Two medicines, side by side
Acamprosate vs naltrexone
Acamprosate and naltrexone are both labeled for alcohol use disorder. Drugs@FDA records approvals of acamprosate since 2004 and of naltrexone since 1984. Pharmacies paid $0.589 per acamprosate calc DR 333 mg tablet and $1.14 per naltrexone 50 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Naltrexone's other strengths are brand-only: $1,716.11 per vial (Vivitrol 380 mg vial-diluent).
Check it at the source: the acamprosate FDA label on DailyMed (effective July 14, 2026); the naltrexone FDA label on DailyMed (effective September 4, 2026).
Highlights of the acamprosate record
Acamprosate (Campral) · label of July 14, 2026
Used for
From the label: indicationsAcamprosate calcium is indicated for the maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation. Treatment with acamprosate calcium should be part of a comprehensive management program that includes psychosocial support. […]
On the market
- Earliest approval on file
- July 29, 2004
- Generic labelers
- 10 labelers
- Pharmacy cost
- $0.589 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Highlights of the naltrexone record
Naltrexone (Revia) · label of September 4, 2026
Used for
From the label: indicationsNaltrexone Hydrochloride Tablets, USP are indicated in the treatment of alcohol dependence and for the blockade of the effects of exogenously administered opioids. Naltrexone Hydrochloride Tablets, USP have not been shown to provide any therapeutic benefit except as part of an appropriate plan of management for the addictions.
On the market
- Earliest approval on file
- November 20, 1984
- Generic labelers
- 21 labelers
- Pharmacy cost
- $1.14 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Acamprosate label of July 14, 2026, Naltrexone label of September 4, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do acamprosate and naltrexone differ on the record?
How each works, in its label's words: Acamprosate, “Chronic alcohol exposure is hypothesized to alter the normal balance between neuronal excitation and inhibition.”; Naltrexone, “of naltrexone hydrochloride in alcoholism is not understood; however, involvement of the endogenous opioid system is suggested by preclinical data.”
Half-life, in each label's words: Acamprosate, “Elimination After oral dosing of 2 x 333 mg of acamprosate calcium, the terminal half-life ranges from approximately 20 …”; Naltrexone, “The mean elimination half-life (T-1/2) values for naltrexone and 6-β-naltrexol are 4 hours and 13 hours, respectively.”
Generics: acamprosate since 2013; naltrexone since 1998 (Drugs@FDA).
| Acamprosate | Naltrexone | |
|---|---|---|
| Labeled for | Alcohol use disorder | Alcohol use disorder, Opioid use disorder |
| Pharmacologic class | n/a | Opioid Antagonist |
| How it works (label) | 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. | of naltrexone hydrochloride in alcoholism is not understood; however, involvement of the endogenous opioid system is suggested by preclinical data. |
| Half-life (label) | Elimination After oral dosing of 2 x 333 mg of acamprosate calcium, the terminal half-life ranges from approximately 20 to 33 hours. | The mean elimination half-life (T-1/2) values for naltrexone and 6-β-naltrexol are 4 hours and 13 hours, respectively. |
| Earliest approval on file (Drugs@FDA) | July 29, 2004 | November 20, 1984 |
| First generic approved | July 16, 2013 | May 8, 1998 |
| Generic labelers (NDC) | 10 labelers | 21 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.589 per tablet (Acamprosate calc DR 333 mg tablet) | $1.14 per tablet (Naltrexone 50 mg tablet) |
| 12-month price change | -1% | -11% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 1 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 322 | 32,067 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Acamprosate label, drug interactionsThe pharmacokinetics of acamprosate are not affected by alcohol, diazepam, or disulfiram, and clinically important interactions between naltrexone and acamprosate were not observed [ see Clinical Pharmacology ( 12.3 ) ].
Source: FDA drug labels via openFDA
What next?
- Alternatives to acamprosate
- every medicine labeled for the same conditions