acamprosate calcium
(a-cam-pro-sate)
Campral

Classification
Therapeutic: alcohol abuse therapy adjuncts
Pharmacologic: gamma aminobutyric acid (GABA) analogues

Pregnancy Category C


Copyright © 2007 by F.A. Davis Company

Indications
Maintenance of alcohol abstinence; part of a comprehensive alcohol abstinence program.

Action
Interacts with and restores balance to CNS glutamate and GABA neurotransmitter systems. Therapeutic Effects: Continued alcohol abstinence.

Pharmacokinetics
Absorption: 11% absorbed following oral administration
Distribution: Unknown
Metabolism and Excretion: Not metabolized, excreted mainly unchanged in urine
Half-life: 20–33 hr

TIME/ACTION PROFILE (blood levels)

ROUTEONSETPEAKDURATION
POunknown3–8 hrunknown


Contraindications/Precautions
Contraindicated in: Hypersensitivity. CCr 30 ml/min or less.
Use Cautiously in: CCr 30–50 ml/min (dose reduction necessary). History of depression or suicide attempt. Pregnancy (use only if potential maternal benefit outweighs fetal risk). Lactation or children (safety not established).

Adverse Reactions/Side Effects*
*CAPITALS indicate life threatening; underlines indicate most frequent.

CNS: abnormal thinking, anxiety, depression, drowsiness, headache. EENT: abnormal vision. Resp: cough, dyspnea, pharyngitis, rhinitis. CV: palpitations, peripheral edema, syncope, vasodilation. GI: abdominal pain, anorexia, constipation, diarrhea, flatulence, ↑ appetite, nausea, taste perversion, vomiting. GU: ↓ libido, impotence. Derm: rash. Metab: weight gain. MS: arthralgia, back pain, mylagia. Neuro: tremor.

Interactions
Drug–Drug: None noted.

Route/Dosage

PO (Adults): Two 333 mg tablets (666 mg/dose) three times daily. Lower doses may be effective in some patients.
Renal Impairment
PO (Adults): CCr 30–50 mL/min—One 333 mg tablet three times daily.

Availability
Tablets: 333 mg .

NURSING IMPLICATIONS


Assessment
Assess for signs of alcohol withdrawal at initiation 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.


Potential Nursing Diagnoses
Ineffective coping (Indications).


Implementation
Treatment with acamprosate should be initiated 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.


Patient/Family Teaching
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 breast feeding.
Encourage patient to continue active counseling and support. Acamprosate helps maintain abstinence only when used as part of a comprehensive psychosocial treatment program.


Evaluation/Desired Outcomes
Continued abstinence from alcohol.

Copyright © 2007 by F.A. Davis Company