It is not for treating withdrawal. Acamprosate helps people remain alcohol-free after they quit. Before prescribing it, a doctor should check your health. That includes looking at your kidneys and past treatment.
Our guide to medications for alcohol use disorder covers other options you can compare.
We are a treatment directory, not a provider. This page shares general info, not medical advice. Please talk to your doctor about your care.
If you have seizures, bad confusion, or hallucinations, call 911 now. Head to the ER if you develop a fast heart rate or a high fever. Call 911 or go to the ER for overdose signs or self-harm thoughts. For suicide thoughts, call or text 988.
Acamprosate for Alcohol Use Disorder: Its Role and How It Acts
Acamprosate is a medicine you need a prescription for. It helps people keep their alcohol-free status. You must have already stopped drinking to use it. The FDA approves it to help people with alcohol dependence stay abstinent. They must be abstinent when treatment starts.[1]
If you are still drinking heavily, talk to a doctor first. This drug is not for acute alcohol withdrawal. It does not stop an immediate urge. Safe detoxification must happen before you start. It has not been shown to work for people who have not finished detox and reached abstinence.[2]
Using alcohol over a long time can shift the brain's balance between neuronal excitation and inhibition.[1] Acamprosate may help bring that balance back. Research points to a link with glutamate and GABA systems.[1] Doctors still do not know the exact mechanism behind it.
View this medicine as a tool to help you. It is not a sure thing. Every person reacts to treatment in their own way. One person's success may not match your path. A prescriber can look at your health history. They can talk about if acamprosate fits your case. Always follow your provider's advice on starting or changing meds.
How Well Does Acamprosate Work?
Acamprosate aids in staying sober. Yet it does not ensure success for every person.
RR 0.83
lower risk of returning to any drinking at 6 months compared to placebo[3]
Varies by person
group results do not predict every individual outcome[3]
The review found that acamprosate is an effective option for maintaining abstinence.[3] It compared how the drug did against a placebo.
Within six months, those on acamprosate had a lower chance of drinking again.[3] This is a good sign. But the drug does not work for everyone. It also does not stop every craving.
Acamprosate is often used with talk therapy. This mix can help people stay sober for a longer time.[3] Group results show what happens on average. Your own experience may be different. For a broader look at how these treatments work together, see our guide to medication and therapy for alcohol.
Speak with your prescriber about your specific situation. They can clarify the drug's limits and benefits for you. This aids in making a clear decision for your care plan.[3]
Acamprosate for alcohol use disorder: Who Uses It and Why?
You and your doctor decide if acamprosate is right for you. The American Psychiatric Association suggests this drug for people with moderate to severe alcohol use disorder. It fits those aiming to cut back or stop drinking. It also fits those who prefer medication or who did not do well with nonpharmacological treatments alone. You must have no contraindications.[4] The VA/DoD also lists it as a top option for these cases.[5]
As a general rule, acamprosate helps keep abstinence going after withdrawal is handled. The FDA approves it for maintaining abstinence in people with alcohol dependence who are sober at the start.[1] It is not just for cutting down on drinks. It has not been shown to work for people who have not finished detox and reached abstinence first.[2]
Use this list to get ready for your visit. Do not use it as a self-test. Only a doctor can say if the drug is safe for you.
Questions to Discuss With a Prescriber
Your ticks are saved on this device only.
If you still drink a lot, you may need medical help first. Doctors say supported withdrawal from alcohol is a key step before starting other care.[6] Acamprosate is not a way to detox at home. Tell your doctor right away if you have ever had seizures or bad shakes when quitting.
Step 1
Talk to a clinician about your drinking and withdrawal risks.
Step 2
Get medical help to manage withdrawal safely if needed.
Step 3
Once you are stable and abstinent, ask if acamprosate fits your plan.
Step 4
Set up regular check-ins and find ongoing recovery support.
Care plans vary for everyone. Read our guide on levels of alcohol care to learn more about where treatment happens.
Acamprosate vs. Naltrexone and Other Alcohol Use Disorder Meds
The FDA has approved three medications for alcohol use disorder. Naltrexone and acamprosate are two of them.[7] How each drug works is different. Your health history and goals decide which one fits you best. If you are comparing options, our guide to naltrexone for alcohol use disorder details how it works and its side effects. If you are considering naltrexone, our guide to naltrexone injection vs oral explains the differences in dosing and effect.
