Identification

Name
Acamprosate
Accession Number
DB00659  (APRD00661)
Type
Small Molecule
Groups
Approved, Investigational
Description

Acamprosate, also known by the brand name Campral™, is a drug used for treating alcohol dependence. Acamprosate is thought to stabilize the chemical balance in the brain that would otherwise be disrupted by alcoholism, possibly by blocking glutaminergic N-methyl-D-aspartate receptors, while gamma-aminobutyric acid type A receptors are activated. Reports indicate that acamprosate only works with a combination of attending support groups and abstinence from alcohol. Certain serious side effects include allergic reactions, irregular heartbeats, and low or high blood pressure, while less serious side effects include headaches, insomnia, and impotence. Acamprosate should not be taken by people with kidney problems or allergies to the drug.

Structure
Thumb
Synonyms
  • 3-Acetamido-1-propanesulfonic acid
  • Acamprosato
  • Acamprosatum
  • N-acetyl homotaurine
  • N-Acetylhomotaurine
Product Ingredients
IngredientUNIICASInChI Key
Acamprosate Calcium59375N1D0U77337-73-6BUVGWDNTAWHSKI-UHFFFAOYSA-L
Product Images
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
CampralTablet, delayed release333 mg/1OralForest Laboratories2005-01-112016-02-29Us
CampralTablet, delayed release333 mg/1OralCarilion Materials Management2005-01-11Not applicableUs
CampralTablet, delayed release333 mgOralMylan Pharmaceuticals2007-07-30Not applicableCanada
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Acamprosate CalciumTablet, delayed release333 mg/1OralGlenmark Pharmaceuticals Inc.,Usa2013-07-16Not applicableUs
Acamprosate CalciumTablet, delayed release333 mg/1OralTeva2016-03-25Not applicableUs
Acamprosate CalciumTablet, delayed release333 mg/1OralCadila Pharnmaceuticals2017-06-01Not applicableUs
Acamprosate CalciumTablet, delayed release333 mg/1OralMylan Institutional2013-07-16Not applicableUs
Acamprosate CalciumTablet, delayed release333 mg/1OralMylan Pharmaceuticals2014-09-24Not applicableUs
Acamprosate CalciumTablet, delayed release333 mg/1OralZydus Pharmaceuticals Usa, Inc.2017-06-01Not applicableUs
Acamprosate CalciumTablet, delayed release333 mg/1OralAvera Mc Kennan Hospital2015-08-17Not applicableUs
Acamprosate CalciumTablet, delayed release333 mg/1OralMarlex Pharmaceuticals Inc2016-08-01Not applicableUs
Acamprosate CalciumTablet, delayed release333 mg/1OralAmerincan Health Packaging2015-10-01Not applicableUs
Acamprosate CalciumTablet, delayed release333 mg/1OralAv Kare, Inc.2016-05-16Not applicableUs00093 5352 86 nlmimage10 244f1238
International/Other Brands
Regtect (Nippon Shinyaku Co., Ltd.)
Categories
UNII
N4K14YGM3J
CAS number
77337-76-9
Weight
Average: 181.21
Monoisotopic: 181.040878535
Chemical Formula
C5H11NO4S
InChI Key
AFCGFAGUEYAMAO-UHFFFAOYSA-N
InChI
InChI=1S/C5H11NO4S/c1-5(7)6-3-2-4-11(8,9)10/h2-4H2,1H3,(H,6,7)(H,8,9,10)
IUPAC Name
3-acetamidopropane-1-sulfonic acid
SMILES
CC(=O)NCCCS(O)(=O)=O

Pharmacology

Indication

For the maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation

Structured Indications
Pharmacodynamics

Pharmacodynamic studies have shown that acamprosate calcium reduces alcohol intake in alcohol-dependent animals in a dose-dependent manner and that this effect appears to be specific to alcohol and the mechanisms of alcohol dependence. Acamprosate calcium has negligible observable central nervous system (CNS) activity in animals outside of its effects on alcohol dependence, exhibiting no anticonvulsant, antidepressant, or anxiolytic activity.

Mechanism of action

The mechanism of action of acamprosate in maintenance of alcohol abstinence is not completely understood. Chronic alcohol exposure is hypothesized to alter the normal balance between neuronal excitation and inhibition. in vitro and in vivo studies in animals have provided evidence to suggest acamprosate may interact with glutamate and GABA neurotransmitter systems centrally, and has led to the hypothesis that acamprosate restores this balance. It seems to inhibit NMDA receptors while activating GABA receptors.

