Yes, there are several FDA-approved pills designed to help people stop or reduce drinking. The three medications approved specifically for alcohol use disorder are naltrexone, acamprosate, and disulfiram, and each one works differently. They aren’t magic bullets, but combined with some form of support or treatment program, they can meaningfully shift the odds in your favor.
The Three FDA-Approved Options
Naltrexone
Naltrexone is the most commonly prescribed first-line medication for alcohol use disorder. It works by blocking the receptors in your brain that make drinking feel rewarding. Alcohol normally triggers a pleasurable response through your brain’s opioid system, and naltrexone dampens that signal. The result: drinking becomes less satisfying, cravings weaken, and it becomes easier to drink less or stop altogether.
The standard dose is one 50 mg pill taken daily. In clinical trials, people taking naltrexone drank about one fewer drink per drinking day compared to those on placebo, and they were significantly less likely to reach blood alcohol levels above the legal limit on days they did drink. Those numbers may sound modest, but over weeks and months, that reduction compounds into a major shift in drinking behavior.
Common side effects include nausea, headaches, joint or muscle pain, trouble sleeping, and anxiety. These tend to be mild and often ease up after the first week or two. One important note: naltrexone blocks opioid receptors, so you cannot take it if you’re currently using opioid medications or substances. It will trigger immediate withdrawal.
Acamprosate
Acamprosate takes a different approach. When you drink heavily for a long time, your brain adjusts its chemistry to compensate. Once you stop drinking, that recalibrated system becomes overexcited, producing anxiety, restlessness, insomnia, and intense cravings. Acamprosate helps restore balance to that excitatory signaling, calming the nervous system and reducing the discomfort that drives many people back to drinking in early sobriety.
This medication works best for people who have already stopped drinking and want to stay abstinent. It’s typically taken as two pills, three times a day, which can be a hassle compared to naltrexone’s single daily dose. Acamprosate is generally well tolerated, with diarrhea being the most common side effect.
Disulfiram
Disulfiram has been around since the 1950s and works on a completely different principle. It doesn’t reduce cravings at all. Instead, it blocks your body’s ability to fully break down alcohol. If you drink while taking disulfiram, a toxic byproduct builds up rapidly in your system, causing flushing, nausea, vomiting, rapid heartbeat, shortness of breath, and intense anxiety. The reaction is unpleasant enough that it serves as a powerful deterrent.
The obvious limitation is that you have to actually take the pill. If you decide to drink, you can simply stop taking it and wait a few days. Studies show disulfiram works best when someone else, like a partner or pharmacist, supervises each dose. For highly motivated people with a support system, it can be very effective. For others, the compliance problem limits its usefulness.
Off-Label Medications With Growing Evidence
Beyond the three FDA-approved options, several other medications show promise. Your doctor may consider these, particularly if the approved medications haven’t worked or cause problematic side effects.
Gabapentin, a medication originally developed for nerve pain and seizures, has shown real benefits for alcohol use disorder in multiple studies. It reduces cravings, improves sleep, and eases the anxiety and low mood that often accompany early sobriety. Higher doses (around 1,200 to 1,800 mg per day) appear more effective than lower ones. Across studies involving over 650 participants, it was generally safe and well tolerated, with no serious drug-related side effects reported.
Topiramate, an anti-seizure medication, may help by dialing down the brain’s dopamine-driven reward response to alcohol. It’s not FDA-approved for this use, but some clinicians prescribe it when first-line options fall short.
The Monthly Injectable Alternative
If remembering a daily pill feels like a barrier, naltrexone also comes as a monthly injection (sold under the brand name Vivitrol). A healthcare provider gives you a 380 mg shot in the muscle once every four weeks. The total monthly dose is actually much lower than what you’d take in pill form over the same period (380 mg injected versus about 1,500 mg orally), but the steady release keeps the medication active around the clock without any daily decision-making on your part.
How Naltrexone Is Sometimes Used Differently
Some people use naltrexone through what’s known as the Sinclair Method, which flips the typical approach. Instead of taking the pill every day whether you drink or not, you take it one hour before you plan to drink. The idea is that by blocking the brain’s reward response each time you drink, the learned association between alcohol and pleasure gradually weakens over months. This approach appeals to people who aren’t ready for full abstinence but want to reduce their consumption. It’s not the standard prescribing protocol, so you’d need to discuss it specifically with a provider who’s familiar with it.
How Long You’d Stay on Medication
There are no rigid guidelines for treatment duration. Most people stay on medication for at least a year, with three months as the bare minimum to see meaningful results. Many continue longer. Stable sobriety often begins to take hold around the one-year mark but is considered more solid after two to three years of abstinence. At that point, you and your provider can reassess whether continuing makes sense.
This is worth emphasizing: these medications aren’t meant to be a short course like antibiotics. Alcohol use disorder is a chronic condition, and medication works best as an ongoing support rather than a quick fix.
Cost and Accessibility
Both naltrexone and acamprosate are available as generics, which keeps costs manageable. Without insurance, a month’s supply of oral naltrexone runs roughly $98, and acamprosate costs about $100. With insurance or discount programs, you’ll typically pay much less. The Vivitrol injection is significantly more expensive, though many insurance plans cover it.
Any primary care doctor can prescribe these medications. You don’t need to see an addiction specialist or enter a formal treatment program to get a prescription, though combining medication with counseling, group support, or a structured program tends to produce better outcomes than medication alone. SAMHSA’s treatment locator can help you find providers in your area who are comfortable treating alcohol use disorder.
What to Realistically Expect
None of these pills eliminate the desire to drink overnight. What they do is take the edge off cravings, reduce the reward you get from drinking, or make the early weeks of sobriety physically and emotionally more tolerable. That breathing room can be the difference between white-knuckling through each day and actually building momentum toward lasting change.
The medications work best when paired with some form of behavioral support, whether that’s formal therapy, a recovery group, or even a structured app-based program. Think of the pill as one tool in a toolbox, not the entire toolbox. But for many people, it’s the tool that makes all the others possible.