| Medication | General Treatment Role | What to Discuss With a Prescriber | Important Limitation |
|---|---|---|---|
| Acamprosate | Supports maintaining abstinence after stopping drinking. | Kidney function and other medical conditions. | Severe kidney problems can make it unsafe to use, while moderate kidney problems may require a lower dose and medical review.[8] |
| Naltrexone | Reduces cravings and the rewarding effects of alcohol. | Current or past opioid use, including pain treatments. | Cannot be used if you take opioids or have certain liver issues. |
| Disulfiram | Creates an unpleasant reaction if alcohol is consumed. | Willingness to strictly avoid alcohol while taking it. | Risk of severe physical reaction if even small amounts of alcohol are ingested. |
It is critical to tell your clinician about any opioid use or pain management plans before starting naltrexone, as there are strict restrictions regarding these drugs. If you are unsure which option fits your situation, our guide on naltrexone versus acamprosate offers a deeper look at how these two common choices compare. For a full look at all medications for alcohol use disorder, check our broader guide on medications for alcohol use disorder. If cost is a concern, our guide to insurance coverage for naltrexone explains how to verify your prescription benefits.
Side Effects and Safety of Acamprosate
For most people, acamprosate does not cause major issues. Yet, a few side effects can show up. Diarrhea is a common one.[9] You may also feel dizzy or sick to your stomach.[9] Trouble sleeping and a dry mouth are possible, too.[9] If you see new signs, talk to your prescriber or pharmacist. They can help you decide if the drug is right for you. Our guide to monitoring alcohol medication progress offers tips on how to discuss these side effects with your doctor.
Acamprosate leaves your body through the kidneys. Because of this, it is not safe for people with severe kidney problems.[8] If your kidney issues are moderate, your doctor may change your dose.[8] Let your care team know about any kidney history before you start.
Keep an eye on your mood. In studies, suicidal thoughts were rare, but they were more common with acamprosate than with a placebo.[10] Contact a clinician right away if you feel very sad. If you have thoughts of self-harm, call 911 or go to the nearest emergency room now. For suicidal thoughts, call or text 988 while getting emergency help.[11] These signs need quick attention.
Read our guide on managing medication side effects for more tips on handling prescription reactions. For questions about your specific health history, your prescriber is the best source.
Slipping Up, Cravings, and Adding Supplements
For people with alcohol dependence who are already abstinent, acamprosate is indicated to help maintain abstinence.[1] Call your care team if you start drinking again.
- Check your safety. If you feel unsafe or sick, call 911 or go to the ER now.
- Contact your therapist. Let them know what happened.
- Tell the truth. Share what you drank and any symptoms you felt. You do not need to feel shame.
- Ask about acamprosate. Contact your prescriber promptly for advice about what to do with it after drinking again.
- Plan next steps. Ask about counseling or recovery support as part of an individualized plan.[13]
Do you have questions about supplements for alcohol cravings? Talk to your prescriber or pharmacist first. Supplements can interact with medicines, so discuss supplement use with a healthcare professional.[14] Alcohol use disorder care may include medication, behavioral treatment, and recovery support as part of an individualized plan.[13] FDA generally does not review dietary supplements for effectiveness before they are marketed, so do not assume a supplement’s claim to reduce alcohol cravings is proven.[15] Ask a clinician or pharmacist to help check a product’s ingredients and the evidence for its specific claims.
Drinking alcohol does not make acamprosate cause a disulfiram-like reaction. It is also not known to create alcohol aversion.[16] Check what to do after a slip for extra help with these times.
Top Picks for Treating Alcohol Addiction
No one plan works for all people. Your health needs, goals, and likes shape the right choice. The NIAAA says care can mix medication, therapy, and recovery support.[13] Doctors look at many things when picking a medicine. They think about your needs, other health issues, and your choices.[17] Our guide to medication options for alcohol use disorder breaks down how these treatments work together for your recovery.
Use this check to choose your next step. This is not a diagnosis.
What Next Step Could Help?
This self-check is for information only and isn't a diagnosis or medical assessment.
If the danger signs above are not present, speak with your doctor or prescriber about next moves. You can also find treatment programs near you to see options for medication-supported care.
Frequently Asked Questions
Can I drink while taking acamprosate?
Does acamprosate make you feel relaxed?
Usually, no. It is meant to help maintain abstinence when used with counseling and support.[18] If you feel different, call your doctor or pharmacist. Do not guess why you feel that way.
Can supplements help reduce alcohol cravings?
Because of this, you cannot rely on product labels or marketing claims to prove they work. Supplements can also interact with your medications, so ask a doctor or pharmacist to check the ingredients first.[14]
What is the most effective treatment for alcohol addiction?
There is no one best plan for everyone. Care should fit your specific needs and goals.[20] A good plan often mixes medicine and therapy. Talk to a provider to find what works for you.
What treatments can help when alcohol cravings or urges feel difficult to manage?
Behavioral therapy can help with cravings. It teaches you how to handle stress and triggers.[21] You learn skills to cope with urges. If urges are strong, call your care team right away. Do not change your meds on your own.
