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Acamprosate vs Naltrexone

Naltrexone vs Campral

By Workit Health Content Team

Medically Reviewed by Dorothy Moore, N.P.

Reviewed November 15, 2021

While both naltrexone and Campral can be used to treat alcohol addiction they have different effects on the body and brain.

Naltrexone (aka ReVia, Depade, and Vivitrol)

Naltrexone (brand names ReVia, Depade, and Vivitrol) is an FDA-approved medication that helps to treat alcohol use disorder by reducing cravings and blocking the euphoric effects of alcohol. Naltrexone belongs is a group of medications called opioid antagonists, and can also be used to treat opioid use disorder.

Acamprosate (aka Campral)

Acamprosate (brand name Campral) is an FDA-approved medication for the treatment of alcohol use disorder. It helps to reduce cravings for alcohol and minimizes withdrawal effects when you’ve quit drinking.

How does naltrexone work?

Naltrexone works by blocking the pleasurable effects of drinking alcohol. Because of this effect, naltrexone has been shown to assist alcohol addiction recovery by reducing the amount and frequency of drinking episodes.

Naltrexone comes in pill form (brands ReVia, Depade) and is available in an extended-release injection (brand name Vivitrol), which Workit providers can prescribe for members in California.

How does Campral work?

Acamprosate (Campral) works by correcting the brain chemistry changes caused by acute alcohol use disorder (including heavy drinking, binge drinking, alcohol dependence, and alcoholism). Over time, addiction affects the brain chemicals responsible for providing a sense of calm. That’s why when you quit drinking you may feel uncomfortable and anxious. Campral works to decrease these unpleasant feelings and maintain abstinence from alcohol.

Do I have to stop drinking to take naltrexone?

No, you can take naltrexone while still drinking to help reduce your heavy drinking days. Naltrexone will not make you feel sick if you drink while you’re taking it.

Do I have to stop drinking to take acamprosate?

No. Acamprosate is generally prescribed and used after you’ve quit drinking to support and stabilize your recovery, but it doesn’t hurt you if you drink while taking it. Acamprosate will not make you feel sick if you drink while you’re taking it.

What are the side effects of naltrexone?

As with any medication, some people will experience side effects. These may subside over time. Some of the reported side effects of taking naltrexone include sleep problems, dizziness, joint pain or muscle cramps, nausea and/or vomiting, and loss of appetite. It can also cause cold-like symptoms, like a stuffy nose, sore throat, and sneezing. 

What are the side effects of Campral?

As with any medication, some people will experience side effects. These may subside over time. Some of the side effects associated with Campral include diarrhea, headache, dizziness, difficulty sleeping, dry mouth.

How is naltrexone different from Antabuse?

Antabuse is a medication that causes you to get sick when you consume alcohol. Antabuse acts as a physical deterrent, but doesn’t assist in the management of cravings. Naltrexone works to reduce the cravings and pleasure from drinking that may cause you to drink in the first place. You will not feel sick if you drink while taking naltrexone.

How is acamprosate different from Antabuse?

Antabuse is a medication that causes you to get sick when you consume alcohol. Antabuse acts as a physical deterrent, but doesn’t assist in the management of cravings. Campral works to reduce the discomfort that may cause you to drink in the first place. You will not feel sick if you drink while taking acamprosate.

What is the purpose of naltrexone?

The purpose of naltrexone is to reduce the frequency and duration of drinking days

What is the purpose of Campral?

The purpose of acamprosate is to support and maintain abstinence recovery (quitting drinking).

What are the benefits of choosing naltrexone?

  • Individuals can still drink if they choose
  • Naltrexone can be taken in a targeted manner: one hour before drinking to help maintain control over the amount the person drinks, or as cravings arise, to help resist drinking

What are the benefits of choosing acamprosate?

  • It can reduce cravings
  • It can be taken if a person relapse

What are the drawbacks of choosing naltrexone?

  • It cannot be used with pain medications containing opioids, as it blocks their effects
  • It should not be taken if the individual has liver problems, experiences depression, is pregnant, or is breastfeeding
  • Some find that it may reduce other pleasurable effects from activities like exercise
  • If a person returns to use (relapses) and takes opioids, they are at increased risk of an opioid overdose

What are the drawbacks of choosing acamprosate?

  • It doesn’t treat withdrawal symptoms, which may be challenging for those with alcohol dependence
  • It should not be taken if you have kidney problems
  • It must be taken at least twice per day, which can be difficult for some people to keep track of

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suboxone risk & concerns

Suboxone (buprenorphine/naloxone) is indicated for the treatment of opioid dependence in adults. Suboxone should not be taken by individuals who have been shown to be hypersensitive to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported. Taking Suboxone (buprenorphine/naloxone) with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants can cause breathing problems that can lead to coma and death. Other side effects may include headaches, nausea, vomiting, constipation, insomnia, pain, increased sweating, sleepiness, dizziness, coordination problems, physical dependence or abuse, and liver problems. For more information about Suboxone (buprenorphine/naloxone) see Suboxone.com, the full Prescribing Information, and Medication Guide, or talk to your healthcare provider. You are encouraged to report negative side effects of drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

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