Campral

acamprosate calcium

Campral

Pharmacologic class: Gamma-aminobutyric acid (GABA) analogue

Therapeutic class: Detoxification agent

Pregnancy risk category C

Action

Unclear. May interact with glutamate and GABA neurotransmitter systems centrally, restoring balance between neuronal excitation and inhibition (which is altered by chronic alcoholism).

Availability

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.

Dosage adjustment

• Moderate renal impairment

Contraindications

• Hypersensitivity to drug

• Severe renal impairment

Precautions

Use cautiously in:

• mild to moderate renal impairment

• suicidal ideation or behavior

• elderly patients

• breastfeeding patients

• children.

Administration

• 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.

Adverse reactions

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

Interactions

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

Patient monitoring

Monitor patient for depression or expressed suicidal ideation.

• Monitor creatinine clearance during therapy.

Patient teaching

• 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) ,

Campral

(trade name)

Classification

Therapeutic: alcohol abuse therapy adjuncts
Pharmacologic: gamma aminobutyric acid gaba analogues
Pregnancy Category: C

Indications

Maintenance of alcohol abstinence; part of a comprehensive alcohol abstinence program.

Action

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

Therapeutic effects

Continued alcohol abstinence.

Pharmacokinetics

Absorption: 11% absorbed following oral administration.
Distribution: Unknown.
Metabolism and Excretion: Not metabolized, excreted mainly unchanged in urine.
Half-life: 20–33 hr.

Time/action profile (blood levels)

ROUTEONSETPEAKDURATION
POunknown3–8 hrunknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity; CCr ≤30 mL/min.
Use Cautiously in: CCr 30–50 mL/min (dose ↓ necessary); History of depression or suicide attempt; Obstetric: Use only if potential maternal benefit outweighs fetal risk; Lactation / Pediatric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • abnormal thinking
  • anxiety
  • depression
  • drowsiness
  • headache

Ear, Eye, Nose, Throat

  • abnormal vision

Respiratory

  • cough
  • dyspnea
  • pharyngitis
  • rhinitis

Cardiovascular

  • palpitations
  • peripheral edema
  • syncope
  • vasodilation

Gastrointestinal

  • abdominal pain
  • anorexia
  • constipation
  • diarrhea
  • flatulence
  • ↑ appetite
  • nausea
  • taste perversion
  • vomiting

Genitourinary

  • ↓ libido
  • erectile dysfunction

Dermatologic

  • rash

Metabolic

  • weight gain

Musculoskeletal

  • arthralgia
  • back pain
  • mylagia

Neurologic

  • tremor

Interactions

Drug-Drug interaction

None noted.

Route/Dosage

Oral (Adults) Two 333-mg tablets (666 mg/dose) 3 times daily. Lower doses may be effective in some patients.

Renal Impairment

Oral (Adults) CCr 30–50 mL/min—One 333-mg tablet 3 times daily.

Availability (generic available)

Tablets: 333 mg

Nursing implications

Nursing assessment

  • 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 Diagnoses

Ineffective coping (Indications)

Implementation

  • 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.

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.
  • 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.

Evaluation/Desired Outcomes

  • Continued abstinence from alcohol.
References in periodicals archive ?
Acamprosate * Campral Acetaminophen * Tylenol Baclofen * Lioresal Bupropion * Zyban Disulfiram * Antabuse Naltrexone * Revia, Vivitrol Varenidine * Chantix
Contract award notice: Upgrading of campral stadium in bergerac
The solutions gap: that is, the relationship between medical treatment and addiction arising from the news article's description of the pharmaceutical Campral (acamprosate) and alternative "social solutions" brought up by the interviewees.
Acamprosate (calcium acetylhomotaurinate, brand name Campral) is an amino acid (homotaurine) derivative.
Campral prices, coupons and patient assistance programs.
He also led the organization through the approval and launch of Bystolic for hypertension and Campral for alcohol dependency.
They found that two drugs, acamprosate (brand name Campral) and oral naltrexone (brand name Revia), have the best evidence supporting their benefits.
The role of antabuse (disulfiram), naltrexone, Campral, methadone, and buprenorphine is also discussed in this chapter.
She gained experience in all aspects of product life cycle from pre-launch, at-launch and post launch phases working at Forest Laboratories with products such as Lexapro, Campral and Celexa.
There are three types of medications that can be employed in the treatment of addiction: aversive medications (Antabuse for alcohol use disorders); agonist medications for maintenance or withdrawal in opioid dependence treatment (methadone and buprenorphine); and antagonist medications that block the effects of the drug (Campral for alcohol dependence and naltrexone and Vivitrol for both alcohol and opioid use disorders).
InnoPharma, a sterile product development company, has launched its acamprosate calcium, 333mg delayed-release tablets, the generic version of Campral, it was reported on Friday.
* Acamprosate (Campral) is approved to prevent people who have already stopped drinking from starting again.