What to Know About Campral (Acamprosate)

Quitting alcohol can lead to symptoms of anxiety, insomnia, and restlessness, causing people to feel tempted to return to this drug. A medication called acamprosate—formerly sold under the brand name Campral—may help by restoring the balance of the brain's neurotransmitters, which eases symptoms and reduces cravings. 

The Food and Drug Administration (FDA) approved Campral in 2004 to treat alcohol dependence after having been used widely in Europe for many years. Campral is no longer available under its brand name, but it is still available in the generic form acamprosate.

How Campral Worked

The acamprosate in Campral helped a person who has given up drinking to maintain sobriety by reducing their desire for alcohol. It worked by restoring the chemical balance in the brain that is disrupted by long-term or chronic alcohol misuse.

When a person drinks heavily or frequently, the balance of neurotransmitters in the brain changes. Specifically, the excitatory neurotransmitter glutamate is decreased, creating a sedative effect. When they quit drinking, glutamate increases, resulting in central nervous system hyperactivity and excitability. This can cause the person to crave alcohol.

Acamprosate is thought to inhibit the release of glutamate and activate taurine, an inhibitory neurotransmitter. Ultimately, this decreases the level of excitation the person experiences.

Acamprosate can also help reduce many of the post-acute withdrawal symptoms that many people experience during the early stages of alcohol abstinence. This includes easing symptoms such as sweating, anxiety, and sleep disturbances. 

Acamprosate vs. Other Medications Used to Treat Alcohol Dependence

There are several medications that can be used to treat alcohol dependence. Each one works a little differently.

For example, Antabuse (disulfiram) works by making someone sick if they drink alcohol and naltrexone blocks the "high" people get when drinking. But acamprosate reduces the physical distress and emotional discomfort people usually experience when they quit drinking.

Acamprosate does not help with withdrawal symptoms experienced while going through early detoxification from alcohol. However, it has been shown to reduce sleep disturbances commonly experienced during early sobriety by people recovering from alcohol use disorder.

As with all other medications approved for the treatment of alcohol dependence, acamprosate is most effective as a part of an overall program of recovery including therapy, counseling, and/or support group participation.

Before Taking Acamprosate

Talk to your physician about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.

People who have stopped drinking alcohol can take acamprosate. This medication does not work for people who continue to drink, nor does it work for those who use illicit drugs or misuse prescription medications.

Precautions and Contraindications

Taking acamprosate can cause drowsiness, dizziness, and decreased alertness in some people. For this reason, it is important to determine how the medication will affect you before operating a motor vehicle. 

Acamprosate should not be taken if you have any of the following conditions:

• Allergic reaction to Campral, sulfites, or other medicines
• Allergic reaction to foods, dyes, or preservatives
• Breastfeeding
• Depression
• Kidney disease
• Pregnant or trying to get pregnant
• Suicidal thoughts
  

Dosage of Campral

Acamprosate is typically prescribed in 333 mg time-release tablets, with two tablets (666 mg total) taken three times a day. Although, some people receive benefits with lower doses.

Because the side effects of acamprosate are few and mild, and because acamprosate is not addictive, it is usually prescribed for up to 12 months after ceasing alcohol consumption.

How to Take and Store

In case of a missed dose of acamprosate, the medication should be taken as soon as possible. However, if it is almost time for the next dose, people should skip the missed dose and take the next dose as they usually would. Never take two doses of acamprosate to make up for a missed dose.

Acamprosate is usually taken three times per day, but always follow your healthcare provider's recommendations. The tablets can be taken with or without food. Because the tablets are time-released, they should be swallowed whole and never crushed, cut, or chewed.

The medication should be stored away from heat, moisture, or direct light and kept in a closed container. It should also be kept out of the reach of children. Always discard any outdated medications.

Side Effects of Campral

People taking Campral sometimes experienced side effects. In some cases, these effects were common and mild while, for others, the side effects of Campral were more severe.

Common Side Effects

Campral was generally well-tolerated and the side effects that were reported were usually mild and temporary, including:

• Diarrhea
• Dizziness
• Dry mouth
• Gas
  
• Headaches
• Insomnia
• Itching
• Joint or muscle pain
• Loss of appetite
  
• Sweating
• Vomiting

Severe Side Effects

In rare cases, acamprosate can cause more severe side effects. Two potential side effects of this drug that can be serious enough to require medical attention are rash and burning, tingling, or numbness in the extremities (hands, feet, arms, or legs).

Warnings and Interactions for Campral

Research has not indicated negative effects with the long-term use of acamprosate. While there are no known interactions that will alter the effects of the medication, you should always talk to the prescribing physician about any medications, supplements, or substances that you are taking.

Acamprosate is contraindicated in people with severe kidney impairment. However, it can be prescribed to those with mild to moderate liver dysfunction. If you have impaired kidney function, your healthcare provider may prescribe a lower dose or recommend that you not take acamprosate.