acamprosate vs donepezil

PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.

Side-by-side comparison of acamprosate and donepezil. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
acamprosate GABA Analog (Alcohol Dependence)
donepezil Acetylcholinesterase Inhibitor
Type
acamprosate Prescription
donepezil Prescription
Summary
acamprosate

Acamprosate is a medicine that can help you stay away from alcohol if you are alcohol-dependent and have already stopped drinking. It should be used with counseling and support.

donepezil

Donepezil is a medicine used to treat dementia caused by Alzheimer's disease. It can help improve memory and thinking.

What It Treats
acamprosate

Acamprosate helps people who are alcohol-dependent to not drink alcohol. You must have already stopped drinking before you start taking acamprosate. This medicine works best when it is part of a complete treatment plan that includes counseling and support.

donepezil

Donepezil treats dementia in people with Alzheimer's disease. It can help with mild, moderate, and severe forms of the disease. This medicine can improve memory, awareness, and the ability to function.

How It Works
acamprosate

Acamprosate is similar to a natural substance in your brain. It is thought to work by helping to restore the normal balance of brain activity that is changed by long-term alcohol use. This can reduce your craving for alcohol.

donepezil

Donepezil works by increasing a chemical in the brain called acetylcholine. This chemical helps nerve cells communicate better. By increasing acetylcholine, donepezil can improve mental function in people with Alzheimer's.

Common Side Effects
acamprosate
  • Accidental injury
  • Weakness
  • Pain
  • Loss of appetite
  • Diarrhea
donepezil
  • Nausea
  • Diarrhea
  • Trouble sleeping
  • Vomiting
  • Muscle cramps
FAERS Reports
acamprosate
  • Hypotension 14
  • Asthenia 13
  • Condition Aggravated 13
  • Acute Kidney Injury 12
  • Coma 12
donepezil
  • Fall 2,965
  • Death 2,020
  • Confusional State 1,893
  • Diarrhoea 1,738
  • Dizziness 1,732
Serious Warnings
acamprosate

Acamprosate may increase the risk of suicidal thoughts or actions. Your doctor should watch you for depression or suicidal thoughts. Tell your doctor right away if you have any new or worsening symptoms of depression or suicidal thoughts.

donepezil

This medicine can slow your heart rate or cause fainting. Tell your doctor if you have heart problems. Donepezil can also cause nausea, vomiting, and stomach bleeding. Watch for these side effects, especially when you start taking it or when your dose is increased.

Pregnancy
acamprosate

Acamprosate may harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if acamprosate passes into breast milk. Talk to your doctor if you are breastfeeding.

donepezil

Talk to your doctor if you are pregnant or plan to become pregnant. This medicine may harm your unborn baby. It is not known if donepezil passes into breast milk, so talk to your doctor if you are breastfeeding.

Also Compare, Nearby Drugs

How to Read This acamprosate vs donepezil Comparison

acamprosate is classified in the GABA Analog (Alcohol Dependence) drug class, while donepezil sits within the Acetylcholinesterase Inhibitor class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, acamprosate has 64 submissions while donepezil has 10,348. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for acamprosate or donepezil.

Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.