Can You Take Acamprosate During Pregnancy?

Acamprosate is an oral medication used to treat alcohol use disorder (AUD). But if you have AUD and become pregnant, is acamprosate safe to take? 

It’s well known that heavy alcohol use during pregnancy is risky for an unborn fetus. It can cause low birth weight, as well as fetal alcohol spectrum disorder (FASD) and other behavioral and learning issues that appear later on. It can also put your pregnancy at risk, increasing the risk of miscarriage and stillbirth. 

But when it comes to taking medication for AUD during pregnancy, you have to weigh the risks versus the potential benefits. Here, we’ll cover what you need to know about taking acamprosate in pregnancy.

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What is acamprosate?

Acamprosate is a first-choice medication for treating AUD. It’s not completely understood how it works to lower cravings for alcohol. It may be that it corrects alcohol-induced changes to your brain.

Acamprosate is usually taken 3 times a day.

Is it safe to take acamprosate during pregnancy?

It’s not known if acamprosate is safe to take during pregnancy. Due to a lack of research on the topic, you and your healthcare team will have to weigh the risks versus the potential benefits of you taking acamprosate while pregnant.

Here, we’ll discuss what we do and don’t know about acamprosate in pregnancy.

Research involving animals

Research on acamprosate involving pregnant animals has had mixed results. Some animal studies suggest an increased risk of birth defects when acamprosate is taken during pregnancy. But other animal studies haven’t shown negative effects on birth outcomes.

Research involving humans

One study looking at the safety of acamprosate in pregnancy compared outcomes for three groups of women in Australia:

1. Women who took acamprosate to treat problematic alcohol use while pregnant

2. Women who had a recent history of problematic alcohol use but didn’t take acamprosate while pregnant

3. Women from the same community in Australia who didn’t have a history of problematic alcohol use

The study looked at which group had the highest rates of: hospitalization, low birth weight in their babies, and FASD in their babies.

The study found that the women who took acamprosate had less hospitalizations than the women with problematic alcohol use who didn’t take acamprosate while pregnant. There was no difference in the rate of low birth weight or FASD in babies born to women in any group.

Outside of this study, we don’t have much information on the safety of taking acamprosate during pregnancy. Due to the potential risks, and lack of new methodology, clinical studies involving pregnant people are not common.

So, is it OK to take acamprosate during pregnancy?

We can’t say for certain whether acamprosate is safe to take during pregnancy. However, we know that heavy alcohol use can contribute to birth defects and other pregnancy-related problems. So you and your healthcare team should weigh the risks versus potential benefits of different treatment options. In general, non-medication options like one-on-one therapy and support groups (e.g. Alcoholics Anonymous) are preferred over medications.

The potential risks of AUD medications during pregnancy include harm to the unborn fetus and other pregnancy-related issues. The potential benefits include reduced alcohol use, which can have a positive impact on pregnancy outcomes.

Can you take acamprosate while breastfeeding?

It’s unlikely that taking acamprosate while breastfeeding will cause harm to your baby. This is based on what we know about the chemical properties of acamprosate. However, acamprosate hasn’t been well studied in breastfeeding mothers. So there is the possibility of adverse effects, even if the risk is low.

If you’re wondering whether to take acamprosate while breastfeeding, talk to your healthcare team. They can help you weigh the risk versus potential benefits.

Can you take other medications to treat AUD during pregnancy?

Currently, there are three FDA-approved medications for treating AUD: naltrexone (Vivitrol), disulfiram, and acamprosate. Here’s what we know about taking the first two medications during pregnancy:

• Naltrexone: Animal studies have shown mixed results about the safety of taking naltrexone during pregnancy. We don’t have human studies on taking naltrexone during pregnancy for AUD. But some research of naltrexone for opioid use disorder indicates the medication may be safe for pregnant people. One thing to consider if you’re taking naltrexone is that you likely won’t be able to receive opioids during your pregnancy or delivery. This is because naltrexone blocks the effects of opioids.

• Disulfiram: We also don’t have much research on disulfiram use during pregnancy. As with acamprosate and naltrexone, you and your healthcare team should weigh the risks versus potential benefits. Also keep in mind that, if you drink alcohol with the medication, you may experience the disulfiram-alcohol reaction. This reaction can cause vomiting, increased heart rate, and even trouble breathing — all of which can be dangerous for your pregnancy.

As discussed above, non-medication treatments like therapy and support groups are the preferred methods for treating AUD during pregnancy. If non-medication options aren’t enough to help you stop drinking, however, the benefit of AUD medications may outweigh the risk.

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Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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