TargetActionsOrganism
AGABA-A receptor (anion channel)
positive modulator
Human
AGlutamate (NMDA) receptor
antagonist
Human
AMetabotropic glutamate receptor 5
antagonist
Human
Absorption

The absolute bioavailability of acamprosate after oral administration is about 11%. The food effect on absorption is not clinically significant and no adjustment of dose is necessary.

Volume of distribution
  • 72 to 109 L
Protein binding

Non detectable

Metabolism

Acamprosate does not undergo metabolism.

Route of elimination

Following oral administration of CAMPRAL®, the major route of excretion is via the kidneys as acamprosate.

Half life

20 - 33 hours

Clearance
Not Available
Toxicity

In all reported cases of acute overdosage with acamprosate (total reported doses of up to 56 grams of acamprosate calcium), the only symptom that could be reasonably associated with acamprosate was diarrhea.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
No interactions found.
Food Interactions
  • Take without regard to meals.
  • Taking the product with food reduces its Cmax by 42% and total drug exposure by 23% (not considered significant).

References

General References
  1. Williams SH: Medications for treating alcohol dependence. Am Fam Physician. 2005 Nov 1;72(9):1775-80. [PubMed:16300039]
  2. Mason BJ: Treatment of alcohol-dependent outpatients with acamprosate: a clinical review. J Clin Psychiatry. 2001;62 Suppl 20:42-8. [PubMed:11584875]
  3. Mason BJ, Goodman AM, Chabac S, Lehert P: Effect of oral acamprosate on abstinence in patients with alcohol dependence in a double-blind, placebo-controlled trial: the role of patient motivation. J Psychiatr Res. 2006 Aug;40(5):383-93. Epub 2006 Mar 20. [PubMed:16546214]
  4. Feeney GF, Connor JP, Young RM, Tucker J, McPherson A: Combined acamprosate and naltrexone, with cognitive behavioural therapy is superior to either medication alone for alcohol abstinence: a single centres' experience with pharmacotherapy. Alcohol Alcohol. 2006 May-Jun;41(3):321-7. Epub 2006 Feb 8. [PubMed:16467406]
  5. Tsai G, Coyle JT: The role of glutamatergic neurotransmission in the pathophysiology of alcoholism. Annu Rev Med. 1998;49:173-84. [PubMed:9509257]
  6. Wilde MI, Wagstaff AJ: Acamprosate. A review of its pharmacology and clinical potential in the management of alcohol dependence after detoxification. Drugs. 1997 Jun;53(6):1038-53. [PubMed:9179530]
External Links
Human Metabolome Database
HMDB14797
KEGG Drug
D02780
PubChem Compound
71158
PubChem Substance
46506657
ChemSpider
64300
ChEBI
51041
ChEMBL
CHEMBL1201293
Therapeutic Targets Database
DAP000857
PharmGKB
PA10344
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
PDRhealth
PDRhealth Drug Page
Wikipedia
Acamprosate
ATC Codes
N07BB03 — Acamprosate
AHFS Codes
  • 28:92.00 — Miscellaneous Central Nervous System Agents
FDA label
Download (815 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedTreatmentTinnitus1
1, 2CompletedTreatmentAlcohol Dependence / Bipolar Disorder (BD)1
1, 2CompletedTreatmentMethamphetamine Dependence, Treatment Seeking1
2CompletedNot AvailableAlcohol Dependence / Alcohol-Related Disorders / Alcoholism / Healthy Volunteers1
2CompletedNot AvailableAlcoholism1
2CompletedTreatmentAlcohol Use Disorder (AUD)1
2CompletedTreatmentAlcoholism2
2CompletedTreatmentDependence, Cocaine1
2CompletedTreatmentDrug-induced Tardive Dyskinesia1
2CompletedTreatmentGilles de la Tourette's Syndrome1
2Enrolling by InvitationTreatmentFragile X Syndrome (FXS)1
2, 3CompletedTreatmentBinge Eating Disorder (BED)1
2, 3RecruitingTreatmentAutistic Disorder1
2, 3RecruitingTreatmentFragile X Syndrome (FXS)1
3CompletedTreatmentAlcohol Dependence / Schizophrenic Disorders1
3CompletedTreatmentAlcoholism1
3CompletedTreatmentAutism Spectrum Conditions/Disorders / Fragile X Syndrome (FXS)1
3TerminatedTreatmentAnxiety Disorders / Dementias / Depression / Psychosomatic Disorders / Schizophrenic Disorders1
4CompletedNot AvailableAlcoholism1
4CompletedTreatmentAlcohol Abuse / Alcohol Dependence / Major Depressive Disorder (MDD)1
4CompletedTreatmentAlcohol Dependence2
4CompletedTreatmentAlcohol Dependence / Generalized Anxiety Disorder (GAD) / Major Depressive Disorder (MDD) / Social Anxiety Disorder (SAD)1
4CompletedTreatmentAlcoholism2
4CompletedTreatmentPathological Gambling Disorder1
4CompletedTreatmentSchizoaffective Disorders / Schizophrenic Disorders1
4TerminatedTreatmentAlcohol Dependence1
4Unknown StatusTreatmentAlcohol Dependence1
4Unknown StatusTreatmentAlcohol Dependence / Bipolar Disorder (BD)1
4Unknown StatusTreatmentAlcoholism1
Not AvailableCompletedTreatmentFeeling Anxious1
Not AvailableTerminatedTreatmentAlcohol Dependence1
Not AvailableWithdrawnTreatmentParkinson's Disease (PD)1

