What is Acamprosate?
Acamprosate (calcium acetylhomotaurinate) is a medication used to maintain alcohol abstinence in people with alcohol dependence. Its brand name is Capral. Medication-assisted treatment (MAT) is the use of medications. It is used along with social support, therapy, and counseling to help somebody who has quit drinking large amounts of alcohol (alcohol use disorder) to avoid relapse. This is according to The National Institute of Health (NIH) .
Consuming alcohol for a long time changes the way the brain works. Acamprosate works by helping the brains of individuals who have drunk large amounts of alcohol to work normally again .
Acamprosate does not prevent the alcohol withdrawal symptoms that individuals may experience when they quit drinking. In addition, Acamprosate has not been shown to work in individuals who have not stopped drinking alcohol or in people who consume large amounts of alcohol and also misuse or abuse other substances such as prescription drugs or street drugs.
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Is Alcohol Use Disorder a Disease?
Alcohol use disorder is a medical condition. It’s a disease of brain function and needs psychological and medical treatments to control it. Alcohol use disorder can be mild, moderate, or severe. It can advance quickly or over a long period of time. Knowing the signs and symptoms of alcohol use disorder can aid you, or your loved one in seeking help before the problem turns into dependence and addiction. According to the National Institue of Health, alcohol use disorder is a disease that causes:
- Craving: It is a strong need to drink
- Loss of Control: Not being able to quit drinking once you’ve started
- Negative Emotional State: Feeling irritable and anxious when you are not drinking
Symptoms of Alcohol Use Disorder
- Being unable to stop using alcohol despite problems with relationships and health
- Requiring to drink more alcohol to achieve the same effect
- Presence of withdrawal symptoms (shaking, sweating, nausea, vomiting, anxiety, confusion) when unable to use alcohol
- Spending the majority of time finding a way to use alcohol
- Having an urge or desire but an inability to decrease the amount of alcohol consumed
- Giving up enjoyable activities in order to use alcohol
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Side Effects Of Acamprosate
Like most medications, acamprosate can cause side effects, but they are usually mild and subside the longer treatment continues. This is according to the National Center for Biotechnology Information (NCBI) . It is this comparative lack of side effects that make the drug a more popular choice than alternatives. This is especially the case when it comes to liver-related side effects. The most common side-effects are gastrointestinal symptoms (such as mild diarrhea or loose bowel movements). You should tell your doctor if you encounter these or any other unexpected effects. If you have kidney problems you should discuss this with your doctor to see if this medication can be used. Sometimes a lower dose of acamprosate can be used.
However, there are a number of side effects, some of which are possibly very serious.
- Hypersensitivity to the drug
- Anxiety and nervousness
- Muscle weakness
- Suicidal thoughts
- Irregular heartbeat
- Vision problems
- Hearing changes
- Reduced urination
- Potential fetal risk
- Severe renal impairment
- Extreme feelings of sadness/emptiness
- Loss of appetite
- Difficulty concentrating
- Loss of strength
How Should I Take Acamprosate?
The usual dose of acamprosate is taken three times every day. However, a lower dose may be effective in some individuals. Follow the directions of your doctor in regards to the proper dose that you should take.
Acamprosate is available as an oral tablet that should be taken whole and not chewed or crushed. It should be prescribed only after the person has stopped alcohol use and gone through initial substance abuse detox.
Consider using a pillbox, alarm clock, calendar, or cell phone alert to help you remember to take your medication. You may also ask a friend or a family member to remind you or check in with you to be sure you are taking your medication.
It is not advisable to take Acamprosate if you suffer from kidney issues or while pregnant. This medication alone is not enough to treat alcoholism, and it should be coupled with therapy and potentially other prescription medications.
Acamprosate is most typically prescribed for a period of one year, although many users take it for shorter or longer periods of time. Acamprosate is often taken in combination with other alcoholism medications such as Disulfiram and Naltrexone .
If you miss a dose of this medication, don’t double the dose at the next scheduled time. There should be at least 2 hours between doses. If this is not possible, skip the dose and wait until your next scheduled dose.
Benefits of Taking Acamprosate
- It protects the liver because it is absorbed through the digestive tract rather than the liver, reducing side effects and improving effectiveness for people with liver damage.
- Generally less severe, fewer and less prevalent side effects than other prescription medications for alcoholism.
