Acamprosate Dosing and Clinical Use in Alcohol Use Disorder

Dosing Recommendations

• Standard dose for patients weighing ≥ 60 kg: 666 mg (two 333 mg tablets) taken three times daily, for a total daily dose of approximately 1,998 mg. 1
• Reduced dose for patients weighing < 60 kg: Approximately one‑third lower total daily dose (~1,332 mg/day) to account for lower body mass. 2

Treatment Duration

• Typical course: 3–6 months of continuous therapy; the optimal duration remains under investigation. 1

Mechanism of Action

• Pharmacologic effect: Acamprosate acts as an NMDA‑receptor antagonist, helping to diminish alcohol craving when used as part of a comprehensive psychosocial treatment program. 3

Hepatic Safety Profile

• Metabolism and toxicity: The drug is excreted unchanged in the urine, undergoes no hepatic metabolism, and no cases of hepatotoxicity have been reported, making it especially suitable for individuals with alcohol‑related liver disease. 4