Acamprosate Dosing and Administration

Standard Dosing for Adults with Normal Renal Function

The American Association for the Study of Liver Diseases recommends acamprosate be administered as 666 mg (two 333 mg tablets) three times daily, totaling 1,998 mg per day, to maintain therapeutic plasma concentrations throughout the day 1, 2
The three-times-daily (TID) dosing schedule is necessary to maintain therapeutic plasma concentrations throughout the day, as stated by the Hepatology society 1, 2

The American Association for the Study of Liver Diseases suggests that acamprosate is particularly advantageous for patients with alcohol-associated liver disease because it has no hepatic metabolism and no reported instances of hepatotoxicity, unlike naltrexone and disulfiram which undergo hepatic metabolism and can cause liver damage 1, 2, 3, 4
Acamprosate is the preferred pharmacotherapy option in patients with alcohol-associated liver disease who have normal or moderately impaired renal function, as recommended by the Hepatology society 1, 2

The American College of Clinical Pharmacology states that because acamprosate is exclusively renally excreted without hepatic metabolism, renal function must be assessed before initiating therapy and monitored during treatment, with dosing adjustments based on renal function 1, 2

Acamprosate has no hepatic metabolism and is renally excreted, making it particularly advantageous in patients with liver disease 5, 6, 7
The American Association for the Study of Liver Diseases notes that acamprosate has no reported instances of hepatotoxicity, unlike naltrexone and disulfiram which undergo hepatic metabolism 5, 6, 7