Alcohol use disorder (AUD) affects millions of people every year. According to the 2021 National Survey on Drug Use and Health, some 29.5 million Americans aged 12 or older reported suffering from alcohol dependency in the previous year. Of the wide variety of treatments available, one of the leading medical options is acamprosate — also known as acamprosate calcium and formerly sold in the United States as Campral.

Although it’s generally safe and effective, acamprosate can cause certain side effects, usually mild but occasionally more serious. This article introduces acamprosate, summarizes those effects, and explains how to manage them and when to seek medical guidance.

What Is Acamprosate and How Does It Work?

Acamprosate tackles the changes to brain chemistry that come from long-term heavy drinking. For people who’ve recently quit, its purpose is to support sobriety by restoring chemical balance in the brain. The specifics of how it works aren’t fully understood, but experts believe it reduces a state of excessive neural excitation caused by alcohol dependence. It’s similar in structure to taurine and GABA and appears to target receptor activity associated with those neurotransmitters, in particular, it helps regulate the surge in glutamate that occurs after alcohol cessation, which is a key driver of cravings. Its calcium content is also believed to play a role.

Acamprosate is not a cure for alcohol addiction, and it doesn’t prevent or treat withdrawal symptoms. It’s intended for people who have already completed detox and stopped drinking entirely. It’s also not intended for those dependent on substances other than alcohol. The medication comes as a delayed-release tablet taken three times daily, with or without food, and is most effective as part of a broader recovery plan that includes behavioral therapy, counseling, and social support.

Even after a significant period of sobriety, consult your doctor before stopping acamprosate, the medication only works as long as it’s taken regularly. If you relapse while taking it, continue the medication and contact your doctor; acamprosate does not produce adverse reactions with alcohol.

Common Acamprosate Side Effects

The safety profile of acamprosate is well established, but side effects are common, particularly early in treatment as the body adjusts. These tend to be mild and may include:

  • Gastric complaints: diarrhea, gas, upset stomach, nausea
  • Decreased appetite
  • Dizziness and weakness
  • Headaches
  • Dry mouth
  • Itching and sweating
  • Difficulty falling or staying asleep
  • Fatigue
  • Anxiety and feelings of confusion
  • Increased feelings of depression

Not everyone experiences these effects, and they vary based on individual response to the medication. If any side effects are persistent or disruptive, contact your doctor — they may adjust your dosage or suggest ways to manage specific symptoms.

Signs of Overuse: What to Watch For

Some side effects overlap with symptoms of taking too much acamprosate. If you’re experiencing severe diarrhea or suspect overdose, contact a poison control hotline immediately. Signs of overusing acamprosate include:

  • Severe appetite loss, upset stomach, or constipation
  • Extreme thirst
  • Vomiting
  • Pronounced tiredness or muscle weakness
  • Restlessness or confusion
  • Incoherent speech
  • Metallic taste in the mouth

Serious Side Effects: When to Seek Immediate Help

More serious side effects are rare but can signal a medical emergency. Seek care immediately if you experience:

  • Burning, tingling, or numbness in the hands, feet, arms, or legs (paresthesia)
  • Rash, hives, difficulty breathing, or swelling of the face, lips, tongue, or throat (signs of allergic reaction)
  • Severe anxiety or depression
  • Significant mood swings or behavior changes
  • Thoughts of suicide or self-harm
  • Signs of kidney problems: swelling, urinating less, shortness of breath, or extreme fatigue
  • Trouble breathing or abnormal bleeding

How to Manage Side Effects

Most mild side effects can be addressed with simple adjustments and consistent communication with your care team:

  • Stay hydrated. Drinking enough water helps relieve headaches and fatigue.
  • Eat regular, balanced meals. Small, frequent meals can help stabilize appetite and energy levels, countering nausea and fatigue.
  • Keep your provider updated. Regular check-ins allow your doctor to adjust your dosage or recommend safe ways to manage specific symptoms, including over-the-counter options where appropriate.
  • Build in rest time. If possible, start the medication during time off from work or school so you can adjust without added pressure.
  • Exercise and practice stress management. Regular physical activity and relaxation techniques such as yoga or meditation can help manage psychological effects like anxiety and sleep disruption.
  • Lean on your support network. Trusted friends, family, or support groups provide an important outlet for the emotional side effects that can accompany early recovery.

Is Acamprosate Right for You?

Before prescribing acamprosate, your healthcare team will want the full picture: your other medications, any preexisting conditions, and whether you have a history of other substance use disorders. All of these factors help determine whether the medication is appropriate for your situation. Being open and honest with your care team gives them the best chance of finding a path forward with the fewest side effects and the lowest risk of relapse.

Get Support From an Experienced Recovery Team

If you’re struggling with alcohol use disorder, you don’t have to face it alone. The team at Sunlight Recovery offers comprehensive addiction treatment, including tailored detox, residential and outpatient programs, and family support, delivered by compassionate professionals in a safe, structured environment. Contact us today to explore your options and take the first step toward recovery.