Acamprosate: what it does and how to use it

If you or someone you care about has finished alcohol detox but worries about relapse, acamprosate (brand name Campral) is a common option doctors offer. It won’t make you sober instantly, but it can reduce cravings and help balance brain chemistry after long-term drinking. Think of it as a tool that supports recovery while you work on behavior, therapy, and support networks.

How acamprosate works and who it's for

Acamprosate works on brain systems that get out of balance with heavy alcohol use — mainly glutamate and GABA. After you stop drinking, those systems stay hyperactive for a while and that drives cravings and anxiety. Acamprosate calms that overactivity, which helps people stay abstinent. Most research shows it modestly improves continuous abstinence rates at 6–12 months when combined with counseling. It’s prescribed for adults who are already detoxed and committed to staying sober, not for people who are still drinking heavily right now.

Practical dosing, side effects, and safety tips

Typical dosing is two 333 mg tablets three times a day (total 1998 mg daily). If you weigh less than about 60 kg your doctor might start a lower dose, usually 333 mg three times daily. Take doses at regular times to help build a routine. You can take acamprosate with or without food. If you miss a dose, skip it — don’t double up the next time.

Common side effects are diarrhea, nausea, stomach pain, and sometimes headache, anxiety, or insomnia. Most side effects are mild and improve after a few days. Serious reactions are rare but include allergic rash or severe diarrhea and dehydration. Stop the drug and contact your doctor if you have signs of an allergic reaction, dark urine, jaundice, or severe stomach problems.

Acamprosate is mostly eliminated by the kidneys. Tell your doctor if you have kidney problems — it’s usually avoided or the dose reduced when kidney function is poor. It has few interactions with other drugs and it’s not heavily metabolized by the liver, which helps for people taking several medications. Still, tell your prescriber about all medicines and supplements you use. Avoid drinking alcohol while on therapy — acamprosate supports abstinence but drinking reduces its benefits.

How long should you stay on it? Many people use acamprosate for 6 to 12 months, sometimes longer if relapse risk remains high. Regular follow-up is important: your care team will check how you’re doing, whether side effects show up, and whether the medication is helping you stay sober. Combine medication with counseling, support groups, or therapy — the best outcomes happen when medication is one part of a broader recovery plan.

Simple tips: get kidney function checked before starting, take doses at the same times daily, stay hydrated if you get diarrhea, and pair the medication with a support plan. If you have questions about starting or stopping acamprosate, talk to your doctor or pharmacist — they can tailor advice to your health and recovery goals.