Acamprosate is contraindicated in which condition?

• A. Hypertension
• B. Liver disease
• C. Renal disease
• D. Diabetes mellitus

Answer: (C)

Acamprosate is cleared from the body mainly by the kidneys as unchanged drug, so kidney function directly controls its elimination. When renal function is significantly impaired, the drug can accumulate to harmful levels, making severe renal disease a contraindication. The other conditions do not inherently prevent use because acamprosate does not rely on the liver for clearance, so liver disease isn’t a contraindication, and hypertension or diabetes don’t by themselves preclude therapy.