Treating Alcoholism With Campral (Acamprosate)

Campral is used to diminish alcohol cravings for those with alcohol use disorder. It is a non-addictive substance and doesn’t carry serious withdrawal symptoms.

Campral is the brand name for acamprosate, a drug used to treat alcohol cravings and urges in people with a history of alcohol use disorder (AUD). Campral is not an addictive substance; it can’t be abused and doesn’t cause withdrawal symptoms. However, Campral can be an effective treatment for people with AUD. People with AUD have an unhealthy relationship with alcohol that often leads to alcohol misuse. When someone with AUD stops drinking, they can experience serious withdrawal symptoms.

After the initial alcohol withdrawal period, Campral can play a role in treatment by decreasing the urge to drink alcohol. Campral doesn’t treat withdrawal symptoms and typically is started after alcohol withdrawal has ended. Campral doesn’t eliminate drug cravings — only cravings for alcohol are diminished. Campral helps stop the urge to drink before it can cause a setback in a person’s sobriety.

What Is Campral?

Acamprosate’s mechanism of action, or the process it performs to treat alcohol dependency, is not fully understood. The drug was initially thought to target the GABA receptors in the brain, but more recently, it is believed to work by affecting NMDA receptors. 

Chronic alcohol use affects how neurotransmitters such as GABA and glutamate and their receptors work in the brain. Various chemical processes involving neurotransmitters change due to the presence of alcohol in the system. When alcohol is no longer present, these neurotransmitters are thrown off balance and must readjust. This readjustment period creates the withdrawal symptoms associated with quitting alcohol. Campral is thought to decrease the excess activity of excitatory neurotransmitters caused by alcohol dependence and control the urge to drink after alcohol detox.

History of Campral

Since its development, Campral has been a popular method for treating alcohol dependency after acute alcohol withdrawal symptoms have ended. It has been used in France and other parts of Europe since 1989. Campral wasn’t approved by the Food and Drug Administration until 2004 and became available for use in the U.S. in January 2005. It is only the third medication for the treatment of AUD to be approved in the United States.

Campral For Alcohol Addiction Treatment

Campral is used to decrease the urge to drink alcohol. It is typically prescribed after alcohol detox and withdrawal and is usually started five days after a person stops drinking. Campral only works to control alcohol cravings and does not work for other drug addictions or addictions to alcohol and other drugs. Since it doesn’t affect opioids or benzodiazepines, it is a safe option for people who need to continue taking these other medications.

Campral is only available as a 333 mg tablet. Typical dosing is 666 mg (2 tablets) three times daily. Campral can be taken with or without food. The number of times a person needs to take Campral each day can make it difficult for some to remember. Taking Campral with the three main meals is recommended, making it easier to remember to take the pill three times a day. 

How Long Does It Take for Campral to Work?

Campral is typically started about five days after a person stops alcohol use. After one dose of acamprosate, maximum levels are reached in 4.3 to 15.3 hours, and full effectiveness occurs five to eight days after regular use. Campral must be taken three times a day to maintain a steady level in the body. 

Campral will continue to help control the urge to drink when taken regularly, but compliance with three times a day dosing is important for Campral work. For people who can stick with taking Campral three times a day every day, it can be a long-term treatment to curb alcohol cravings. 

Campral Side Effects

Campral is a tolerable drug with few side effects. The most common side effect reported is diarrhea. During clinical trials, diarrhea was the most common reason for stopping Campral. Some less common side effects of acamprosate are:

• Headache
• Nausea
• Dizziness
• Depression
• Anxiety
• Dry mouth
• Itching
• Sweating
• Trouble falling or staying asleep

Warnings & Interactions

People with moderately impaired kidney function may need to take a reduced dose of Campral. Typical dosing for people with mild to moderate kidney disease is 333 mg (one tablet) three times daily. People with severe kidney impairment cannot take Campral because kidneys are the main pathway for Campral metabolism.

Campral will not help with withdrawal symptoms, only cravings. It is okay to continue to take Campral if an individual starts to drink again. People who start drinking again while taking Campral usually do not drink as heavily as they once did and may return to sobriety faster than people who are not taking Campral.

Women who become or think of becoming pregnant and those breastfeeding or thinking of breastfeeding should speak with their healthcare provider if they are taking Campral. Alcohol can have negative effects on an unborn fetus, but there are no well-controlled studies of Campral use in pregnant women. Women and their healthcare provider should look at the risks and benefits of Campral use during pregnancy.

Campral has no known drug interactions and will not affect other medications, such as opioids and benzodiazepines, when taken together. It’s also safe to take Campral with other medications used to treat AUD, like naltrexone and disulfiram.

What Happens If You Drink on Campral?

Campral doesn’t prevent a person from drinking alcohol and, unlike other medications for AUD, will not create uncomfortable side effects if alcohol is consumed. For people who begin drinking again, Campral reduces how much alcohol a person drinks, leading to lighter amounts of drinking than before.

Unlike the detox medication Disulfiram, Campral does not cause sickness and discomfort when you consume alcohol. Additionally, Campral acts differently than the medication naltrexone and will not make drinking alcohol less rewarding. If you do begin to drink alcohol while taking Campral, it is typically recommended to continue taking Campral; however, you should always talk to your doctor in the event of a relapse. 

Is Campral Effective?

Campral is most effective in people who want to quit drinking alcohol but find their cravings difficult to manage. Campral effectively reduces cravings for people after they go through alcohol withdrawal. It does not treat withdrawal symptoms and is usually started five days after stopping alcohol use. Additionally, those who use Campral during treatment do not typically develop a tolerance to the drug. Campral is non-addictive and doesn’t carry the potential of abuse associated with several other addiction treatment medications.

Campral seems to be effective in maintaining sobriety, whereas naltrexone is more effective in decreasing heavy drinking. Naltrexone can not be taken by people also taking opioids since it blocks the pain-relieving effects of opioids and can cause withdrawal symptoms in people who are opioid dependent. Naltrexone would be a better treatment option for people who have already gone through detox for alcohol and opioids and want to stay substance-free. Campral doesn’t work to control the urges associated with opioid use in these individuals.

Disulfiram is another option for people with AUD, but unlike Campral, it is no longer considered a first-line treatment. It works to curb alcohol use by creating unpleasant effects such as nausea, vomiting and headache in people who drink alcohol while taking disulfiram. Disulfiram seems to be more effective in a controlled environment where medication is given to an individual by a healthcare provider. People with liver disease, psychotic disorders and seizure disorders should not use disulfiram. While disulfiram and naltrexone can’t be used in people with liver disease, Campral is a safe option for those with poor liver function. 

For individuals with poor liver function, those taking opioids or other substances and people that would like to quit drinking alcohol completely, Campral is a safe and effective option. If you or a loved one is struggling with alcohol use disorder and would like to quit drinking and live an alcohol-free life, contact The Recovery Village today.

Editor – Abby Doty

Abby Doty graduated from Hamline University in 2021 with a Bachelor's in English and Psychology. She has written and edited creative and literary work as well as academic pieces focused primarily on psychology and mental health. Read more

Medically Reviewed By – Elizabeth Cambria

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