How Does Acamprosate for Alcohol Use Disorder Work?

Last Updated: November 2, 2023

Editorial Policy | Research Policy

Acamprosate is a medication prescribed for those with alcohol use disorder to stay sober. It has few side effects and a low risk for withdrawal symptoms.

Alcohol use disorder, the clinical term for an alcohol addiction or alcoholism, is extremely common in the United States, impacting almost 15 million Americans. Although many would benefit from treatment for alcohol addiction, less than 10% of eligible Americans seek treatment. Acamprosate, an important tool in staying sober, is considered by experts to be a first-line drug in helping people overcome alcoholism.

What Is Acamprosate Used For?

Acamprosate (brand name Campral) is an FDA-approved medication to treat alcohol dependence. Specifically, the drug is used to help people who are already in recovery from alcohol addiction to stay sober. Studies show that the drug boosts a person’s ability to stay sober by around 11%.

Acamprosate Mechanism of Action

Acamprosate works by preventing some of the changes in brain chemicals that might otherwise trigger someone to start drinking. Drinking increases levels of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. This neurotransmitter calms and relaxes the brain, working against a different neurotransmitter called glutamate that excites the brain.

When someone is dependent on alcohol and quits drinking, the flood of glutamate in the brain triggers alcohol withdrawal symptoms and can be an overwhelming trigger to start drinking again. Acamprosate works by tamping down on the glutamate transmission in the brain after someone stops drinking, making the brain less excitable. In turn, this reduces alcohol cravings.

How Long Does Acamprosate Take To Work?

Acamprosate is a short-acting drug and, as such, starts working quickly. Experts recommend starting it as soon as possible after a person stops drinking. Because it is so short-acting, it needs to be taken three times a day to maintain effect.

Acamprosate Dosage

Most adults would take an acamprosate dose of 666 mg three times daily. Although it does not need to be taken with food, taking it with meals may reduce the risk that a person forgets to take a dose.

Some people may need a lower dose of acamprosate. This includes people with kidney disease, who would take acamprosate 333 mg three times daily. Your doctor will check your lab work before you start acamprosate and let you know what dose is right for you.

Acamprosate Side Effects

Although all drugs have side effects, acamprosate has fewer than many others. The only commonly reported acamprosate side effects are diarrhea and a general feeling of weakness. 

Acamprosate Interactions

Acamprosate has very few drug interactions because the body does not break it down, instead eliminating it unchanged in the urine. However, acamprosate may interact with a couple of medications, including:

  • Antidepressants: Both weight gain and weight loss have been reported when the person is also taking acamprosate.
  • Naltrexone: A person who takes both naltrexone and acamprosate may have increased levels of acamprosate in their body.

Acamprosate and Alcohol

Some people may still relapse despite acamprosate therapy. However, acamprosate does not have any drug interactions with alcohol, and acamprosate can still be continued even if you slip up and have a drink.

Acamprosate Withdrawal

Acamprosate is not a controlled substance nor a psychoactive medication. As a result, a person cannot become physically dependent on acamprosate, and stopping the drug will not lead to withdrawal symptoms.

That said, you should only stop acamprosate if your doctor instructs you to do so. If you are taking the medication to stay sober, stopping it may trigger a relapse into alcohol use. Even if you have already relapsed, you should stay on acamprosate and talk to your doctor about what to do next. You should not stop acamprosate without medical advice to do so.

Get Help for Alcohol Addiction in New Jersey

If you or a loved one struggle with drinking or staying sober, it is common to feel overwhelmed. Help is available. The Recovery Village Cherry Hill at Cooper offers a full continuum of care in helping you quit alcohol for good. From medical detox to get you off alcohol to rehab to keep you sober, we are there with you every step of the way. Medications like acamprosate can be prescribed as medically appropriate to help you in your journey to recovery. Don’t wait: contact us today to learn more.


Cayley, William E. “Effectiveness of Acamprosate in the Trea[…]f Alcohol Dependence.” American Family Physician, 2011. Accessed May 31, 2022.

National Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.” Accessed May 31, 2022.

American Psychiatric Association. “Practice Guideline for the Pharmacologic[…]Alcohol Use Disorder.” 2018. Accessed May 31, 2022. “Acamprosate.” April 21, 2022. Accessed May 31, 2022. “Drug Interaction Report.” Accessed May 31, 2022.

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