acamprosate vs methadone
Side-by-side comparison of acamprosate and methadone Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Campral
Dolophine
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.
Methadone Hydrochloride Injection is a strong pain medicine. It is also used to treat opioid dependence temporarily when you cannot take medicine by mouth.
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.
This medicine is used to manage severe, ongoing pain that needs a strong opioid medicine when other pain medicines don't work well enough. It is also used for the short-term treatment of opioid dependence when you cannot take oral medication, such as if you are in the hospital. Injectable methadone is not approved for outpatient treatment of opioid dependence.
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.
Methadone works by attaching to opioid receptors in the brain and body. This changes how your body feels pain. It can also help reduce withdrawal symptoms if you are opioid dependent.
- • Accidental injury
- • Weakness
- • Pain
- • Loss of appetite
- • Diarrhea
- • Lightheadedness
- • Dizziness
- • Sedation
- • Nausea
- • Vomiting
- Low blood pressure 14
- Weakness 13
- Condition worsened 13
- Using the medicine for something it is not approved for 13
- Sudden kidney damage 12
- Addiction to the drug 5,614
- Harmful effects from different substances 5,213
- Misuse of the drug 4,797
- Taking too much of the drug 3,841
- Pain 3,669
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.
Methadone Hydrochloride Injection can cause serious and life-threatening risks, including addiction, abuse, and misuse. It can also cause life-threatening breathing problems, especially when you first start taking it or after a dose increase. Using methadone during pregnancy can cause withdrawal symptoms in the newborn. Using methadone with benzodiazepines or other drugs that can cause drowsiness, including alcohol, can cause severe sedation, breathing problems, coma, and death. Methadone can also cause a serious heart problem called QT prolongation.
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.
Using Methadone Hydrochloride Injection during pregnancy can cause withdrawal symptoms in the newborn. Talk to your doctor about the risks and benefits of using this medicine if you are pregnant or plan to become pregnant. It is not known if methadone passes into breast milk, so talk to your doctor before breastfeeding.
How to Read This acamprosate vs methadone Comparison
acamprosate is classified in the GABA Analog (Alcohol Dependence) drug class, while methadone sits within the Opioid Agonist 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 65 submissions while methadone has 23,134. 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 substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between acamprosate and methadone — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.