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[Pharmacology](https://durgical.com/en/pharmacology/) · Class

# Medicines for alcohol use disorder

Medicines that help people stay away from alcohol: acamprosate eases craving, naltrexone reduces reward and disulfiram makes drinking unpleasant.

Updated 2026-11-01

## What they are

Medicines used with counselling and psychosocial support to keep abstinence or reduce heavy drinking. None of them treats withdrawal itself, which is managed with benzodiazepines.

## Mechanism of action

Acamprosate is thought to rebalance glutamate and GABA signalling disturbed by long-term drinking. Disulfiram blocks aldehyde dehydrogenase, so acetaldehyde builds up if alcohol is drunk. Naltrexone blocks opioid receptors and blunts alcohol's reward.

Target: Glutamate/GABA systems (acamprosate); aldehyde dehydrogenase (disulfiram); opioid receptors (naltrexone)

## Key points

- Disulfiram is never given to someone intoxicated or without their full knowledge.
- The disulfiram–alcohol reaction (flushing, throbbing headache, vomiting, hypotension) can occur up to 14 days after the last dose.
- Acamprosate is cleared by the kidneys unchanged: contraindicated in severe kidney impairment, usable in liver disease.
- Acamprosate does not reduce withdrawal symptoms; it is started once the person is abstinent.

## Drugs in this class

- [**Acamprosate** A medicine that helps people who have stopped drinking stay abstinent. It is not metabolised and leaves through the… Glutamate and GABA systems (mechanism not fully known)](https://durgical.com/en/pharmacology/acamprosate/)
- [**Disulfiram** A medicine that makes drinking alcohol very unpleasant by blocking acetaldehyde breakdown. It is never given without… Aldehyde dehydrogenase (ALDH2)](https://durgical.com/en/pharmacology/disulfiram/)

## Others in the class

- Naltrexone
- Nalmefene

## Test yourself

Think of the answer, then tap the question to see it.

## Which enzyme does disulfiram block, and what builds up?

Aldehyde dehydrogenase; acetaldehyde builds up after drinking.

## Which alcohol use disorder medicine is avoided in severe kidney impairment?

Acamprosate, which is excreted unchanged by the kidneys.

## Do these medicines treat alcohol withdrawal?

No; withdrawal is treated with benzodiazepines.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - ACAMPROSATE CALCIUM tablet, delayed release](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=43e9ef60-2d85-4394-906b-93042fea099a) (DailyMed (U.S. National Library of Medicine), 2026); [DailyMed - DISULFIRAM tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b90f8ff4-4fb3-46ab-8149-cb55f24a4044) (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 27 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N07BB) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/classes/medicines-for-alcohol-use-disorder/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/classes/medicines-for-alcohol-use-disorder/