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|Amantadine Hydrochloride |
Drugs search, click the first letter of a drug name: | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 1 | 2 | 3 | 4 | 5 | 6 | 8 | 9 Home Amantadine HydrochloridePronouncation: (uh-MAN-tuh-deen HIGH-droe-KLOR-ide)Class: Antiparkinson, Antiviral Trade Names: Trade Names: Gen-Amantadine (Canada) Symmetrel (Canada) Mechanism of ActionPharmacologyExact mechanism is unknown; thought to facilitate dopamine release from intact dopaminergic terminals, increasing dopamine concentration at dopaminergic terminals. Exhibits antiviral activity against influenza A virus by inhibiting entry of virus into host cell. PharmacokineticsAbsorptionWell absorbed. C max is about 0.22 mcg/mL and T max is about 3.3 h. DistributionVd is 3 to 8 L/kg and about 67% protein bound. Metabolism8 metabolites were identified. EliminationPrimarily excreted unchanged in the urine. Cl is about 0.28 L/h/kg. The t ½ is about 17 h. Excretion increases when urine is acidic. Special PopulationsRenal Function ImpairmentElimination t ½ increased 2- to 3-fold or greater when Ccr is less than 40 mL/min/1.73 m 2 . ElderlyCl reduced and plasma t ½ and concentrations are increased. Indications and UsageSymptomatic treatment of several forms of Parkinson disease or syndrome and drug-induced extrapyramidal reactions; prevention and treatment of influenza A viral respiratory illness, especially in high-risk patients. ContraindicationsStandard considerations. Dosage and AdministrationParkinson DiseaseAdults PO 100 mg twice daily when used as single agent. Initial dosePO 100 mg/day if patient is debilitated or receiving high doses of other antiparkinson drugs. If necessary, dose may be titrated to max of 400 mg/day. Drug-Induced Extrapyramidal ReactionsAdults PO 100 mg twice daily; up to 300 mg/day may be given in divided doses. Influenza A Viral Infection (Symptomatic Treatment)Adults PO 200 mg/day as single dose or 100 mg twice daily. If CNS effects develop on a once-daily dosage, split dosage schedule may reduce complaints. Elderly over 65 yr of agePO 100 mg every day. Children 9 to 12 yr of agePO 100 mg twice daily. Children 1 to 9 yr of agePO 4.4 to 8.8 mg/kg/day; not to exceed 150 mg/day. Renal ImpairmentAdults PO Ccr 30 to 50 mL/min: Administer 200 mg first day followed by 100 mg/day thereafter; Ccr 15 to 29 mL/min: Administer 200 mg first day followed by 100 mg on alternate days; Ccr less than 15 mL/min and hemodialysis patients: Administer 200 mg every 7 days. Influenza A Viral Infection (Prophylaxis)Same dosages as for symptomatic treatment. However, start in anticipation of contact or as soon as possible after exposure. Continue drug administration for at least 10 days after known exposure. When influenza A virus vaccine is unavailable or contraindicated, administer amantadine for up to 90 days. In conjunction with the vaccine, administer amantadine for 2 to 3 wk after vaccination. Storage/StabilityStore tablets, capsules, and syrup at controlled room temperature (59° to 86°F). Drug InteractionsAnticholinergic agents, quinidine, quinine, triamterene, thiazide diuretics, trimethoprim-sulfamethoxazoleMay increase the effects of amantadine. CNS stimulantsThe effects of the CNS stimulant may be increased by amantadine. Laboratory Test InteractionsNone well documented. Adverse ReactionsCardiovascularOrthostatic hypotension (1% to 5%); cardiac arrest, arrhythmias (including malignant arrhythmias), hypotension, tachycardia (postmarketing). CNSDizziness, lightheadedness, insomnia (5% to 10%); depression, anxiety, irritability, hallucinations, confusion, headache, somnolence, nervousness, abnormal dreams, agitation (1% to 5%); coma, stupor, delusions, aggressive behavior, paranoid reaction, manic reaction, involuntary muscle contractions, abnormal gait, paresthesia, EEG changes, tremor, (postmarketing). DermatologicPruritus, diaphoresis (postmarketing). EENTDry nose (1% to 5%); keratitis, mydriasis (postmarketing). GINausea (5% to 10%); dry mouth, constipation, diarrhea (1% to 5%); dysphagia (postmarketing). HematologicLeukocytosis (postmarketing). Lab TestsElevated CPK, BUN, serum creatinine, alkaline phosphatase, LDH, bilirubin, glucose tolerance test, AST, ALT. RespiratoryAcute respiratory failure, pulmonary edema, tachypnea (postmarketing). MiscellaneousAtaxia, livedo reticularis, peripheral edema, fatigue (1% to 5%); allergic reactions (including anaphylactic reactions, edema, and fever), neuroleptic malignant syndrome (postmarketing). PrecautionsPregnancyCategory C . LactationExcreted in breast milk. ChildrenSafety and efficacy in newborns and infants under 1 yr not established. ElderlyDecreased dosage is necessary. Renal FunctionReduced dose is required in renal function impairment. Hepatic FunctionUse with caution. Special Risk PatientsUse with caution in patients with a history of recurrent eczematoid rash, psychosis, or severe psychoneurosis not controlled by chemotherapeutic agents. CHFCHF has developed in patients taking amantadine. GlaucomaBecause amantadine has anticholinergic effects and may cause mydriasis, do not give to patients with untreated angle-closure glaucoma. Neuroleptic malignant syndromeNeuroleptic malignant syndrome may occur in association with dose reduction or withdrawal of amantadine therapy. SeizuresReduced dose is necessary in patients with prior seizure disorders, including epilepsy. SuicideSuccessful suicide and suicide attempts have been reported in patients with and without a history of psychiatric illness. OverdosageSymptomsDeath, cardiac, respiratory, renal, or CNS toxicity, cardiac dysfunction (including arrhythmia, tachycardia, and hypertension), pulmonary edema, respiratory distress (including adult respiratory distress syndrome), renal dysfunction (including increased BUN, decreased Ccr and renal insufficiency), CNS effects (including insomnia, anxiety, agitation, aggressive behavior, hypertonia, hyperkinesias, ataxia, gait abnormality, tremor, confusion, disorientation, depersonalization, fear, delirium, hallucinations, psychotic reactions, lethargy, somnolence, and coma), seizures, hyperthermia. Patient Information
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