CAMPRAL EC 333MG (ACAMPROSATE) Tabs 168`S

Campral (acamprosate) helps people with alcohol use disorder who have already stopped drinking to maintain their abstinence. Prolonged alcohol use disrupts the balance of neurotransmitters in the brain. When alcohol is suddenly stopped, the brain remains in a state of chemical imbalance — contributing to cravings, anxiety, insomnia, and restlessness that drive relapse. Campral works by restoring this chemical balance.

Campral does NOT prevent or treat alcohol withdrawal symptoms such as shaking or seizures — these require separate medical management before Campral is started. It is most effective when used as part of a comprehensive treatment programme that includes counselling and psychological support.

Approved Uses

•     Maintenance of abstinence from alcohol in alcohol-dependent adults who have already completed alcohol detoxification

•     Used as an adjunct (add-on) to psychosocial therapy — not to be used as a standalone treatment

•     Treatment should start as soon as possible after the alcohol withdrawal period ends

Dosing

•     Adults ≥60 kg: 2 tablets (666 mg) three times daily — morning, noon, and evening. Total daily dose: 1,998 mg

•     Adults <60 kg: 333 or 666 mg 2 times daily

•     Moderate renal impairment (CrCl 30–50 mL/min): Reduce to 1 tablet (333 mg) three times daily

•     Children/adolescents under 18: NOT recommended — safety and efficacy not established

•     Elderly: Use with caution due to reduced renal function; assess kidney function before starting

Recommended treatment duration is 1 year. Continue even if a relapse (return to drinking) occurs — relapse is a common part of recovery, not a reason to stop.

Administration

•     Swallow tablets whole with water — do not crush or chew (the enteric coating protects against stomach acid)

•     Can be taken with or without food; taking with meals helps remember the three daily doses

Common (may affect more than 1 in 10 patients)

•     Diarrhoea — the most common side effect; usually mild and decreases with time

•     Nausea and abdominal discomfort

•     Flatulence

•     Itching (pruritus) and skin rash

Serious — Tell Your Doctor Immediately

•     Suicidal thoughts or depression: alcohol dependence is closely linked with depression — report any thoughts of self-harm immediately

•     Severe allergic reactions: difficulty breathing, swelling of the face, lips, or throat — stop immediately and seek emergency help

•     Acute kidney failure (rare): reduced urination, swelling — seek urgent care

•     Do not take if you have severe renal impairment (CrCl ≤30 mL/min) — CONTRAINDICATED

•     Do not take if you are breastfeeding

•     Do not take if you are allergic to acamprosate or any ingredient in the tablet

•     Note: Campral is NOT for use in patients still drinking alcohol actively — detoxification must be completed first

Pregnancy

Acamprosate caused malformations in animal studies. Avoid during pregnancy unless clearly necessary. Inform your doctor immediately if you become pregnant during treatment.

Breastfeeding

CONTRAINDICATED — do not use while breastfeeding.

Kidney Function

Acamprosate is entirely excreted by the kidneys. Dose reduction is required in moderate renal impairment and the drug is contraindicated in severe impairment.

Liver Disease

Acamprosate is NOT metabolised by the liver — dose adjustment is not required in mild to moderate liver disease. This makes it suitable for patients with alcohol-related liver injury.

Mental Health

Regular monitoring for depression and suicidal ideation is essential, as these are common in people with alcohol use disorder. Contact your doctor if your mood worsens.

•     Naltrexone: Co-administration increases acamprosate blood levels by up to 33% (Cmax) — monitor, though dose adjustment is usually not required

•     Alcohol: Does not affect the pharmacokinetics of either drug — Campral can be continued even after a relapse

•     NSAIDs: Potential interaction via renal tubular secretion — use with caution

•     Antidepressants, anxiolytics, disulfiram, diazepam: No clinically significant interactions reported

•     Store at room temperature (15–30°C), away from moisture and heat

•     Do not store in the bathroom

•     Keep out of reach of children

POM — Prescription Only Medicine. Must be prescribed by a doctor and used alongside a structured alcohol treatment programme.

•     Do not stop Campral without consulting your doctor — even if you have a relapse

•     Continue attending counselling and support group sessions — Campral is not effective without psychological support

•     Tell your doctor about any changes in mood, especially depression or thoughts of self-harm

•     Campral does not cause drowsiness but alcohol does — you are expected to remain alcohol-free during treatment

•     Campral works on the glutamate (NMDA receptor) system — distinct mechanism from naltrexone (opioid antagonist) and disulfiram (aversion therapy); can be combined with naltrexone under supervision

•     Liver-safe: No hepatic metabolism — suitable for patients with alcohol-related liver disease (unlike naltrexone which has hepatotoxicity risk)

•     Screen for baseline renal function (eGFR/CrCl) before prescribing — dose reduction required in moderate CKD, contraindicated in severe CKD

•     If starting immediately post-detoxification: can begin with as little as 0 days abstinence — earlier start improves outcomes

•     Duration: Prescribe for minimum 6 months, ideally 1 year — short courses are less effective

•     Relapse does not mean failure: continue prescribing even after a drinking episode — continued use post-relapse is associated with a return to abstinence

Q: What if I start drinking again while taking Campral?

A: Do not stop taking Campral. Continue taking it and tell your doctor. Campral can still help you return to abstinence. Relapse is a recognised part of recovery — not a failure — and continuing Campral increases your chances of getting back on track.

Q: How long does it take for Campral to work?

A: Campral reaches steady-state levels in the blood within about 5 days. You may not notice the effects immediately — it works gradually and subtly to reduce the brain's urge to drink. The benefit builds over weeks to months.

Q: Does Campral treat withdrawal symptoms?

A: No. Campral does not prevent or treat alcohol withdrawal symptoms such as shaking, sweating, or seizures. These are managed separately — usually with benzodiazepines under medical supervision — before Campral is started.