Acamprosate

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[edit] BRAND NAMES

[edit] STRUCTURE

Acamprosate.jpg

[edit] MECHANISM OF ACTION

Chronic alcohol exposure is hypothesized to alter the normal balance between neuronal excitation and inhibition. In vitro and in vivo studies in animals have provided evidence to suggest acamprosate may interact with glutamate and GABA neurotransmitter systems centrally, and has led to the hypothesis that acamprosate restores this balance. Acamprosate presumably blocks excitatory glutamatergic N-methyl-d-aspartate (NMDA) receptors while enhancing γ-aminobutyric acid (GABA)-mediated nerve inhibition.

Acamprosate calcium reduces alcohol intake in alcohol-dependent animals

[edit] INDICATIONS

Acamprosate is indicated for the maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation.

Treatment with Acamprosate should be part of a comprehensive management program that includes psychosocial support

[edit] DOSAGE

Recommended dose: 666 mg (two 333 mg tablets) taken three times daily.

Dose reduction to one 333 mg tablet taken three times daily for patients with moderate renal impairment (creatinine clearance 30-50 mL/min).

[edit] CONTRAINDICATIONS

  • Hypersensitivity to acamprosate.
  • Patients with with severe renal impairment (creatinine clearance of ≤30 mL/min)

[edit] WARNINGS AND PRECAUTIONS

  • Dose reduction is required for patients with moderate renal impairment.
  • Monitor patients for depression or suicidal ideation and prompt patients, families, and caregivers to report such symptoms to the health care provider
  • Use of Acamprosate does not eliminate or diminish withdrawal symptoms.

[edit] INTERACTIONS

Acamprosate does not affect the pharmacokinetics of alcohol. The pharmacokinetics of acamprosate are not affected by alcohol, diazepam, or disulfiram, and clinically important interactions between naltrexone and acamprosate were not observed

[edit] PREGNANCY AND LACTATION

Pregnancy Category C (US): Acamprosate should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nursing Mothers: Caution should be exercised when Acamprosate is administered to a nursing woman

[edit] SIDE EFFECTS

Common adverse events that occurred in any Acamprosate treatment group at a rate of 3% or greater and greater than the placebo group in controlled clinical trials with spontaneously reported adverse events are: accidental injury, asthenia, pain, anorexia, diarrhea, flatulence, nausea, anxiety, depression, dizziness, dry mouth, insomnia, paresthesia, pruritus and sweating

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