Pharmacoeconomics

Manufacturers
  • Forest laboratories inc
Packagers
Dosage forms
FormRouteStrength
Tablet, delayed releaseOral333 mg/1
Tablet, delayed releaseOral333 mg
Prices
Unit descriptionCostUnit
Campral 333 mg Enteric Coated Tabs0.98USD tab
Campral 333 mg dose pak0.95USD each
Campral dr 333 mg tablet0.95USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
logP-1.1Not Available
Predicted Properties
PropertyValueSource
Water Solubility18.8 mg/mLALOGPS
logP-1.8ALOGPS
logP-2.8ChemAxon
logS-0.98ALOGPS
pKa (Strongest Acidic)-1.1ChemAxon
pKa (Strongest Basic)-0.47ChemAxon
Physiological Charge-1ChemAxon
Hydrogen Acceptor Count4ChemAxon
Hydrogen Donor Count2ChemAxon
Polar Surface Area83.47 Å2ChemAxon
Rotatable Bond Count4ChemAxon
Refractivity38.91 m3·mol-1ChemAxon
Polarizability17.17 Å3ChemAxon
Number of Rings0ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.5669
Blood Brain Barrier+0.9764
Caco-2 permeable-0.6797
P-glycoprotein substrateNon-substrate0.6973
P-glycoprotein inhibitor INon-inhibitor0.9056
P-glycoprotein inhibitor IINon-inhibitor0.9783
Renal organic cation transporterNon-inhibitor0.8969
CYP450 2C9 substrateNon-substrate0.7676
CYP450 2D6 substrateNon-substrate0.8124
CYP450 3A4 substrateNon-substrate0.5906
CYP450 1A2 substrateNon-inhibitor0.877
CYP450 2C9 inhibitorNon-inhibitor0.8857
CYP450 2D6 inhibitorNon-inhibitor0.9267
CYP450 2C19 inhibitorNon-inhibitor0.8726
CYP450 3A4 inhibitorNon-inhibitor0.9806
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9614
Ames testNon AMES toxic0.7031
CarcinogenicityNon-carcinogens0.5213
BiodegradationReady biodegradable0.6698
Rat acute toxicity1.9578 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9006
hERG inhibition (predictor II)Non-inhibitor0.878
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-001i-1900000000-095fc64fb4490a8d6b4d
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-001i-0900000000-c177d5ee7162b0b8756d
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-001i-0900000000-40eaa1bb480a68330940
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-001i-1900000000-35bfe6cae36755d1cf1c
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-0059-9500000000-d366cda3213379d7501b
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-004i-9000000000-4374601f59e1dc8df0eb
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-004i-9000000000-011f30e0257faffd4553
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-001i-0900000000-c179316d784a91f87c59
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-001i-0900000000-8cf123c7cf7dddcf6838
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-001i-1900000000-84a7d1cc6ca5022d4da7
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-0059-9500000000-4503d9afc6bab741521b
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-004i-9000000000-8c2ba21c044eeada7839
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-004i-9000000000-dd14c920c5211780d172
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-001i-1900000000-dac38f625c8648b643c4
LC-MS/MS Spectrum - LC-ESI-QTOF , positiveLC-MS/MSsplash10-0006-0900000000-3684e08456a971400c3d
LC-MS/MS Spectrum - LC-ESI-QTOF , positiveLC-MS/MSsplash10-0006-0900000000-6137fe4463b3675f55eb
LC-MS/MS Spectrum - LC-ESI-QTOF , positiveLC-MS/MSsplash10-00di-0900000000-58f776a52000101b8fb7
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-0006-0900000000-d8de420d40b45a34ea95
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-001l-0900000000-1bb28abe8034966ad829
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-0006-0900000000-5569cd774f81a8ad3beb
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-0006-0900000000-d51d458e07e98c42c969
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-006x-0900000000-42a3136ea9ce1e3d0b0c
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-00di-0900000000-b6bc76af98d68215b053
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-00di-1900000000-7ee4d8c6bba02edefaeb
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-001l-0900000000-80aa0f717cea42829204
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-0006-0900000000-4246d18ec0420680b089
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-0006-0900000000-9871f1e5e3101ac2bd24
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-006x-0900000000-f59a73516f3bcdc1c2fb
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-00di-0900000000-813aef9ee3b4334a24da
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-00di-1900000000-1089cca2bf8eb2fda2b2
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-0006-0900000000-d8de420d40b45a34ea95

