Your Patients Can't Find Acamprosate — Here's How You Can Help

As a prescriber managing patients with alcohol use disorder, you're likely hearing from patients who can't get their Acamprosate prescriptions filled. The ongoing Acamprosate shortage means that simply writing a prescription is no longer enough — your patients may need your help navigating the supply chain.

This guide provides a practical, step-by-step workflow for helping patients locate Acamprosate or transition to an appropriate alternative without disrupting their recovery.

Current Availability: What You Need to Know

As of early 2026, Acamprosate Calcium 333 mg delayed-release tablets remain in an active shortage:

• Zydus: Temporarily discontinued
• Teva and Amneal: Producing with intermittent supply
• Brand (Campral): Permanently discontinued

Availability is inconsistent by region. Some pharmacies have adequate stock while others in the same city may be completely out. The shortage is a distribution problem as much as a manufacturing one.

Why Your Patients Can't Find It

Understanding the barriers your patients face helps you provide better guidance:

• Chain pharmacy allocation: Large chains allocate inventory across thousands of locations, meaning individual stores may receive limited quantities
• Lack of transparency: Patients have no easy way to check which pharmacies have stock without calling individually
• Stigma and frustration: Some patients feel uncomfortable repeatedly calling pharmacies asking about an addiction medication, leading them to give up rather than keep searching
• Cost surprises: Patients who find Acamprosate at a new pharmacy may face unexpected pricing, especially without insurance or established discount cards

What Providers Can Do: 5 Practical Steps

Step 1: Verify Stock Before Prescribing

Before writing or renewing an Acamprosate prescription, use Medfinder for Providers to check which pharmacies in your patient's area currently have stock. This simple step can save your patient days of frustration.

If their usual pharmacy is out of stock, you can direct them to a specific pharmacy that has it — or send the prescription electronically to that pharmacy directly.

Step 2: Prescribe With Flexibility

To give patients the best chance of getting their prescription filled:

• Write for the generic (Acamprosate Calcium) rather than a specific manufacturer
• Consider sending the prescription to multiple pharmacies (where regulations allow) or giving the patient a printed prescription they can take to whichever pharmacy has stock
• Write for a 90-day supply when possible — this reduces the frequency of refill-related supply problems

Step 3: Recommend Independent and Specialty Pharmacies

Independent pharmacies often have different wholesale relationships than chains and may have access to supply that CVS or Walgreens doesn't. Specialty pharmacies focused on behavioral health or addiction treatment may also prioritize stocking Acamprosate.

If you know of independent pharmacies in your area that reliably stock Acamprosate, maintain a list to share with patients.

Step 4: Have an Alternative Plan Ready

For every patient on Acamprosate, have a documented contingency plan in their chart. Key alternatives include:

• Naltrexone oral (50 mg daily): Widely available, affordable, first-line alternative. Contraindicated with opioid use.
• Naltrexone injectable (Vivitrol, 380 mg monthly): Addresses adherence concerns. More expensive but often covered by insurance.
• Disulfiram (250 mg daily): Aversion-based; best for motivated patients with support systems.
• Gabapentin (900-1,800 mg/day): Off-label; helpful for patients with co-occurring anxiety or insomnia.
• Topiramate (200-300 mg/day): Off-label; evidence for reducing heavy drinking days.

Having this conversation before a crisis occurs — when the patient still has medication — reduces anxiety and improves treatment continuity. See our patient-facing alternatives guide for a resource you can share.

Step 5: Help With Cost Barriers

During a shortage, patients may need to fill prescriptions at unfamiliar pharmacies where they don't have established pricing. Help by:

• Informing patients about coupon programs: GoodRx and SingleCare offer prices as low as $68/month for Acamprosate
• Referring uninsured patients to SAMHSA-funded treatment programs or state substance abuse agencies that may cover medication costs
• Directing patients to NeedyMeds or RxAssist for patient assistance programs
• Sharing our provider guide to saving patients money on Acamprosate

Alternatives in Detail

When switching patients from Acamprosate, keep these clinical considerations in mind:

Switching to Naltrexone

• No washout period needed from Acamprosate
• Check liver function (ALT/AST) before starting
• Confirm patient is not using opioids (7-10 day opioid-free period required)
• Start at 25 mg for 1-2 days, then increase to 50 mg daily
• Vivitrol injection requires an observed opioid-free period and in-office administration

Switching to Disulfiram

• Patient must be completely abstinent from alcohol (at least 12 hours)
• Baseline liver function tests recommended
• Detailed patient education about alcohol-disulfiram reaction is essential (includes hidden alcohol in products)
• Informed consent is standard practice

Adding Gabapentin or Topiramate

• Both require dose titration
• Gabapentin: check renal function; may be classified as controlled in some states
• Topiramate: warn about cognitive effects, paresthesias, and teratogenicity

Workflow Tips for Your Practice

Here are ways to build shortage management into your clinical workflow:

• Set calendar reminders to check ASHP shortage updates monthly
• Bookmark Medfinder for Providers for real-time stock checking during appointments
• Create a shortage protocol in your EHR with template notes for Acamprosate alternatives
• Train front-desk staff to ask about medication access at check-in — early identification of supply problems allows same-visit intervention
• Coordinate with your preferred pharmacies — build relationships with pharmacists who can give you heads-up on supply changes

Final Thoughts

The Acamprosate shortage adds friction to an already challenging treatment journey for patients with alcohol use disorder. But providers who proactively verify stock, maintain contingency plans, and leverage tools like Medfinder can make a significant difference in treatment continuity.

Your patients are counting on you — not just for the prescription, but for help navigating the system. A few extra minutes spent checking availability and discussing backup options can protect weeks or months of recovery progress.

For the broader clinical context, see our Acamprosate shortage briefing for prescribers.