U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ACHIRAL
Molecular Formula 2C5H10NO4S.Ca
Molecular Weight 400.482
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of ACAMPROSATE CALCIUM

SMILES

[Ca++].CC(=O)NCCCS([O-])(=O)=O.CC(=O)NCCCS([O-])(=O)=O

InChI

InChIKey=BUVGWDNTAWHSKI-UHFFFAOYSA-L
InChI=1S/2C5H11NO4S.Ca/c2*1-5(7)6-3-2-4-11(8,9)10;/h2*2-4H2,1H3,(H,6,7)(H,8,9,10);/q;;+2/p-2

HIDE SMILES / InChI
Acamprosate was the third medication, after disulfiram and naltrexone, to receive U.S. Food and Drug Administration (FDA) approval for postwithdrawal maintenance of alcohol abstinence. The French pharmaceutical company Laboratoires Meram began clinical development and testing of acamprosate in 1982. From 1982 to 1988, acamprosate was tested for safety and for efficacy as a treatment for alcohol dependence. Based on these studies, in 1989 Laboratoires Meram was granted marketing authorization for acamprosate in France under the trade name Aotal®. Since then, acamprosate has been extensively used and studied throughout Europe and, subsequently, in the United States. Although acamprosate has been used in Europe for more than 20 years, it was not approved by FDA until July 2004. Acamprosate became available for use in the United States in January 2005, under the trade name Campral® Delayed-Release Tablets (Merck Santé, a subsidiary of Merck KGaA, Darmstadt, Germany). Campral is currently marketed in the United States by Forest Pharmaceuticals. The mechanism of action of acamprosate in maintenance of alcohol abstinence is not completely understood. Chronic alcohol exposure is hypothesized to alter the normal balance between neuronal excitation and inhibition. in vitro and in vivo studies in animals have provided evidence to suggest acamprosate may interact with glutamate and GABA neurotransmitter systems centrally, and has led to the hypothesis that acamprosate restores this balance. It seems to inhibit NMDA receptors while activating GABA receptors.

CNS Activity

Curator's Comment: Chronic alcohol intake alters the balance of excitatory (e.g. glutamate) and inhibitory (e.g. gamma amino butyric acid) and amino acids within the brain. Acamprosate crosses the blood brain barrier and is thought to act by complex neuromodulatory processes to restore the balance, especially the inhibition of glutamate which is thought to have an important role in dependency. It reduces craving and therefore the risk of relapse.

Originator

Curator's Comment: The French pharmaceutical company Laboratoires Meram began clinical development and testing of acamprosate in 1982.

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
Acamprosate

Approved Use

Acamprosate calcium delayed-release tablets are indicated for the maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation. Treatment with Acamprosate calcium delayed-release tablets should be part of a comprehensive management program that includes psychosocial support.

Launch Date

2004
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
244.64 ng/mL
666 mg single, oral
dose: 666 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACAMPROSATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
3829.56 ng × h/mL
666 mg single, oral
dose: 666 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACAMPROSATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
10.26 h
666 mg single, oral
dose: 666 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACAMPROSATE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
Doses

Doses

DosePopulationAdverse events​
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources:
unhealthy, adult
n = 1539
Health Status: unhealthy
Condition: alcohol-dependence
Age Group: adult
Population Size: 1539
Sources:
Disc. AE: Diarrhea, Nausea...
AEs leading to
discontinuation/dose reduction:
Diarrhea (2%)
Nausea (<1%)
Depression (<1%)
Anxiety (<1%)
Sources:
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources: Page: p. 93
unhealthy, adult
n = 1346
Health Status: unhealthy
Condition: alcohol (ethanol)-dependence
Age Group: adult
Population Size: 1346
Sources: Page: p. 93
Disc. AE: Pain, Constipation...
AEs leading to
discontinuation/dose reduction:
Pain (<1%)
Constipation (<1%)
Somnolence (<1%)
Insomnia (<1%)
Impotence (<1%)
Sources: Page: p. 93
56 g single, oral
Overdose
Dose: 56 g
Route: oral
Route: single
Dose: 56 g
Sources:
unknown
Other AEs: Diarrhea...
66 mg 3 times / day steady, oral
Dose: 66 mg, 3 times / day
Route: oral
Route: steady
Dose: 66 mg, 3 times / day
Sources:
unhealthy
n = 14
Health Status: unhealthy
Condition: Alcohol Dependence
Population Size: 14
Sources:
Other AEs: Anaphylactoid reaction, Diffuse pain...
Other AEs:
Anaphylactoid reaction (serious, 1 patient)
Diffuse pain (below serious, 2 patients)
Suicidal ideation (below serious, 2 patients)
Tremor (below serious, 2 patients)
Sources:
AEs

