Acamprosate for drinking

What is acamprosate?

Acamprosate is a prescription tablet approved in Australia to help people who are dependent on alcohol stay off alcohol after they've stopped.

It isn't a sedative, it isn't addictive, and it doesn't cause a reaction if you drink.

How does acamprosate help with drinking?

Acamprosate is thought to help rebalance brain chemistry that changes with long-term heavy drinking. This can ease cravings in the weeks and months after you stop.

It's used to help people stay stopped, not to help them cut down while still drinking. It's started once you've stopped and any withdrawal has settled, usually 3 to 7 days after your last drink.

Who might acamprosate suit?

It may suit people who are dependent on alcohol and whose goal is to stop drinking completely. It's often started soon after withdrawal.

• People who want help with cravings after stopping.
• People who take opioids, or may need them for pain, since acamprosate doesn't block them.
• People with some liver problems, as long as the liver problems aren't severe. Your GP will check.

Who shouldn't take acamprosate?

Acamprosate isn't suitable for everyone. Your kidneys clear it from your body, so kidney health matters most.

• People with significant kidney problems. Your GP will usually check your kidney function with a blood test before you start.
• People with severe liver failure.
• People who have had an allergic reaction to it.

If you're pregnant, planning a pregnancy or breastfeeding, talk to your GP first.

What are the side effects of acamprosate?

Diarrhoea is the most common side effect. It often settles by itself within days. Others include:

• Feeling sick, vomiting or stomach pain.
• Itchy skin or a rash.

Low mood is common when people stop drinking, whatever the reason. Tell your GP if your mood drops, and get help straight away if you have thoughts of harming yourself. Lifeline is on 13 11 14, 24 hours a day.

How long do people take acamprosate?

Usually for some months, with regular reviews. You and your GP decide together how long to keep going.

It's usually taken three times a day, with meals. The number of tablets depends on your weight and your kidney function, so take it exactly as your GP and pharmacist explain.

If you have a drink or a slip-up, don't just stop taking it. Tell your GP, so you can look at what happened together.

How much does acamprosate cost, and is it on the PBS?

Acamprosate is on the Pharmaceutical Benefits Scheme (PBS) for alcohol dependence. You pay the standard PBS amount for each script, and less if you have a concession card.

The PBS listing has conditions: it's for people who are dependent on alcohol and aiming to stop drinking, as part of a comprehensive treatment program. Your GP will check whether you meet them.

What should I ask my GP about acamprosate?

• Is acamprosate a good fit for my goal and my health?
• When should I start it, and do I need to finish withdrawal first?
• Do I need a blood test to check my kidneys?
• How do I fit three doses a day into my routine?
• Which side effects should I watch for?
• What should I do if I have a drink?
• How long would I take it, and when will we review it?

This is general information. Your GP will explain what applies to you and how acamprosate compares with the other medicines that can help.