Learn about Acamprosate drug interactions, including medications, supplements, and foods to watch. Know what to tell your doctor before starting treatment.
One of the advantages of Acamprosate (formerly sold as Campral) is that it has relatively few drug interactions compared to many other medications. It's not processed by the liver, doesn't affect liver enzymes, and doesn't interact with the cytochrome P450 system that causes many common drug-drug interactions.
That said, there are still some interactions worth knowing about — and a few situations where you should exercise caution. This guide covers what the research shows, what to watch for, and what to tell your doctor before starting Acamprosate.
Drug interactions happen when one medication affects how another medication works in your body. This can happen in several ways:
Acamprosate is unique because it is not metabolized by the liver at all. It passes through your body and is eliminated entirely by the kidneys, unchanged. This means it avoids the most common category of drug interactions — those involving liver enzymes. Learn more about how Acamprosate works in your body.
Interaction type: Moderate — pharmacokinetic
When Acamprosate and Naltrexone (brand name: ReVia, Vivitrol) are taken together, Naltrexone can increase Acamprosate blood levels by approximately 25%. However, this combination is commonly used in clinical practice because the two medications work through different mechanisms and can complement each other.
Naltrexone blocks the rewarding effects of alcohol (opioid receptor antagonist), while Acamprosate reduces the neurological discomfort of sobriety (glutamate modulation). Many addiction specialists prescribe them together intentionally.
What to do: No dose adjustment is routinely required when combining these medications. Your doctor should be aware you're taking both so they can monitor for any unusual side effects.
Interaction type: Theoretical — absorption
Acamprosate contains calcium (it's formulated as Acamprosate Calcium). Tetracycline antibiotics — including Doxycycline, Minocycline, and Tetracycline — can bind to calcium in the GI tract, which may reduce the absorption of the antibiotic.
Common tetracyclines to be aware of:
What to do: If you need a tetracycline antibiotic while taking Acamprosate, talk to your doctor. Separating the doses by 2–3 hours may reduce the risk of reduced antibiotic absorption.
Interaction type: Theoretical — absorption
Similar to tetracyclines, fluoroquinolone antibiotics can also bind to divalent cations like calcium, potentially reducing their absorption. Fluoroquinolones include:
What to do: Separate doses of Acamprosate and the antibiotic by at least 2 hours. Inform your doctor that you're taking Acamprosate Calcium so they can advise accordingly.
Since Acamprosate already contains calcium, taking additional calcium supplements could theoretically increase the total calcium you're consuming. While this is unlikely to be clinically significant for most people, it's worth mentioning to your doctor, especially if you're already taking calcium for osteoporosis or another condition.
Over-the-counter antacids like Tums (calcium carbonate) add to your calcium intake. This isn't typically a concern at normal doses, but if you take antacids frequently, let your doctor know.
Non-steroidal anti-inflammatory drugs like Ibuprofen (Advil, Motrin) and Naproxen (Aleve) are not known to have a direct interaction with Acamprosate. However, chronic use of NSAIDs can affect kidney function, and since Acamprosate is eliminated entirely through the kidneys, anything that impairs renal function could potentially affect Acamprosate clearance.
What to do: Occasional use of NSAIDs is generally fine. If you use them regularly, mention it to your doctor so they can monitor your kidney function.
There are no well-documented herbal interactions with Acamprosate. However, supplements that affect the nervous system — such as Valerian root, Kava, or St. John's Wort — should be discussed with your doctor, as they may have additive or opposing effects on the brain chemistry that Acamprosate is trying to balance.
Taking Acamprosate with food decreases its bioavailability, meaning your body absorbs less of the medication. However, this effect has already been accounted for in the standard dosing, and no dose adjustment is needed whether you take it with or without food.
In fact, taking Acamprosate with meals is often recommended because it can help reduce gastrointestinal side effects like diarrhea and nausea and may improve adherence to the three-times-daily schedule.
Acamprosate does not cause a harmful reaction if combined with alcohol (unlike Disulfiram, which causes severe nausea and flushing). However, drinking alcohol defeats the purpose of taking Acamprosate, which is designed to support abstinence.
If you do drink while on Acamprosate, do not stop taking the medication. Continue your doses and contact your healthcare provider to discuss the relapse.
There is no known interaction between Acamprosate and caffeine. However, caffeine can worsen insomnia and anxiety — two side effects some patients experience with Acamprosate. If you're having trouble sleeping, consider reducing caffeine intake, especially in the afternoon and evening.
Before your provider prescribes Acamprosate, make sure they know about:
Keeping your provider fully informed helps them monitor for interactions and adjust your treatment plan as needed.
Acamprosate has one of the cleanest drug interaction profiles of any medication used for alcohol dependence. Because it bypasses liver metabolism entirely, it avoids the complex interactions that plague many other drugs. The main concerns are theoretical interactions with certain antibiotics (due to the calcium component) and monitoring kidney function if you're taking other medications that affect the kidneys.
The bottom line: Acamprosate plays well with most other medications, but always keep your doctor informed about everything you're taking. If you're ready to start treatment, learn how to find a prescriber near you, and use Medfinder to locate a pharmacy with Acamprosate in stock.
You focus on staying healthy. We'll handle the rest.
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