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N-Acetyl homotaurine

N-Acetyl Homotaurine (Acamprosate / Homotaurine)
Also known as: Acamprosate, Homotaurine, Tramiprosate, 3-APS, 3-amino-1-propanesulfonic acid
Evidence ★★☆☆☆2/5
Best for
TinnitusCognitive decline
Typical dose333 mg twice daily (OTC homotaurine); acamprosate studies used 666 mg three times daily
SafetyWorth noting
Onset4–8 weeks
Cost$20-40/mo
References2 studies cited

TL;DR

  • Neuromodulatory compound that acts as an NMDA receptor antagonist and GABA-A agonist. The acetylated form (acamprosate) is FDA-approved for alcohol dependence; the base form (homotaurine/tramiprosate) is available OTC and studied for tinnitus and neuroprotection. Reduces excitatory glutamate signaling in the auditory pathway and inhibits amyloid-beta aggregation.

  • Safety: Generally well-tolerated. Most common side effects are mild GI issues (diarrhea, nausea). Acamprosate is FDA-approved with established safety data from alcohol-dependence trials. OTC homotaurine has limited long-term safety data. Contraindicated in severe renal impairment.

  • Cost: approximately $20-40/month.

  • Best for: Tinnitus, Cognitive decline

What the research says

TinnitusRelevance: Moderate
Evidence
2/5
Onset speed
2/5
Typical dose: 333 mg twice daily (OTC homotaurine); acamprosate studies used 666 mg three times daily

Azevedo 2005 double-blind RCT (n=50) showed 87% improvement rate over 3 months. Farhadi 2020 RCT (n=20) showed improved tinnitus scores and cochlear electrophysiology. However, a 2021 meta-analysis of 2 trials (n=121) found no significant pooled effect. Lancet eClinicalMedicine network meta-analysis (36 RCTs, 2,761 pts) ranked it among effective pharmacologic treatments. Promising mechanism but evidence base is small and methodologically limited.

Cognitive declineRelevance: Moderate
Evidence
2/5
Onset speed
1/5
Typical dose: 100-200 mg daily (OTC homotaurine)

Homotaurine (tramiprosate) inhibits amyloid-beta oligomer formation. Phase III Alzheimer's trial showed reduced hippocampal volume loss and slower memory decline in APOE4 carriers. Prodrug ALZ-801 (valiltramiprosate) is in active Phase III trials. Preclinical data shows neuroprotection after traumatic brain injury. Evidence is early-stage but mechanism is well-characterized.

N-Acetyl homotaurine on Amazon

$20-40/mo (estimated)
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Safety & practical info

Safety:Generally well-tolerated

Most common side effects are mild GI issues (diarrhea, nausea). Acamprosate is FDA-approved with established safety data from alcohol-dependence trials. OTC homotaurine has limited long-term safety data. Contraindicated in severe renal impairment.

Interactions:Sedatives, alcohol-recovery meds

May potentiate sedatives and other GABAergic compounds. Use caution with anti-epileptics and other NMDA-modulating drugs. No significant CYP450 interactions.

Cost:$20-40/mo

OTC homotaurine supplements moderately priced. Prescription acamprosate varies by insurance coverage.

References

  1. Azevedo AA, Figueiredo RR. Tinnitus treatment with acamprosate: double-blind study. Braz J Otorhinolaryngol. 2005;71(5):618-623.
    RCTTinnitusPubMed →
  2. Farhadi M, Mahmoudian S, Saddadi F, et al. Functional hearing changes in tinnitus patients under treatment with acamprosate. Iran J Otorhinolaryngol. 2020;32(108):31-40.
    RCTTinnitus

Sources for this page include published meta-analyses, systematic reviews, and NIH dietary supplement fact sheets. All claims reflect the evidence as of early 2026.

This is not medical advice. Consult your healthcare provider before starting any supplement, especially if you take medications.