- No known drug interactions with other medications or substances.
- Actively reduces urge and cravings for and dependence on alcohol, by reacting with neurotransmitters in the brain, rather than reducing the pleasurable effects of alcohol or creating negative side effects from alcohol use.
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Safety of Taking Acamprosate
Acamprosate has a good safety profile :
Clients maintained on acamprosate have not developed a tolerance for or dependence on it, and it appears to have no potential for abuse.
It carries practically no overdose risk; even at overdoses up to 56 grams (a normal daily dose is 2 grams), acamprosate was generally well tolerated by someone taking the drug.
Most side effects are transient and mild, disappearing or lessening within the first few weeks of treatment (diarrhea tends to persist).
Although there is a pharmacokinetic interaction by which acamprosate can increase naltrexone blood levels, there are no other clinically significant interactions between acamprosate and other medications.
Acamprosate and Pregnancy
If there is a possibility of becoming pregnant, use an effective method of birth control while taking acamprosate. If you miss a menstrual period, report this to your doctor at once and take a pregnancy test. If you become pregnant, you will need to inform your doctor to discuss ongoing treatment options.
Your doctor will help you abstain from alcohol during pregnancy. Your health should be monitored throughout your pregnancy, as should the health of your baby after delivery. Even though acamprosate should not be used during pregnancy, animal studies have not shown any ill effects, nor is there evidence that acamprosate causes birth defects.
Acamprosate, Alcoholics Anonymous (AA), and Other Mutual Support Groups
There is no problem with participating in support groups such as Alcoholics Anonymous, Smart Recovery, Refuge Recovery, Celebrate Recovery, while taking this medication. Acamprosate is most likely to be effective for you if your goal is to quit drinking altogether.
If other group members are cautious against taking any medications, refer them to the pamphlet “The AA Member—Medications and Other Drugs,” which states that AA members should not “play doctor” and advise others on medication provided by medical practitioners or treatment programs.
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Before Taking Acamprosate
- Inform your pharmacist and if you are allergic to acamprosate, any other medications, sulfites, or any of the ingredients in acamprosate tablets. Ask your pharmacist for a list of the ingredients.
- Alert your pharmacist and doctor what prescription and nonprescription medications, nutritional supplements, vitamins, and herbal products you are taking. Be sure to mention antidepressants. Your physician may need to change the doses of your medications or monitor you carefully for side effects.
- Tell your doctor if you are thinking of, or have ever thought of, harming or killing yourself, if you have ever tried to do so, or if you use or have ever used street drugs or have overused prescription medications. Also, tell your physician if you have or have ever had depression or kidney disease.
- Inform your physician if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking acamprosate, alert your doctor.
- If you are having surgery, including dental surgery, tell the dentist or doctor that you are taking acamprosate.
- You should know that acamprosate may affect your coordination, ability to make decisions, and thinking. Do not drive a car or operate machinery until you know how this medication affects you.
- You should know that individuals who consume large amounts of alcohol often become depressed and sometimes try to kill or harm themselves. Taking acamprosate does not decrease and may increase the risk that you will try to harm yourself.
- You may develop depression while you are taking acamprosate, even if you do not go back to drinking. Alcoholism, is often described as a “family disease” because it affects more people than just those struggling with alcohol addiction. Therefore, alcohol use in families should be addressed by the the whole family as a unit .
- You or your family should call the doctor right away if you experience symptoms of depression such as:
- feelings of sadness
- loss of interest or pleasure in activities you once enjoyed
- lack of energy
- difficulty concentrating, making decisions, or remembering
- sleep problems
- changes in appetite or weight
- thinking about harming or killing yourself or planning or trying to do so
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Although Acamprosate has proven to be effective in treating alcohol use disorder, it is not enough on its own. Before it can be prescribed, the client needs to have already gone through the initial withdrawal and medically assisted detox. If you or someone you love is struggling with alcoholism, get them the safest help they need and deserve. We Level Up NJ offers a safe and medically-assisted alcohol abuse treatment program. Contact our team today!
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 NIH – https://medlineplus.gov/druginfo/meds/a604028.html
 NIDA – https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/pharmacotherapies/alcohol
  NCBI – https://www.ncbi.nlm.nih.gov/books/NBK64035/
 FDA – https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021431s013lbl.pdf