6 Common Questions About Acamprosate Interactions

Acamprosate is an oral medication that treatsalcohol use disorder (AUD). In fact, it's a first-choice medication for treating AUD.

If you're prescribed acamprosate, knowing about its risks can help keep you safe. Acamprosate is unique because it hasno known directdrug interactions. Still, it's important to know whether acamprosate can be combined with other medications that treat AUD. It's also good to know what to do in case you return to drinking alcohol while taking acamprosate. Here, we'll answer six questions about acamprosate interactions.

1. What does acamprosate interact with?

There areno drug interactions listed in the product information for acamprosate. But it doesn't necessarily mean that none exist. It just means that acamprosate interactions haven't been seen or studied thus far.

Drug interactions with acamprosate could cause two things to happen:

• Acamprosate becomes less effective. A drug interaction with acamprosate could decrease acamprosate levels in the body, making it less effective. There aren't any known acamprosate interactions that cause this to happen.

• Unwanted side effects. A medication that increases acamprosate levels in the body may increase the risk of side effects. For example, Probenecid, a medication used for gout, blocks a protein (OAT1) that helps clear acamprosate from the body. Blocking OAT1 could increase acamprosate levels in the body. This could increase your risk ofside effects like diarrhea and nausea. However, this interaction hasn't been well studied.

Provide your healthcare team with alist of your current medications before you start taking acamprosate. They can help you screen for interactions. It's also a good idea to let them know if you notice a change in your acamprosate treatment after starting a new medication.

2. Can you drink alcohol with acamprosate?

Since acamprosate is used to treat AUD, drinking alcohol isn't recommended while you take it. However, relapsing to alcohol use is part of the recovery process for many people with AUD. If you relapse to alcohol while taking acamprosate, continue taking your medication. But reach out to your prescriber immediately. Even though acamprosate and alcohol aren't known to interact, you'll still want your prescriber's input on what to do next.

If you've started drinking alcohol again while taking acamprosate, don't get discouraged. Thisdoesn't mean you failed your treatment or that you can't get back on track. Talk to your prescriber and/or therapist about ways to avoid triggers. They can help you strengthen your recovery program moving forward.

3. Can you take acamprosate with naltrexone?

Naltrexone (Vivitrol) is another first-choice medicationfor treating AUD. It also treats opioid use disorder.

Naltrexone and acamprosate work in different ways to treat AUD. So it's possible that the combination is better at treating AUD compared to using either medication alone.

One large real-world study found that people taking acamprosate with naltrexone were less likely to be hospitalized than people taking acamprosate alone. Other research shows that the combination may bemore effective than acamprosate alone at preventing relapse to alcohol. But the combination wasn't more effective than naltrexone alone in this study.

Based on the available research, taking acamprosate with naltrexone may be beneficial. But it also comes with an extra risk of side effects from taking two medications. So talk to your healthcare team about what's best for you. They'll consider your medical history, other medications you take, and your personal goals when helping you pick the best option.

4. Can you take acamprosate with disulfiram?

Disulfiram is another medication that treats AUD. But for most people, disulfiram isn't considered a first-choice medication for AUD, while acamprosate is.

Disulfiram and acamprosate work in different ways to treat AUD. They aren't known to directly interact. But even though it may be safe to take together, this combination hasn't been well studied. One small, older study suggests a possible benefit from taking disulfiram with acamprosate. But more research is needed to know for sure so the combination isn't usually prescribed.

Still, if you're wondering whether the combination of disulfiram and acamprosate is a good option for you, talk to your healthcare professional (HCP). They can discuss whether trying one of these medications alone (or naltrexone) is a better option for you.

5. Can you take acamprosate with gabapentin?

Gabapentin (Neurontin) is a medication that's FDA approved to treat some types of seizures and nerve pain. It's also usedoff-label totreat AUD.

Gabapentin is recommended as a medicationoption for moderate-to-severe AUD in some people. There's research showing that gabapentin can help people with AUDdrink less andreduce alcohol withdrawal symptoms. It may beeven moreeffective in people with alcohol withdrawal symptoms.

It's possible that your HCP will recommend combining acamprosate with gabapentin. While we don't have research on this combination, the two medications don't have any known interactions. And compared to acamprosate, gabapentin seems tobetter target specific alcohol withdrawal symptoms, such as trouble sleeping. However, gabapentin comes with its ownside effects, so it's important to consider these as well. Your prescriber can help you weigh the risks versus benefits.

6. Can you take acamprosate with benzodiazepines?

Benzodiazepines, or "benzos," are a group of medications that treat several health conditions. Examples include anxiety, panic disorder, and seizures. They're also a first-choice treatment option for alcohol withdrawal syndrome. This describes a range of symptoms that can occur when you stop drinking alcohol after long-term, heavy drinking. People with AUD may experience alcohol withdrawal syndrome when trying to quit.

Acamprosate isn't known to interact with benzodiazepines. So it's possible that your HCP will recommend taking benzodiazepines short-term for alcohol withdrawal syndrome while also taking Acamprosate.