AEs

AESignificanceDosePopulation
Diarrhea 2%
Disc. AE
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources:
unhealthy, adult
n = 1539
Health Status: unhealthy
Condition: alcohol-dependence
Age Group: adult
Population Size: 1539
Sources:
Anxiety <1%
Disc. AE
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources:
unhealthy, adult
n = 1539
Health Status: unhealthy
Condition: alcohol-dependence
Age Group: adult
Population Size: 1539
Sources:
Depression <1%
Disc. AE
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources:
unhealthy, adult
n = 1539
Health Status: unhealthy
Condition: alcohol-dependence
Age Group: adult
Population Size: 1539
Sources:
Nausea <1%
Disc. AE
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources:
unhealthy, adult
n = 1539
Health Status: unhealthy
Condition: alcohol-dependence
Age Group: adult
Population Size: 1539
Sources:
Constipation <1%
Disc. AE
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources: Page: p. 93
unhealthy, adult
n = 1346
Health Status: unhealthy
Condition: alcohol (ethanol)-dependence
Age Group: adult
Population Size: 1346
Sources: Page: p. 93
Impotence <1%
Disc. AE
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources: Page: p. 93
unhealthy, adult
n = 1346
Health Status: unhealthy
Condition: alcohol (ethanol)-dependence
Age Group: adult
Population Size: 1346
Sources: Page: p. 93
Insomnia <1%
Disc. AE
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources: Page: p. 93
unhealthy, adult
n = 1346
Health Status: unhealthy
Condition: alcohol (ethanol)-dependence
Age Group: adult
Population Size: 1346
Sources: Page: p. 93
Pain <1%
Disc. AE
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources: Page: p. 93
unhealthy, adult
n = 1346
Health Status: unhealthy
Condition: alcohol (ethanol)-dependence
Age Group: adult
Population Size: 1346
Sources: Page: p. 93
Somnolence <1%
Disc. AE
666 mg 3 times / day steady, oral
Recommended
Dose: 666 mg, 3 times / day
Route: oral
Route: steady
Dose: 666 mg, 3 times / day
Sources: Page: p. 93
unhealthy, adult
n = 1346
Health Status: unhealthy
Condition: alcohol (ethanol)-dependence
Age Group: adult
Population Size: 1346
Sources: Page: p. 93
Diarrhea
56 g single, oral
Overdose
Dose: 56 g
Route: oral
Route: single
Dose: 56 g
Sources:
unknown
Diffuse pain below serious, 2 patients
66 mg 3 times / day steady, oral
Dose: 66 mg, 3 times / day
Route: oral
Route: steady
Dose: 66 mg, 3 times / day
Sources:
unhealthy
n = 14
Health Status: unhealthy
Condition: Alcohol Dependence
Population Size: 14
Sources:
Suicidal ideation below serious, 2 patients
66 mg 3 times / day steady, oral
Dose: 66 mg, 3 times / day
Route: oral
Route: steady
Dose: 66 mg, 3 times / day
Sources:
unhealthy
n = 14
Health Status: unhealthy
Condition: Alcohol Dependence
Population Size: 14
Sources:
Tremor below serious, 2 patients
66 mg 3 times / day steady, oral
Dose: 66 mg, 3 times / day
Route: oral
Route: steady
Dose: 66 mg, 3 times / day
Sources:
unhealthy
n = 14
Health Status: unhealthy
Condition: Alcohol Dependence
Population Size: 14
Sources:
Anaphylactoid reaction serious, 1 patient
66 mg 3 times / day steady, oral
Dose: 66 mg, 3 times / day
Route: oral
Route: steady
Dose: 66 mg, 3 times / day
Sources:
unhealthy
n = 14
Health Status: unhealthy
Condition: Alcohol Dependence
Population Size: 14
Sources:
Overview

