Acamprosate is contraindicated in patients with which condition?

• A. Liver disease
• B. Kidney problems
• C. Lung disease
• D. Diabetes

Answer: (B)

Acamprosate is cleared from the body mainly by the kidneys as an unchanged drug, not by the liver. Because of this renal route of elimination, impaired kidney function leads to slower clearance and drug accumulation, increasing the risk of adverse effects and toxicity. That’s why kidney problems are a contraindication to using acamprosate. In practice, severe renal impairment or dialysis typically means the medication should not be used, while milder impairment requires dose adjustments if used. Liver disease isn’t a contraindication because hepatic metabolism isn’t the primary concern with this medication. The key idea is to assess and monitor renal function before and during treatment to ensure safety.