ACAMPROSATE CALCIUM
(a-cam-pro'sate)
Classifications: central nervous system agent; substance abuse deterrent
Pregnancy Category: C

Availability

333 mg delayed-release tablets

Actions

May interact with CNS glutamate and GABA neurotransmitter systems and help restore normal balance between neuronal excitation and inhibition. Acamprosate is a neurotransmitter analog.

Therapeutic Effects

Reduces craving for alcohol intake due to chronic use, but does not cause alcohol aversion or a disulfiram-like reaction as a result of ethanol ingestion.

Uses

Maintenance of abstinence from alcohol in patients with alcoholism

Contraindications

Hypersensitivity to acamprosate calcium or any of its components; suicidal ideation; pregnancy (category C). Safety and efficacy in patients with severe renal impairment (Cl_cr 30 mL/min) have not been established.

Cautious Use

Moderate renal impairment; depression; lactation. Safety and efficacy of acamprosate have not been established in adolescents or children <18 y.

Route & Dosage

Maintenance of Alcohol Abstinence
Adult: PO 666 mg t.i.d.

Renal Impairment
Adult: PO Cl_cr 30–50 mL/min: 333 mg t.i.d.; Cl_cr <30 mL/min: do not use

Administration

Oral

Ensure that the drug is not chewed or crushed. It must be swallowed whole.
Store at 15°–30° C (59°–86° F).

Adverse Effects (1%)

Body as a Whole: Flu syndrome, chills. CNS: Depression, anxiety, insomnia, asthenia, dizziness, paresthesia, headache, somnolence, decreased libido, amnesia, abnormal thinking, tremor. CV: Palpitation, syncope. GI: Diarrhea , nausea, vomiting, anorexia, flatulence, dry mouth, abdominal pain, dyspepsia, constipation, increased appetite. Metabolic : Peripheral edema, weight gain. Musculoskeletal : Musculoskeletal pain. Respiratory : Rhinitis, cough, dyspnea, pharyngitis, bronchitis. Skin : Pruritus, diaphoresis, rash. Special Senses: Abnormal vision, taste perversion. Urogenital : Impotence.

Interactions

Drug: None reported.

Pharmacokinetics

Absorption : 11% bioavailability. Metabolism : Not metabolized. Elimination : Renal. Half-Life: 20–33 h.

Nursing Implications

Assessment & Drug Effects

Monitor for S&S depression or suicidal thinking.
Monitor for dizziness or impaired judgment, thinking, and motor skills; take appropriate protective measures.

Patient & Family Education

Report any alcohol consumption while taking acamprosate.
Report promptly any of the following: unusual anxiousness or nervousness; depression or suicidal thoughts; burning or tingling sensations in arms, legs, hands, or feet; chest pains or palpitations; difficulty urinating.
Do not drive or engage in other hazardous activities until reaction to the drug is known.
Do not breast feed while taking this drug.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug