Pharmacologic class: Gamma-aminobutyric acid (GABA) analogue
Therapeutic class: Detoxification agent
Pregnancy risk category C
Unclear. May interact with glutamate and GABA neurotransmitter systems centrally, restoring balance between neuronal excitation and inhibition (which is altered by chronic alcoholism).
Tablets (enteric-coated): 333 mg
Indications and dosages
➣ To maintain abstinence from alcohol in patients with alcohol dependence who are abstinent when treatment begins
Adults: 2 tablets P.O. t.i.d.
• Moderate renal impairment
• Hypersensitivity to drug
• Severe renal impairment
Use cautiously in:
• mild to moderate renal impairment
• suicidal ideation or behavior
• elderly patients
• breastfeeding patients
• Give without regard to meals.
• Don't crush or break enteric-coated tablet.
• Know that drug helps maintain alcohol abstinence only when used as part of treatment program that includes counseling and support.
CNS: apathy, confusion, agitation, neurosis, malaise, somnolence, abnormal thinking, vertigo, asthenia, anxiety, depression, dizziness, insomnia, paresthesia, tremor, withdrawal syndrome headache, migraine, abnormal dreams, hallucinations, seizures, suicidal ideation or suicide attempt
CV: chest pain, palpitations, syncope, hypotension, angina pectoris, varicose veins, phlebitis, peripheral edema, orthostatic hypotension, vasodilation, tachycardia, hypertension, myocardial infarction
EENT: abnormal vision, amblyopia, hearing loss, tinnitus, rhinitis, pharyngitis
GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, flatulence, belching, gastroenteritis, gastritis, esophagitis, hematemesis, dry mouth, anorexia, pancreatitis, rectal hemorrhage, GI hemorrhage
GU: urinary frequency, urinary tract infection, urinary incontinence, erectile dysfunction, increased or decreased libido, metrorrhagia, vaginitis
Hematologic: anemia, ecchymosis, eosinophilia, lymphocytosis, thrombocytopenia
Hepatic: hepatic cirrhosis
Metabolic: hyperglycemia, diabetes mellitus, hyperuricemia, gout, avitaminosis
Musculoskeletal: joint, muscle, neck, or back pain
Respiratory: cough, dyspnea, bronchitis, epistaxis, pneumonia, asthma
Skin: pruritus, sweating
Other: abnormal taste, increased thirst, increased appetite, weight gain or loss, pain, infection, flulike symptoms, chills, abscess, hernia, allergic reaction, accidental or intentional injury, intentional overdose
Drug-drug. Naltrexone: increased acamprosate blood level
Drug-diagnostic tests. Bilirubin, eosinophils, lymphocytes: increased levels
Liver function tests: abnormal results
Red blood cells: decreased count
☞ Monitor patient for depression or expressed suicidal ideation.
• Monitor creatinine clearance during therapy.
• Instruct patient to swallow tablet whole, with or without food.
• Advise patient to keep taking drug exactly as prescribed, even if he has a relapse. Encourage him to discuss any renewed alcohol consumption with prescriber.
☞ Instruct patient to contact prescriber immediately if he experiences seizure, chest pain, suicidal thoughts, or symptoms of liver problems (such as unusual tiredness or yellowing of skin or eyes).
• Caution patient to move slowly to a sitting or standing position, to avoid dizziness or light-headedness from a sudden blood pressure decrease.
• Advise patient to avoid driving and other hazardous activities until he knows how drug affects concentration, alertness, vision, coordination, and physical dexterity.
• Instruct female patient to notify prescriber if she becomes or intends to become pregnant or to breastfeed during therapy.
• Inform patient that drug helps maintain abstinence from alcohol only when used as part of treatment program that includes counseling and support.
• Emphasize that drug doesn't eliminate or diminish alcohol withdrawal symptoms.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.
acamprosate calcium(a-cam-pro-sate) ,
ClassificationTherapeutic: alcohol abuse therapy adjuncts
Pharmacologic: gamma aminobutyric acid gaba analogues
Time/action profile (blood levels)
Adverse Reactions/Side Effects
Central nervous system
- abnormal thinking
Ear, Eye, Nose, Throat
- abnormal vision
- peripheral edema
- abdominal pain
- ↑ appetite
- taste perversion
- ↓ libido
- erectile dysfunction
- weight gain
- back pain
Drug-Drug interactionNone noted.
Renal ImpairmentOral (Adults) CCr 30–50 mL/min—One 333-mg tablet 3 times daily.
Availability (generic available)
- Assess for signs of alcohol withdrawal at initiation 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 Nursing DiagnosesIneffective coping (Indications)
- Treatment with acamprosate should be initiated as soon as possible after the period of alcohol withdrawal, when the patient has achieved abstinence, and should be continued if the patient relapses.
- Oral: Administer without regard to meals. May be given with meals to increase adherence.
- 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 breast feeding...
- Encourage patient to continue active counseling and support. Acamprosate helps maintain abstinence only when used as part of a comprehensive psychosocial treatment program.
- Continued abstinence from alcohol.