alcohol abuse therapy adjuncts
gamma aminobutyric acid gaba analogues
Maintenance of alcohol abstinence; part of a comprehensive alcohol abstinence program.
Interacts with and restores balance to CNS glutamate and GABA neurotransmitter systems.
Continued alcohol abstinence.
Absorption: 11% absorbed following oral administration.
Metabolism and Excretion: Not metabolized, excreted mainly unchanged in urine.
Half-life: 20–33 hr.
TIME/ACTION PROFILE (blood levels)
- CCr ≤30 mL/min.
Use Cautiously in:
- CCr 30–50 mL/min (dose ↓ necessary)
- History of depression or suicide attempt
- OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk
- Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
- Pedi: Safety and effectiveness not established in children.
Adverse Reactions/Side Effects
CV: palpitations, peripheral edema, syncope, vasodilation
EENT: abnormal vision
GI: abdominal pain, anorexia, constipation, diarrhea, flatulence, ↑ appetite, nausea, taste perversion, vomiting
GU: ↓ libido, erectile dysfunction
Metabolic: weight gain
MS: arthralgia, back pain, myalgia
Neuro: tremor, abnormal thinking, anxiety, depression, drowsiness, headache
Resp: cough, dyspnea, pharyngitis, rhinitis
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
PO (Adults): Two 333-mg tablets (666 mg/dose) 3 times daily. Lower doses may be effective in some patients.
PO (Adults): CCr 30–50 mL/min– One 333-mg tablet 3 times daily.
Availability (generic available)
Delayed-release tablets: 333 mg
- Assess for signs of alcohol withdrawal at start of therapy. Acamprosate does not eliminate or diminish withdrawal symptoms.
Lab Test Considerations:
May cause anemia, lymphocytosis, thrombocytopenia, hyperglycemia, abnormal liver function tests, ↑ AST, ↑ ALT, hyperuricemia, and bilirubinemia.
- Ineffective coping (Indications)
- Treatment with acamprosate should be started as soon as possible after the period of alcohol withdrawal, when the patient has achieved abstinence, and should be continued if the patient relapses.
- PO Administer without regard to meals. May be given with meals to increase adherence.
- Instruct patient to take medication as directed, even if relapse occurs. Advise patient to discuss any renewed drinking with health care professional.
- May cause dizziness and changes in vision. Caution patients to avoid driving and other activities requiring alertness until response to medication is known.
- Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
- Encourage patient to continue active counseling and support. Acamprosate helps maintain abstinence only when used as part of a comprehensive psychosocial treatment program.
Continued abstinence from alcohol.