Quitting alcohol can lead to symptoms of anxiety, insomnia, and restlessness. Such symptoms can often cause people to feel tempted to hit the bottle again. A medication called acamprosate (formerly sold under the brand name Campral) may help. It works by restoring the balance of your brain’s neurotransmitters to ease symptoms and reduce cravings. 

The Food and Drug Administration (FDA) approved Campral in 2004 to treat alcohol dependence or alcoholism after having been used widely in Europe for many years. More than 4 million people have been treated worldwide with Campral. Campral is no longer available under its brand name, but it is still available in the generic form acamprosate.

Uses

Acamprosate can help people who have already stopped drinking alcohol. It does not work in a person who continues to drink alcohol, nor does it help ease withdrawal symptoms. Rather, it helps the person who has given up drinking to maintain sobriety by reducing the desire for alcohol. 

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.

Acamprosate is believed to restore chemical balance in the brain that is disrupted by long-term or chronic alcohol misuse. In other words, it helps the brain to begin working normally again by correcting the underlying neurochemical changes caused by chronic drinking. In this way, it helps people maintain alcohol abstinence.

When a person drinks heavily or frequently, the balance of neurotransmitters in the brain changes. Specifically, drinking decreases the excitatory neurotransmitter glutamate, creating a sedative effect.

When someone with alcohol dependence quits drinking, glutamate increases, resulting in central nervous system hyperactivity and excitability. This can cause the person to crave alcohol to quell uncomfortable symptoms.

Acamprosate is thought to somewhat inhibit the release of glutamate as well as activate taurine, an inhibitory neurotransmitter, ultimately decreasing the level of excitation the person experiences. 

While Antabuse (disulfiram) works by making someone sick if they drink alcohol and naltrexone blocks the “high” people get when drinking, acamprosate reduces the physical distress and emotional discomfort people usually experience when they quit drinking. Acamprosate reduces many of the post-acute withdrawal symptoms that many people experience during the early stages of alcohol abstinence, such as sweating, anxiety, and sleep disturbances.

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

Acamprosate does not help someone quit drinking. But, it does help those who have already withdrawn from alcohol to maintain abstinence.

Before Taking

People who have stopped drinking alcohol can begin taking acamprosate. It does not work if you are still drinking, or if you are using illicit drugs or abusing or overusing prescription medications.

It is also important to recognize that acamprosate is not a standalone treatment for alcohol addiction. Treatment for alcohol withdrawal should only be provided by a trained healthcare professional as symptoms can range from uncomfortable to life-threatening.

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. 

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

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

  • Allergic reaction to Campral, sulfites, or other medicinesAllergic reaction to foods, dyes, or preservativesBreastfeedingDepressionKidney diseasePregnant or trying to get pregnantSuicidal thoughts

Dosage

Acamprosate is typically prescribed in 333mg time-release tablets, with two tablets (666mg total) taken three times a day. Some people may do fine with lower doses. Because acamprosate tablets are time-release, they should be swallowed whole and never crushed, cut, or chewed.

Acamprosate is contraindicated in people with severe kidney impairment, but lower doses may be prescribed in less severe cases. 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 simply 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 doctor’s recommendations. A lower dose may be effective in some cases. The tablets can be taken with or without food.

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

Side Effects

Campral was “generally well-tolerated in clinical trials” and the side effects that were reported are usually mild and temporary.

Common

  • DiarrheaDizzinessDry mouthGasHeadachesInsomniaItchingJoint or muscle painLoss of appetiteSweatingVomiting

Severe

In rare cases, acamprosate can cause more severe side effects. Anyone who experiences any of the following symptoms should stop taking acamprosate immediately and contact their healthcare provider:

  • Anxiety or nervousnessBurning, prickling, or tingling in arms, legs, hands, or feetDepressionChest painsPassing urine less oftenSuicidal thoughts

Warnings and Interactions

Research has not indicated negative effects associated 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 your doctor about any medications, supplements, or substances that you are taking.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

The medication is usually tolerated well and has a low risk of drug interactions. Acamprosate can also be prescribed to people with mild to moderate liver impairment without dosage adjustments. If you have impaired kidney function, your doctor may prescribe a lower dose or the medication may be contraindicated altogether.

Frequently Asked Questions

  • How long does Campral take to work?
  • Acamprosate is slow to absorb, so it acts as a modified-release medication. It takes around six hours for it to reach its maximum concentrations in the body. It takes about five days for it to reach a steady state. You may begin experiencing the effects of the medications sooner, however.
  • How much does Campral cost?
  • Medication costs vary depending on the pharmacy. GoodRX suggests that prices for acamprosate range between $76 to $243 or 180 tablets. The cost of your medication may be covered by your insurance depending on your prescription coverage.
  • How long can you take Campral?
  • There are no associated risks of long-term use, but the medication is often taken for between three to 12 months.
  • What are the risks of acamprosate (Campral)?
  • Campral is considered safe, well-tolerated, and effective when taken as prescribed. Side effects tend to be mild, but some people may experience more serious symptoms such as anxiety, depression, allergic reactions, or suicidal thinking. You should always contact your doctor if you are experiencing any concerning side effects while taking this medication.

Acamprosate is slow to absorb, so it acts as a modified-release medication. It takes around six hours for it to reach its maximum concentrations in the body. It takes about five days for it to reach a steady state. You may begin experiencing the effects of the medications sooner, however.

Medication costs vary depending on the pharmacy. GoodRX suggests that prices for acamprosate range between $76 to $243 or 180 tablets. The cost of your medication may be covered by your insurance depending on your prescription coverage.

There are no associated risks of long-term use, but the medication is often taken for between three to 12 months.

Campral is considered safe, well-tolerated, and effective when taken as prescribed. Side effects tend to be mild, but some people may experience more serious symptoms such as anxiety, depression, allergic reactions, or suicidal thinking. You should always contact your doctor if you are experiencing any concerning side effects while taking this medication.