Acamprosate Dosage

Usual Adult Dose for Alcohol Dependence

666 mg orally three times a day

Usual Geriatric Dose for Alcohol Dependence

666 mg orally three times a day

Since geriatric patients may be more prone to a decrease in renal function, the manufacturer advises greater care in dose selection and close monitoring of renal function during therapy in this population.

Usual Pediatric Dose for Alcohol Dependence

There are no data on the safety and efficacy of acamprosate in this population.

Renal Dose Adjustments

In patients with moderate renal dysfunction (creatinine clearance 30 to 50 mL/min) an initial dose of 333 mg three times daily is recommended by the manufacturer.

Acamprosate is contraindicated in patients with severe renal dysfunction (creatinine clearance equal to or less than 30 mL/min).

Liver Dose Adjustments

Acamprosate is not metabolized by the liver and the pharmacokinetics of acamprosate are not altered in patients with mild to moderate hepatic impairment (groups A and B of the Child-Pugh classification). No adjustment of dosage is recommended in such patients.

Acamprosate is contraindicated in patients with severe hepatic impairment (Child-Pugh C).

Precautions

Acamprosate is contraindicated in patients with a creatinine clearance equal to or less than 30 mL/min.

Acamprosate therapy has not been reported to eliminate or diminish alcohol withdrawal symptoms.

Acamprosate has not been reported to cause a disulfiram type reaction as a result of ethanol ingestion.

There are no data on acamprosate causing alcohol aversion.

Acamprosate may impair the mental abilities necessary for potentially hazardous tasks such as driving or operating machinery.

Acamprosate should only be used in conjunction with a treatment program that includes counseling and support.

Patients undergoing treatment for alcohol dependence, whether they are taking acamprosate or not, should be monitored for the emergence of symptoms of depression and/or suicidal behavior. Families and caregivers of patients being treated with acamprosate should be alerted to the need to monitor patients for the emergence of symptoms of depression or suicidality, and to report such symptoms to the patient's physician.

The concomitant intake of alcohol and acamprosate does not affect the pharmacokinetics of either alcohol or acamprosate.

Safety and efficacy have not been established in pediatric patients (less than 18 years of age).

Dialysis

Acamprosate is contraindicated in patients with severe renal dysfunction (creatinine clearance equal to or less than 30 mL/min).