OverviewOther

Other InhibitorOther SubstrateOther Inducer






Drug as perpetrator​Drug as victimTox targets

Tox targets

PubMed

PubMed

TitleDatePubMed
Interactions between taurine and ethanol in the central nervous system.
2002
Alcohol misuse and dependence. Assessment and management.
2002 Dec
Acamprosate inhibits the binding and neurotoxic effects of trans-ACPD, suggesting a novel site of action at metabotropic glutamate receptors.
2002 Dec
The European NEAT program: an integrated approach using acamprosate and psychosocial support for the prevention of relapse in alcohol-dependent patients with a statistical modeling of therapy success prediction.
2002 Oct
Acamprosate, MK-801, and ifenprodil inhibit neurotoxicity and calcium entry induced by ethanol withdrawal in organotypic slice cultures from neonatal rat hippocampus.
2002 Oct
Use of acamprosate and opioid antagonists in the treatment of alcohol dependence: a European perspective.
2003
Current pharmacotherapies of alcoholism: a U.S. perspective.
2003
Pharmacological mechanisms of naltrexone and acamprosate in the prevention of relapse in alcohol dependence.
2003
[Drug therapy of alcohol dependence--a critical review].
2003
[Neural basis of alcohol dependence].
2003
The anti-craving taurine derivative acamprosate: failure to extinguish morphine conditioned place preference.
2003
Research advances in the understanding and treatment of addiction.
2003
Acamprosate.
2003
Cost-effectiveness of adjuvant treatment with acamprosate in maintaining abstinence in alcohol dependent patients.
2003 Apr
Effects of naltrexone alone and in combination with acamprosate on the alcohol deprivation effect in rats.
2003 Aug
New pharmacotherapies for alcohol dependence: are they being used and what do they cost?
2003 Aug 18
Does acamprosate improve reduction of drinking as well as aiding abstinence?
2003 Dec
Acamprosate and naltrexone treatment for alcohol dependence: an evidence-based risk-benefits assessment.
2003 Dec
Local acamprosate modulates dopamine release in the rat nucleus accumbens through NMDA receptors: an in vivo microdialysis study.
2003 Feb
The anti-relapse compound acamprosate inhibits the development of a conditioned place preference to ethanol and cocaine but not morphine.
2003 Jan
Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study.
2003 Jan
[Deficits in preventing recurrence in alcoholic patients. Withdrawal--and immediately back to the bottle].
2003 Jan 16
[The role of the glutamatergic system in alcohol addiction].
2003 Jul
Testing combined pharmacotherapies and behavioral interventions for alcohol dependence (the COMBINE study): a pilot feasibility study.
2003 Jul
Testing combined pharmacotherapies and behavioral interventions in alcohol dependence: rationale and methods.
2003 Jul
The effect of acamprosate on the development of morphine-induced behavioral sensitization in rats.
2003 Jul
[Acamprosate (Aotal): could adverse effects upset the treatment of alcohol dependence?].
2003 Jul-Aug
Acamprosate for the adjunctive treatment of alcohol dependence.
2003 Jul-Aug
A pilot study on the effects of treatment with acamprosate on craving for alcohol in alcohol-dependent patients.
2003 Jun
Dose-ranging kinetics and behavioral pharmacology of naltrexone and acamprosate, both alone and combined, in alcohol-dependent subjects.
2003 Jun
Acamprosate does not induce a conditioned place preference and reveals no state-dependent effects in this paradigm.
2003 Jun
Acamprosate and its efficacy in treating alcohol dependent adolescents.
2003 Jun
Effects of acamprosate on excitatory amino acids during multiple ethanol withdrawal periods.
2003 Mar
Acamprosate in Korean alcohol-dependent patients: a multi-centre, randomized, double-blind, placebo-controlled study.
2003 Mar-Apr
Physicians' opinions about medications to treat alcoholism.
2003 May
[Preventing recurrence after alcohol withdrawal treatment with drugs. Reducing the drive to drink].
2003 May 8
Acamprosate blocks the increase in dopamine extracellular levels in nucleus accumbens evoked by chemical stimulation of the ventral hippocampus.
2003 Oct
Caroverine inhibits the conditioned place aversion induced by naloxone-precipitated morphine withdrawal in rats.
2003 Oct 2
Efficacy of acamprosate in the treatment of alcohol-dependent outpatients.
2003 Sep
[Psychosocial treatment plus drug prophylaxis. Fewer recurrences after alcohol withdrawal].
2003 Sep 4
Pharmacology of acamprosate: an overview.
2003 Winter
Prevention of relapse to addiction: information for the practitioner.
2004 Feb
Effect of the combination of naltrexone and acamprosate on alcohol intake in mice.
2004 Feb
Acamprosate in alcohol dependence: a randomized controlled efficacy study in a standard clinical setting.
2004 Jan
Improvement in quality of life after treatment for alcohol dependence with acamprosate and psychosocial support.
2004 Jan
The efficacy of acamprosate in the maintenance of abstinence in alcohol-dependent individuals: results of a meta-analysis.
2004 Jan
NR2B subunit selective NMDA antagonists inhibit neurotoxic effect of alcohol-withdrawal in primary cultures of rat cortical neurones.
2004 Jan
Neurochemical changes of the extracellular concentrations of glutamate and aspartate in the nucleus accumbens of rats after chronic administration of morphine.
2004 Jan 12
A comparison of two intensities of psychosocial intervention for alcohol dependent patients treated with acamprosate.
2004 May-Jun
Buprenorphine and a CRF1 antagonist block the acquisition of opiate withdrawal-induced conditioned place aversion in rats.
2005 Jan
Patents

