Glutamate modulator

Acamprosate

Campral
FDA-Approved Indications
  • Maintenance of abstinence from alcohol in patients with alcohol use disorder who are abstinent at treatment initiation
Common Off-Label Uses
  • Anxiety (limited evidence)
  • Tinnitus (limited evidence)

Side Effects Worth Knowing

Diarrhea: the most common side effect

Occurs in a substantial proportion of patients. Usually mild to moderate and may improve over time. Can be treatment-limiting for some patients. Management: dietary adjustments, loperamide if needed.

Nausea: common

Usually mild. May improve with continued treatment.

Flatulence/abdominal discomfort: common

GI side effects as a group are the primary tolerability concern with acamprosate.

Headache: reported

Usually mild and not treatment-limiting.

Insomnia: reported

Paradoxical in the context of a medication proposed to reduce the hyperexcitable state, but reported at rates above placebo in some trials.

Pruritus: reported

Occasionally reported. Usually mild.

Depression/suicidality: monitor

Post-marketing reports exist, though causality is not established. Patients with AUD have elevated baseline suicide risk. Monitor mood regardless of medication.

See This Medication in Action

These case studies show how acamprosate decisions play out in real clinical scenarios:

Substance Use & ComorbidityThe Sales Rep Who Drinks to CopeSubstance Use & ComorbidityThe Contractor Who Started with a Prescription

References & Further Reading

This page synthesizes information from standard clinical references. Consult primary sources for all prescribing decisions.

Test your Acamprosate knowledge

Review flashcards on dosing, side effects, and interactions, or build a custom quiz with board-style questions.

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For learning and board prep — not a prescribing reference. Dosing and safety information change. Always verify against current FDA labeling and your institution’s protocols before prescribing.