no known tolerance for or dependence on it. It also carries little overdose risk. Even at overdoses up to 56 grams (a normal daily dose is 2 grams), acamprosate was generally well tolerated.

When should you stop taking acamprosate?

Discontinuation of acamprosate may be considered once you have:

1.  Achieved stable abstinence from alcohol
2.  Established a sound plan and support for ongoing recovery
3.  Report diminished craving for alcohol

Acamprosate therapy also may be discontinued if/when you are not compliant with the medication regimen. Acamprosate should not be discontinued just because a patient slips or relapses.

How to come off acamprosate safely?

There is no withdrawal syndrome associated with discontinuing acamprosate, and it is NOT necessary to taper the dose if you want to quit. However, you should not stop taking acamprosate without talking to your doctor first.

Acamprosate safety questions

Do you still have questions about acamprosate safety use? Please leave them here. We are happy to help answer your questions personally and promptly. If we do not know the answer to your particular question, we will refer you to someone who does.

Reference Sources: NCBI: Acamprosate: safety and tolerability in the treatment of alcohol dependence
NCBI: Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review
Medline Plus: Acamprosate: Why is this medication prescribed?
SAMHSA: Acamprosate: A New Medication for Alcohol Use Disorders
SAMHSA Store: Acamprosate

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