Sample Use Guides

The recommended dose of CAMPRAL (Acamprosate) is two 333 mg tablets (each dose should total 666 mg) taken three times daily. Although dosing may be done without regard to meals, dosing with meals was employed during clinical trials and is suggested as an aid to compliance in those patients who regularly eat three meals daily. A lower dose may be effective in some patients. Treatment with CAMPRAL should be initiated as soon as possible after the period of alcohol withdrawal, when the patient has achieved abstinence, and should be maintained if the patient relapses. CAMPRAL should be used as part of a comprehensive psychosocial treatment program.
Route of Administration: Oral
In Vitro Use Guide
Acamprosate (0.1-1 mM) added to the perfusion fluid in vitro reduced excitatory and inhibitory postsynaptic potentials and the depolarizing responses evoked by iontophoretic application of the excitatory amino acids, L-glutamate, L-aspartate, L-homocysteate and N-methyl-D-aspartate, but did not alter the responses to gamma-aminobutyric acid in rat neocortical neurons.
Name Type Language
ACAMPROSATE CALCIUM
EP   USAN  
Official Name English
ACAMPROSATE CALCIUM [USAN]
Common Name English
ACAMPROSATE CALCIUM [MI]
Common Name English
Calcium 3-(acetylamino)propane-1-sulfonate
Systematic Name English
3-ACETAMIDO-1-PROPANESULFONATE CALCIUM
Systematic Name English
ACAMPROSATE CALCIUM [USP MONOGRAPH]
Common Name English
1-PROPANESULFONIC ACID, 3-(ACETYLAMINO)-, CALCIUM SALT (2:1)
Common Name English
3-ACETAMIDO-1-PROPANESULPHONATE CALCIUM
Systematic Name English
SN-102
Code English
NSC-759186
Code English
ACAMPROSATE CALCIUM [MART.]
Common Name English
ACAMPROSATE CALCIUM [JAN]
Common Name English
ACAMPROSATE CALCIUM [EP MONOGRAPH]
Common Name English
CAMPRAL
Brand Name English
Acamprosate calcium [WHO-DD]
Common Name English
ACAMPROSATE CALCIUM [ORANGE BOOK]
Common Name English
CALCIUM 3-(ACETYLAMINO)PROPANE-1-SULPHONATE
Systematic Name English
ACAMPROSATE CALCIUM [USP-RS]
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C1509
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
EU-Orphan Drug EU/3/14/1337
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
Code System Code Type Description
USAN
OO-21
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
EVMPD
SUB00239MIG
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
ECHA (EC/EINECS)
278-665-3
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
CHEBI
51042
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
CAS
77337-73-6
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
RXCUI
152761
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY RxNorm
RS_ITEM_NUM
1000554
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
NCI_THESAURUS
C65209
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
SMS_ID
100000078804
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
FDA UNII
59375N1D0U
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
DAILYMED
59375N1D0U
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
DRUG BANK
DBSALT000002
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
EPA CompTox
DTXSID6047529
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
NSC
759186
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
PUBCHEM
155434
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY
MERCK INDEX
m1288
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY Merck Index
ChEMBL
CHEMBL1201293
Created by admin on Fri Dec 15 15:26:48 GMT 2023 , Edited by admin on Fri Dec 15 15:26:48 GMT 2023
PRIMARY