Taxonomy

Description
This compound belongs to the class of organic compounds known as organosulfonic acids. These are compounds containing the sulfonic acid group, which has the general structure RS(=O)2OH (R is not a hydrogen atom).
Kingdom
Organic compounds
Super Class
Organic acids and derivatives
Class
Organic sulfonic acids and derivatives
Sub Class
Organosulfonic acids and derivatives
Direct Parent
Organosulfonic acids
Alternative Parents
Sulfonyls / Alkanesulfonic acids / Propargyl-type 1,3-dipolar organic compounds / Carboximidic acids / Organopnictogen compounds / Organooxygen compounds / Organonitrogen compounds / Organic oxides / Hydrocarbon derivatives
Substituents
Organosulfonic acid / Sulfonyl / Alkanesulfonic acid / Carboximidic acid / Carboximidic acid derivative / Organic 1,3-dipolar compound / Propargyl-type 1,3-dipolar organic compound / Organic nitrogen compound / Hydrocarbon derivative / Organic oxide
Molecular Framework
Aliphatic acyclic compounds
External Descriptors
organosulfonic acid, acetamides (CHEBI:51041)

Targets

Kind
Protein group
Organism
Human
Pharmacological action
Yes
Actions
Antagonist
General Function
Voltage-gated cation channel activity
Specific Function
NMDA receptor subtype of glutamate-gated ion channels with high calcium permeability and voltage-dependent sensitivity to magnesium. Mediated by glycine. This protein plays a key role in synaptic p...

Components:
References
  1. Mann K, Kiefer F, Spanagel R, Littleton J: Acamprosate: recent findings and future research directions. Alcohol Clin Exp Res. 2008 Jul;32(7):1105-10. doi: 10.1111/j.1530-0277.2008.00690.x. [PubMed:18540918]
  2. Witkiewitz K, Saville K, Hamreus K: Acamprosate for treatment of alcohol dependence: mechanisms, efficacy, and clinical utility. Ther Clin Risk Manag. 2012;8:45-53. doi: 10.2147/TCRM.S23184. Epub 2012 Feb 1. [PubMed:22346357]
Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Antagonist
General Function
Glutamate receptor activity
Specific Function
G-protein coupled receptor for glutamate. Ligand binding causes a conformation change that triggers signaling via guanine nucleotide-binding proteins (G proteins) and modulates the activity of down...
Gene Name
GRM5
Uniprot ID
P41594
Uniprot Name
Metabotropic glutamate receptor 5
Molecular Weight
132467.635 Da
References
  1. De Witte P, Littleton J, Parot P, Koob G: Neuroprotective and abstinence-promoting effects of acamprosate: elucidating the mechanism of action. CNS Drugs. 2005;19(6):517-37. [PubMed:15963001]

Transporters

Kind
Protein
Organism
Human
Pharmacological action
Unknown
General Function
L-proline transmembrane transporter activity
Specific Function
Neutral amino acid/proton symporter. Has a pH-dependent electrogenic transport activity for small amino acids such as glycine, alanine and proline. Besides small apolar L-amino acids, it also recog...
Gene Name
SLC36A1
Uniprot ID
Q7Z2H8
Uniprot Name
Proton-coupled amino acid transporter 1
Molecular Weight
53075.045 Da
References
  1. Thwaites DT, Basterfield L, McCleave PM, Carter SM, Simmons NL: Gamma-Aminobutyric acid (GABA) transport across human intestinal epithelial (Caco-2) cell monolayers. Br J Pharmacol. 2000 Feb;129(3):457-64. [PubMed:10711343]

Drug created on June 13, 2005 07:24 / Updated on December 10, 2017 17:18