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Campral vs. Naltrexone for Alcohol Use Disorder

Campral (acamprosate) and naltrexone (Vivitrol) are both FDA-approved medications that support the treatment of alcohol use disorder (AUD).[1,2] While both medications aim to aid in recovery, they have different mechanisms of action and characteristics. Understanding their unique features can facilitate informed decision-making for AUD management.

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Understanding Campral & Naltrexone

These medications work best when combined with behavioral therapies, counseling, and support groups. When used as part of a medication-assisted treatment (MAT) program to address alcohol abuse, they are most effective at supporting long-term recovery.[3]

How Does Campral Work?

Campral’s exact mechanism isn’t fully established. However, researchers theorize it works by restoring a balance in brain chemistry that’s disrupted by chronic alcohol misuse.[4] 

It targets neurotransmitters glutamate and GABA, which play a role in alcohol withdrawal and cravings. By modulating these systems, Campral might reduce persistent cravings and discomfort associated with abstinence from alcohol, making it easier to stay sober. [4]

How Does Naltrexone Work?

Naltrexone works as an opioid antagonist. It blocks the pleasurable and euphoric sensations associated with alcohol consumption.[5] 

When someone who is taking naltrexone drinks, they don’t experience the usual “reward” effect associated with drinking. This can decrease motivation to drink and reduce the likelihood of heavy drinking episodes or relapse[5]

Comparing Campral & Naltrexone

Campral and naltrexone can both effectively help people manage AUD. There are similarities between the two medications as well as many differences. The table below explores how naltrexone and Campral compare to treat alcohol abuse and addiction:[1,2,5,6] 

UseMaintaining abstinence from alcohol after detoxificationReducing heaving drinking and cravings for alcohol
Drug ScheduleNoYes, Schedule IV
FormsDelayed-release tabletOral tablet or extended-release intramuscular injection
Frequency of UseTaken three times dailyTaken once daily orally or injected once per month
Common Side EffectsDiarrhea, headache, nausea, flatulence, and insomniaNausea, headache, stomach pain, dizziness, and fatigue
Addition PotentialNone Low
CostGeneric version available to make it less expensiveCan be more expensive, especially in the intramuscular injection form
Insurance CoverageYes, generally coveredYes, generally covered
Efficacy & SafetyConsidered effective and safe, but specific factors influence successConsidered effective and safe, but specific factors influence success

Key Differences Between Campral & Naltrexone

Campral and naltrexone vary in terms of how they are administered, what doses they are available in, and the ultimate goal they are aiming to accomplish.  

Method of Administration

Campral is an oral tablet taken multiple times a day. You must swallow the tablet with water and be responsible about adhering to your treatment schedule. The effectiveness of Campral depends on your ability to take it regularly.[6] 

Naltrexone, on the other hand, is only injected once per month. You must make an appointment with a qualified healthcare provider to receive the injection.[5] Some people prefer naltrexone since they don’t have to remember to take a pill multiple times per day like they do with Campral or acamprosate.

Dosing Ranges

A typical Campral dosage is two tables taken three times per day. Since it is taken so frequently, Campral is offered in lower doses than naltrexone.[6] 

When taken as a tablet, naltrexone is prescribed as a 50 mg dose once per day. The naltrexone injection is administered in a 380 mg dose, once per month.[5]

Primary Goal

A key difference between Campral and naltrexone is the main goal for treatment. Campral is primarily used to support abstinence by making the act of drinking alcohol a highly unpleasant experience. 

Naltrexone, which is used to support abstinence, can also be used for harm reduction and to reduce alcohol cravings, even when occasional relapses occur. 

Choosing the Right AUD Medication 

Choosing whether Campral or Naltrexone is the better medication for you depends on your personal preference, goals for treatment, and ability to adhere to a dosing schedule. There isn’t a single form of MAT that is right for everyone. 

When selecting an AUD medication, consider the following: 

  • What are your treatment goals? Are you focused on complete abstinence and no longer drinking any alcohol, or is reducing harmful drinking patterns and withdrawal symptoms your primary goal?
  • What is your medical history? Do you have any health conditions that would make one of the medications a safe choice for you? Do you take any medications that could interact with either Campral or naltrexone?
  • What is your lifestyle like? Would you prefer to take an oral tablet a few times per day or receive a once-monthly injection? If you opt for the tablet, will you remember to take it each time?

The choice between Campral and naltrexone is highly individualized. Your doctor will discuss your medical history and treatment goals with you as well as potential risks and side effects associated with each medication. 

While either medication can be a crucial part of your recovery plan, behavioral therapy is a key component of MAT as well. You and your treatment team will devise a comprehensive treatment plan that effectively addresses your alcohol abuse issues from multiple angles.

Updated April 2, 2024
  1. Kalk NJ, Lingford-Hughes AR. The clinical pharmacology of acamprosate. British Journal of Clinical Pharmacology. 2014;77(2):315-323.
  2. Singh D, Saadabadi A. Naltrexone. StatPearls. Published 2020. Accessed March 20, 2024.
  3. Stokłosa I, Więckiewicz G, Stokłosa M, Piegza M, Pudlo R, Gorczyca P. Medications for the Treatment of Alcohol Dependence—Current state of knowledge and future perspectives from a public health perspective. International Journal of Environmental Research and Public Health. 2023;20(3):1870.
  4. Polascheck N, Bankstahl M, Löscher W. The COX-2 inhibitor parecoxib is neuroprotective but not antiepileptogenic in the pilocarpine model of temporal lobe epilepsy. Experimental Neurology. 2010;224(1):219-233.
  5. Naltrexone. Substance Abuse and Mental Health Services Administration. Published January 30, 2024. Accessed March 20, 2024.
  6. Acamprosate. U.S. National Library of Medicine. Published May 15, 2016. Accessed March 20, 2024.
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