From the Guidelines
Combining Campral (acamprosate) with Vivitrol (naltrexone) is a recommended approach for treating alcohol use disorder, as it has been shown to be effective in reducing cravings and preventing relapse 1.
Treatment Overview
The combination of Campral and Vivitrol addresses different aspects of alcohol dependence, with Campral focusing on reducing cravings and withdrawal symptoms, and Vivitrol decreasing the rewarding effects of alcohol.
- Campral is typically taken as a 333mg tablet three times daily
- Vivitrol is administered as a monthly 380mg intramuscular injection
Efficacy and Safety
According to a network meta-analysis, the combination of acamprosate and naltrexone has been shown to have a moderate to high quality of evidence for abstinence, with an NMA estimate of 3.68 (1.50 to 9.02) and a corresponding absolute probability of abstinence of 55% (33 to 75) 1.
- Side effects may include nausea, headache, dizziness, and injection site reactions for Vivitrol
- Liver function should be monitored regularly, especially with Vivitrol, and patients should inform their healthcare provider about all medications they're taking to avoid potential interactions
Comprehensive Treatment Program
It's essential to note that these medications work best as part of a comprehensive treatment program that includes counseling and support groups.
- Brief motivational interventions should be routinely used in the medical management of alcohol use disorders 1
- Patients with advanced ALD should be approached with caution, as some medications may have potential side-effects 1
From the FDA Drug Label
The pharmacokinetics of acamprosate calcium delayed-release tablets were unaffected when co-administered with ... naltrexone However, co-administration of acamprosate calcium delayed-release tablets with naltrexone led to a 33% increase in the Cmax and a 25% increase in the AUC of acamprosate. The use of Campral (acamprosate) with Vivitrol (naltrexone) may lead to increased acamprosate levels, with a 33% increase in Cmax and a 25% increase in AUC.
- No dosage adjustment is recommended for acamprosate when co-administered with naltrexone 2.
From the Research
Campral with Vivitrol
- Campral (acamprosate) and Vivitrol (naltrexone) are two medications used to treat alcohol dependence.
- Studies have shown that combining acamprosate and naltrexone may be efficacious and safe for treating alcohol dependence 3, 4.
- The combination of acamprosate and naltrexone has been shown to have a synergistic effect, with improved drinking outcomes compared to monotherapy with either medication 4.
- Acamprosate has been shown to be effective in maintaining abstinence in alcohol-dependent patients, with a similar efficacy to naltrexone 5, 6.
- Naltrexone and acamprosate have different pharmacological profiles, which may complement each other when used in combination 3, 7.
- The use of acamprosate and naltrexone in combination may be particularly beneficial for patients who have not responded to monotherapy with either medication 4, 6.
- Acamprosate is generally well-tolerated and has a low propensity for drug interactions, making it a suitable option for patients with hepatic impairment or liver disease 5, 6.