Which drug for alcohol abuse patients should be used cautiously in older adults?

In the context of treating alcohol use disorder, acamprosate requires caution when used in older adults primarily due to the pharmacokinetic changes associated with aging. Older individuals often have altered kidney function, which can impact the excretion of the drug. Acamprosate is primarily eliminated through the kidneys, and impaired renal function can lead to increased serum levels and a higher risk of adverse effects. The safety and effectiveness of this medication in geriatric populations are not as clearly established as in younger patients, making it essential to monitor kidney function and adjust doses accordingly in older adults.

While other options may have their own considerations for use in specific populations, acamprosate's direct dependence on renal function makes it particularly important to evaluate in older patients who may already have some degree of renal impairment.